Evolving Role of Deep Brain Stimulation for Parkinson Disease, Essential Tremor: Julie Pilitsis, MD, PhD, MBA

WATCH TIME: 4 minutes

"In the last 5 years, there have been improvements, whereas [before that] it was a little stagnant. Some of those improvements include the ability to direct where energy goes. Now we have directional leads."

The development of modern deep brain stimulation (DBS) technology began in 1947, with the introduction of an innovative stereotactic apparatus by 2 scientists who referred to it as stereoencephalotomy. Originally designed for the localization of ablative procedures, the approach significantly cut down mortality rate, and was further explored across other subspecialties.

In 1975, Medtronic became the first company to trademark the term “DBS” for deep brain stimulation. Years later, the first reports of the approach being used to treat neurological symptoms of dystonia, tremor, and speech impairment, were first reported. In the mid 1990s, DBS gained CE Mark and FDA approval to target the ventral intermediate (VIM) nucleus of the thalamus for use in essential tremor and severe Parkinson disease (PD) tremor. Since then, indications for DBS have expanded to encompass a variety of movement disorders and neuropsychiatric indications, targeting brain structures such as the subthalamic nucleus, globus pallidus internus, and the original thalamic target in the VIM.

To learn more about the landscape of invasive procedures, including DBS, NeurologyLive® sat down with Julie Pilitsis, MD, PhD, MBA, neurosurgeon, Marcus Neuroscience Institute, Baptist Health, and dean of the Charles E. Schmidt College of Medicine and vice president of Medical Affairs at Florida Atlantic University. Pilitsis, a neurosurgeon, provided perspective on the advances of these procedures, and how technology has expanded the capabilities clinicians can provide to their patients.