Editing Deep brain stimulation (section)

== History ==
Though DBS was developed in the 1980s, research on electric neurostimulation has a tumultuous history spanning thousands of years. Physicians in ancient Greece considered thunderbolts to be sacred and experimented with medical applications of electrical current. At the same time in dynastic Egypt, [[electric catfish]] of [[the Nile]] were used to treat migraines. In 46 A.D., [[Scribonius Largus]] wrote about the use of [[electric ray]]s for the treatment of headache.<ref name="psycnet">{{cite book |last1=Foley |first1=J |title=Psychological assessment of surgical candidates: Evidence-based procedures and practices - Deep brain stimulation for Parkinson's disease and depression. |date=2023 |publisher=R. J. Marek & A. R. Block (Eds.) |pages=181–200 |url=https://psycnet.apa.org/record/2023-53317-010}}</ref>

In 1890, [[Victor Horsley|Horsley]] performed the first [[surgical extirpation|extirpation]] of the motor cortex for treatment of [[athetosis]]. Sixty years later, [https://de.wikipedia.org/wiki/Ernest_Adolf_Spiegel Spiegel] described the first [[stereotactic surgery|stereotactic frame]] and made lesions in patients with PD to interrupt [[pallidothalamic tracts|pallidofugal fibers]], causing improvement in bradykinesia, rigidity, and tremor. The 1950s were also when parkinsonism was first treated with ventrolateral thalamic lesions. While attempting to section the cerebral peduncle, a surgeon inadvertently disrupted the [[anterior choroidal artery]] and was forced to [[Ligature (medicine)|ligate]] it, leading to disappearance of rigidity and tremor with preserved motor and sensory function.<ref name = "JAMA neurology 2013">{{cite journal |last1=Miocinovic |first1=S |last2=Somayajula |first2=S |last3=Chitnis |first3=S |last4=Vitek |first4=JL |title=History, applications, and mechanisms of deep brain stimulation. |journal=JAMA Neurology |date=February 2013 |volume=70 |issue=2 |pages=163–71 |doi=10.1001/2013.jamaneurol.45 |pmid=23407652}}</ref>

In 1963, the first neurostimulation of the thalamic VIM at frequencies of 100–200&nbsp;Hz improved tremor in patients with parkinsonism. Early pioneers included [[:nb:Carl Wilhelm Sem-Jacobsen|Carl-Wilhelm Sem-Jacobsen]], [[Natalia Bekhtereva]], [[José Manuel Rodríguez Delgado|José Delgado]], [[Robert Galbraith Heath|Robert Heath]] and Irvine Cooper.<ref name="An update on best practice of deep"/> Sem-Jacobsen's work was funded by the [[United States Department of Defense|United States military]] and criticized for ethical concerns. Similarly, Heath's research faced considerable controversy because of its lack of rigorous [[scientific method]] and [[Bioethics#Medical ethics|ethical violations]], particularly with regards to [[informed consent]] and attempts at [[conversion therapy]]. The associated negative publicity, along with the emerging effectiveness of levodopa for Parkinson's after its discovery in 1969, led to a general distaste for electrical neurostimulation and stereotactic surgery in the medical community that lasted until the 21st century.<ref name = "Neurotherapeutics 2024">{{cite journal |last1=Chan |first1=JL |last2=Carpentier |first2=AV |last3=Middlebrooks |first3=EH |last4=Okun |first4=MS |last5=Wong |first5=JK |title=Current perspectives on tractography-guided deep brain stimulation for the treatment of mood disorders. |journal=Expert Review of Neurotherapeutics |date=January 2024 |volume=24 |issue=1 |pages=11–24 |doi=10.1080/14737175.2023.2289573 |pmid=38037329|doi-access=free }}</ref>

[[Alim Louis Benabid]] and [https://fr.wikipedia.org/wiki/Pierre_Pollak Pierre Pollak] heralded the modern era of DBS in 1987 when battery technology and public sentiment had evolved enough to allow manufacture of a portable neurostimulator variant, the addition of a lithium battery allowing it to maintain long term sustained charge. The first application of DBS was to the thalamus in individuals with a history of tremor and prior contralateral thalamotomy.

Though the inhibition of Parkinson's tremor from basal ganglia electrical stimulation had been reliably demonstrated decades before by Bekhtereva in the [[Soviet Union]], Benabid and Pollak were reportedly unaware of this earlier work, with their own discovery of the phenomenon being incidental. They were using electrodes to map out the effects of a planned surgical lesioning for a patient with tremor related to a tumor in the basal ganglia and found that when they electrically stunned tissue around the tumor, the tremor would temporarily disappear.

The surgeons used this observation to construct a device powered by a lithium battery, allowing it to be small enough to be housed entirely within a [[subcutaneous tissue|subcutaneous]] [[thoracic wall|chest wall]] pocket and charged by [[electromagnetic induction]]. The portability and relative longevity of the device led DBS to gain widespread adaptation.

In 1990, the first models of basal ganglia function were mapped out based on the segregated circuits in its thalamocortical network. During this time pallidotomies were reintroduced for individuals with advanced PD and severe levodopa induced dyskinesia. In 1998, neurostimulation to the STN was first attempted for PD and two years later to the GPi for dystonia.<ref name = "JAMA neurology 2013"/>

Over the past two decades, DBS has become the major research hotspot for surgical treatment of tremor in Parkinson's disease, with the United States being its dominant hub for research and [[Michael S. Okun]] at the [[University of Florida]] being the most productive author in the field over this time.<ref name="Hotspot"/> Their protocol has recommended the use of a 3T volumetric thin-slice, 1&nbsp;mm thick MRI sequence, FGATIR (fast gray matter acquisition T1 inversion recovery), for sharper delineation of basal ganglia contour in an effort to minimize field distortion and recreate the anatomic precision formerly afforded by air based ventriculography.<ref>{{cite journal |last1=Brandão |first1=P |last2=Grippe |first2=TC |last3=Modesto |first3=LC |last4=Ferreira |first4=AGF |last5=Silva |first5=FMD |last6=Pereira |first6=FF |last7=Lobo |first7=ME |last8=Allam |first8=N |last9=Freitas |first9=TDS |last10=Munhoz |first10=RP |title=Decisions about deep brain stimulation therapy in Parkinson's disease. |journal=Arquivos de Neuro-psiquiatria |date=June 2018 |volume=76 |issue=6 |pages=411–420 |doi=10.1590/0004-282X20180048 |pmid=29972424}}</ref>