Received for publication September 3, 2003.
Revised January 6, 2004.
Accepted for publication January 7, 2004.

Brain Stimulation for Neurological and Psychiatric Disorders, current status and future direction

Abstract

Interest in brain stimulation therapies has been rejuvenated over the last decade and brain stimulation therapy has become an alternative treatment for many neurological and psychiatric disorders, including Parkinson's disease (PD), dystonia, pain, epilepsy, depression and schizophrenia. The effects of brain stimulation on PD are well described and this treatment has been widely used for such conditions worldwide. Treatments for other conditions are still in experimental stages and large-scale, well-controlled studies are needed to refine the treatment procedures. In the treatment of intractable brain disorders, brain stimulation, especially transcranial magnetic stimulation (TMS), is an attractive alternative to surgical lesioning as it is relatively safe, reversible and flexible. Brain stimulation, delivered either via deeply implanted electrodes or from a surface mounted transcranial magnetic device, can alter abnormal neural circuits underlying brain disorders. The neural mechanisms mediating the beneficial effects of brain stimulation however are poorly understood. Conflicting theories and experimental data have been presented. It seems that the action of stimulation on brain circuitry is not limited to simple excitation or inhibition. Alterations of neural firing patterns and long term effects on neurotransmitter and receptor systems may also play important roles in the therapeutic effects of brain stimulation. Future research on both the basic and clinical fronts will deepen our understanding of how brain stimulation works. Real-time computation of neural activity allows for integration of brain stimulation signals into ongoing neural processing. In this way abnormal circuit activity can be adjusted and thus provide information for optimizing therapeutic brain stimulation paradigms.

Key words: deep brain stimulation, depression, epilepsy, pain, parkinson's disease, schizophrenia

This article has been cited by other articles:

				C. Hague, M. A. Uberti, Z. Chen, R. A. Hall, and K. P. Minneman Cell Surface Expression of {alpha}1D-Adrenergic Receptors Is Controlled by Heterodimerization with {alpha}1B-Adrenergic Receptors J. Biol. Chem., April 9, 2004; 279(15): 15541 - 15549. [Abstract] [Full Text] [PDF]