AAN 2026 | The evolving field of DBS as a treatment for movement and psychiatric disorders

So deep brain stimulation is this fantastic new field, which is actually a part of this larger field called neuromodulation. Neuromodulation is, the goal of neuromodulation is to therapeutically alter brain states in order to effect some change. And its applications are across the spectrum of neurological and psychiatric diseases. And DBS, deep brain stimulation, is the front runner of that. 20, 30 years ago, DBS became the standard of care for certain manifestations of movement disorders, such as Parkinson’s disease and essential tremor. So the tremor component of these movement disorders was very prominent and needed to be addressed, and DBS was a way for doing that. So typically, the neurosurgeon implants electrodes into certain specific regions in the brain, and we call them leads, and it’s connected to a pulse generator, and there is a preset program which stimulates regions of the brain, and then that suppresses, that leads to suppression of tremor and suppression of certain unwanted manifestations of the disease. But DBS currently is moving towards a much more circuit-based approach rather than a focal approach and is also expanding its indications to target other manifestations in these movement disorders. So regions in the brain such as the zona incerta or the dentatorubrothalamic tract, these are all new and emerging targets where other manifestations of movement disorders, such as gait disturbance, balance issues, speech difficulty, they’re being addressed as well. Beyond movement disorder itself, there is a lot of potential for DBS and related neuromodulation techniques to treat psychiatric disorders. The most prominent one that has been approved for in certain conditions is obsessive compulsive disorder. Brain regions such as the ventral capsule or the ventral striatum, the anterior limb of the internal capsule are all conventional targets for OCD. But beyond OCD, treatment-resistant depression is being studied. Regions of the brain, such as the nucleus accumbens and medial forebrain bundle, are all being investigated for treatment-resistant depression, like I mentioned. Also, disorders like addiction, PTSD, and anorexia are being investigated. So it’s an entire world of possibilities and I’m really excited to have stepped into it.

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