An update on best practice of deep brain stimulation in Parkinson's disease.

During the last 30 years, deep brain stimulation (DBS) has evolved into the clinical standard of care as a highly effective treatment for advanced Parkinson's disease. Careful patient selection, an individualized anatomical target localization and meticulous evaluation of stimulation parameters for chronic DBS are crucial requirements to achieve optimal results. Current hardware-related advances allow for a more focused, individualized stimulation and hence may help to achieve optimal clinical results. However, current advances also increase the degrees of freedom for DBS programming and therefore challenge the skills of healthcare providers. This review gives an overview of the clinical effects of DBS, the criteria for patient, target, and device selection, and finally, offers strategies for a structured programming approach.
Competing Interests: Conflict of interest statement: CJH received a travel grant from Abbott; SF declares no conflicts of interest; SJG received honoraria and travel expenses from Medtronic, Abbott, and Boston Scientific; LW received honoraria from Medtronic and Abbott/St. Jude Medical; AS received honoraria from Abbott, Boston Scientific, Medtronic and Abbvie.