Stimulating the Brain and Spinal Cord: A Short-Circuit or the Future of Targeted Therapy?

Abstract

Movement disorders such as Parkinson’s disease, essential tremor, and dystonia are incurable and can be resistant to pharmacological treatment. These and other neuropsychiatric disorders can significantly reduce quality of life and cause an economic burden. Deep-brain stimulation (DBS) has been shown to alleviate symptoms as an advanced therapeutic for some disease indications. Similarly, spinal cord stimulation (SCS) has been used for cases of chronic pain. However, the mechanisms of either are unclear. This narrative literature review aims to understand the mechanism behind DBS and SCS in order to evaluate potential synergies and future developments. Neurostimulation from DBS and SCS is suggested to regulate dysfunctional imbalances by modulating local and network activity and influencing glial cells. Developments and technological advances point towards targeted therapeutic interventions implementing optimized and adaptive closed-loop stimulation based on patient-specific neuroimaging and biomarkers. Future research can look into effects of multi-target stimulation, simultaneous use of DBS and SCS, and varying stimulation parameters.