Mechanism of action for deep brain stimulation and electrical neuro-network modulation (ENM)

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  • Okun Michael S.
    Center for Movement Disorders and Neurorestoration, Departments of Neurology and Neurosurgery, University of Florida
  • Oyama Genko
    Center for Movement Disorders and Neurorestoration, Departments of Neurology and Neurosurgery, University of Florida Department of Neurology, Juntendo University, School of Medicine

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Deep brain stimulation (DBS) has become an important treatment option for carefully screened medication resistant neurological and neuropsychiatric disorders. DBS therapy is not always applied deep to the brain; does not have to be applied exclusively to the brain; and the mechanism for DBS is not simply stimulation of structures. The applications and target locations for DBS devices are rapidly expanding, with many new regions of the brain, spinal cord, peripheral nerves, and muscles now possibly accessed through this technology. We will review the idea of “electrical neuro-network modulation (ENM)”; discuss the importance of the complex neural networks underpinning the effects of DBS; discuss the expansion of brain targets; discuss the use of fiber based targets; and discuss the importance of tailoring DBS therapy to the symptom, rather than the disease.

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