Deep brain stimulation has preliminary evidence of clinical efficacy, but has been difficult to develop into a robust therapy, in part because its mechanisms are incompletely understood. We review evidence from movement and psychiatric disorder studies, with an emphasis on how deep brain stimulation changes brain networks. From this, we argue for a network-oriented approach to future deep brain stimulation studies. That network approach requires methods for identifying patients with specific circuit/network deficits. We describe how dimensional approaches to diagnoses may aid that identification. We discuss the use of network/circuit biomarkers to develop self-adjusting “closed loop” systems.
Bibliographical noteFunding Information:
Preparation of this work was not sponsored or supported by any commercial entity. A.S. Widge, A.K. Gosai, and M.T. Bilge were supported by grants to A.S. Widge from the Brain & Behavior Research Foundation, National Institutes of Health (MH109722, MH111320, and NS100548), and Defense Advanced Research Projects Agency (Cooperative Agreement W911NF-14-2-0045). The views, opinions, and/or findings expressed are those of the authors and should not be interpreted as representing the official views or policies of any sponsor or funding source.
© 2018 Elsevier Inc.
- Closed-loop DBS
- DBS in psychiatry
- Dimension-oriented psychiatry
- Mechanisms of DBS
- Network-oriented DBS