Deep brain stimulation (DBS) is a neurosurgical procedure that allows targeted circuit-based neuromodulation and is commonly used for the treatment of movement disorders such as Parkinson disease, tremor and dystonia.Innovations in the field of cardiac pacemakers have enabled pulse generators for DBS to evolve from external devices to small rechargeable, implantable devices.With directional DBS leads, the current can be directed or shaped to personalize stimulation to individual anatomical structures.Closed-loop DBS systems simultaneously record and stimulate neural activity, allowing the stimulation to be adjusted according to disease-specific neural biomarkers.Open-access software can be used to localize DBS electrodes and, on the basis of the stimulation parameters, to model the volume of tissue activated around the electrodes, shedding light on key neurocircuitry elements.As DBS systems become compatible with wireless networks, remote programming by physicians will become possible but privacy issues will also need to be addressed to prevent misuse, including ‘brainjacking’.
