Deep brain stimulation for movement disorders: 2015 and beyond

Purpose of review The purpose of this review was to review the recent and future developments of deep brain stimulation (DBS) for movement disorders. Recent findings In the last 2 years, we have gained a better understanding of established indications, particularly with respect to the debate on whether subthalamus or globus pallidus pars interna should be the target of choice for Parkinson's disease. In addition, the role of DBS for dystonia has been further defined in terms of patients' selection and outcome of surgery. Other established (e.g. essential tremor) and novel indications (e.g. Tourette syndrome) have been addressed. Along with the evolving knowledge of the clinical aspects of DBS, technological advances are also shaping the present and the future of DBS. New implantable pulse generators (e.g. allowing storage of electrophysiological data and eventual adaptive stimulation) as well as new electrode configurations are now available. Furthermore, high-resolution structural imaging, including high-field MRI and diffusion tensor tractography, will facilitate both the planning of DBS procedures, and the optimization of postoperative outcomes by aiding stimulation programming. The recent successes of DBS along the clinical and technological directions are changing the current practice of neuromodulation and, more importantly, will also drive future developments of this fascinating treatment.