Technology for deep brain stimulation at a gallop

Along with levodopa and botulinum toxin, deep brain stimulation (DBS) has been a milestone achievement in the treatment of movement disorders. Although the hardware for DBS has undergone technological improvement, and more than one manufacturer has appeared in the global market, in general the concept for DBS has remained almost unchanged over the past two decades. As the pathophysiology of movement disorders becomes clearer (thanks partly to DBS itself) and electronic know‐how and equipment advance, an even more fascinating future opens for treating patients. As happens in other therapeutic fields, not every innovation brings about substantial changes that will really influence patients' quality of life, but many can simply involve commercial restyling aimed to push the market forward. Technological advancements have an especially important role in DBS, now becoming an increasingly more appealing business given the growing Parkinson's disease (PD) prevalence—expected to reach 8.7 million in 20301—and the evidence that early DBS implant induces benefits.2 Currently the estimated market for DBS devices for PD is approximately $200 million to $300 million per year worldwide, but the coming years promise a further powerful push.3 Because good clinical practice requires us to offer our patients the best possible and most suitable healthcare solutions, we should critically assess whether technical advances are really useful. To provide clinicians with the knowledge needed to orient themselves in the wide innovative DBS field, here I introduce and try to explain in simple terms understandable to the general reader DBS technological advances that could improve health care. In very broad terms, the most relevant recent technological progresses in the DBS field outlined later aim to increase the temporal and spatial resolution of this treatment by developing solutions to deliver stimulation only where and when it is needed, thus reducing energy wasting and limiting adverse effects.