Deep brain stimulation: A mechanistic and clinical update

Patrick J. Karas, Charles B. Mikell, Eisha Christian, Mark A. Liker, Sameer A. Sheth

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Deep brain stimulation (DBS), the practice of placing electrodes deep into the brain to stimulate subcortical structures with electrical current, has been increasing as a neurosurgical procedure over the past 15 years. Originally a treatment for essential tremor, DBS is now used and under investigation across a wide spectrum of neurological and psychiatric disorders. In addition to applying electrical stimulation for clinical symptomatic relief, the electrodes implanted can also be used to record local electrical activity in the brain, making DBS a useful research tool. Human single-neuron recordings and local field potentials are now often recorded intraoperatively as electrodes are implanted. Thus, the increasing scope of DBS clinical applications is being matched by an increase in investigational use, leading to a rapidly evolving understanding of cortical and subcortical neurocircuitry. In this review, the authors discuss recent innovations in the clinical use of DBS, both in approved indications as well as in indications under investigation. Deep brain stimulation as an investigational tool is also reviewed, paying special attention to evolving models of basal ganglia and cortical function in health and disease. Finally, the authors look to the future across several indications, highlighting gaps in knowledge and possible future directions of DBS treatment.

Original languageEnglish (US)
Article numberE1
JournalNeurosurgical focus
Issue number5
StatePublished - Nov 2013
Externally publishedYes


  • Deep brain stimulation
  • Dystonia
  • Essential tremor
  • Mechanism
  • Parkinson disease
  • Review

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


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