Technische Entwicklungen in der Tiefen Hirnstimulation und ihre Anwendung in der klinischen Praxis

Besides increasing indications for deep brain stimulation (DBS), technical innovations have found their way into DBS systems over the last years. Handling of the devices is now simpler for the physician and patients thanks to modern controllers and charging devices. Battery life time of rechargeable systems has multiplied to nearly 30 years. Shorter pulse widths can allow a more selective activation of varying fiber tracts and contribute to avoid side effects and achieve a more energy-efficient stimulation. Current steering in vertical and since the end of 2015 in horizontal direction helps to direct the current flow to the target region and to adjust the size and shape of the volume of activated tissue to the individual position of the electrode. For many patients, these new options should result in less side-effects and a more energy-efficient stimulation setting. Nevertheless, a thorough and more time-consuming programming is needed to find the individual best stimulation settings.