Editing Deep brain stimulation (section)

==Specific DBS targets==
There are a number of different targets with the procedure, depending on the specific disease and symptomatology. The procedure is FDA approved or has FDA device exemptions for treatment of [[Parkinson's disease]], [[dystonia]], [[essential tremor]], [[obsessive-compulsive disorder]] and [[epilepsy]]. In Europe, beyond these indications, a CE mark exists for treatment of Alzheimer's Disease. There was a past device exemption for OCD as well but this has not been renewed.<ref name="nature.com">{{Cite journal |last1=Visser-Vandewalle |first1=Veerle |last2=Andrade |first2=Pablo |last3=Mosley |first3=Philip E. |last4=Greenberg |first4=Benjamin D. |last5=Schuurman |first5=Rick |last6=McLaughlin |first6=Nicole C. |last7=Voon |first7=Valerie |last8=Krack |first8=Paul |last9=Foote |first9=Kelly D. |last10=Mayberg |first10=Helen S. |last11=Figee |first11=Martijn |last12=Kopell |first12=Brian H. |last13=Polosan |first13=Mircea |last14=Joyce |first14=Eileen M. |last15=Chabardes |first15=Stephan |date=August 2022 |title=Deep brain stimulation for obsessive–compulsive disorder: a crisis of access |url=https://www.nature.com/articles/s41591-022-01879-z |journal=Nature Medicine |language=en |volume=28 |issue=8 |pages=1529–1532 |doi=10.1038/s41591-022-01879-z |pmid=35840727 |issn=1078-8956}}</ref> Other indications are considered investigational and require [[Institutional Review Board]] approval.

The table below summarizes DBS targets and their respective FDA approvals:
{| class="wikitable"
|+
!Indication
!Approval Date
!Details
!DBS Target
!Evidence
!Source
|-
|Essential Tremor (or Parkinsonian Tremor)
|July 31, 1997
|Approved for essential tremor.
|Ventral intermediate nucleus of the thalamus (VIM)
|Significant tremor reduction with thalamic DBS in patients with essential tremor, long-term efficacy and safety.<ref>{{Cite journal |last1=Benabid |first1=A.L. |last2=Pollak |first2=P. |last3=Hoffmann |first3=D. |last4=Gervason |first4=C. |last5=Hommel |first5=M. |last6=Perret |first6=J.E. |last7=de Rougemont |first7=J. |last8=Gao |first8=D.M. |date=February 1991 |title=Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus |url=https://linkinghub.elsevier.com/retrieve/pii/014067369191175T |journal=The Lancet |language=en |volume=337 |issue=8738 |pages=403–406 |doi=10.1016/0140-6736(91)91175-T|pmid=1671433 |url-access=subscription }}</ref>
|[https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P960009 FDA]
|-
|Parkinson's Disease
|January 14, 2002
|Approved for advanced Parkinson's disease symptoms not adequately controlled by medications.
|Subthalamic nucleus (STN) or internal globus pallidus (GPi)
|DBS in the subthalamic nucleus with better motor function and quality of life compared to best medical therapy,.<ref>{{Cite journal |date=2001-09-27 |title=Deep-Brain Stimulation of the Subthalamic Nucleus or the Pars Interna of the Globus Pallidus in Parkinson's Disease |url=http://www.nejm.org/doi/abs/10.1056/NEJMoa000827 |journal=New England Journal of Medicine |language=en |volume=345 |issue=13 |pages=956–963 |doi=10.1056/NEJMoa000827 |pmid=11575287 |issn=0028-4793 |author1=Deep-Brain Stimulation for Parkinson's Disease Study Group |last2=Obeso |first2=J. A. |last3=Olanow |first3=C. W. |last4=Rodriguez-Oroz |first4=M. C. |last5=Krack |first5=P. |last6=Kumar |first6=R. |last7=Lang |first7=A. E. }}</ref><ref>{{Cite journal |last1=Deuschl |first1=Günther |last2=Schade-Brittinger |first2=Carmen |last3=Krack |first3=Paul |last4=Volkmann |first4=Jens |last5=Schäfer |first5=Helmut |last6=Bötzel |first6=Kai |last7=Daniels |first7=Christine |last8=Deutschländer |first8=Angela |last9=Dillmann |first9=Ulrich |last10=Eisner |first10=Wilhelm |last11=Gruber |first11=Doreen |last12=Hamel |first12=Wolfgang |last13=Herzog |first13=Jan |last14=Hilker |first14=Rüdiger |last15=Klebe |first15=Stephan |date=2006-08-31 |title=A Randomized Trial of Deep-Brain Stimulation for Parkinson's Disease |url=http://www.nejm.org/doi/abs/10.1056/NEJMoa060281 |journal=New England Journal of Medicine |language=en |volume=355 |issue=9 |pages=896–908 |doi=10.1056/NEJMoa060281 |pmid=16943402 |issn=0028-4793}}</ref>
|[https://web.archive.org/web/20170225173912/http://www.accessdata.fda.gov/cdrh_docs/pdf/P960009S007a.pdf FDA]
|-
|Dystonia
|April 15, 2003
|Humanitarian Device Exemption for the treatment of chronic, intractable primary dystonia, including generalized and segmental dystonia, hemidystonia, and cervical dystonia in individuals seven years of age or above.
|Internal globus pallidus (GPi)
|Improved motor function in individuals with primary dystonia.<ref>{{Cite journal |last1=Vidailhet |first1=Marie |last2=Vercueil |first2=Laurent |last3=Houeto |first3=Jean-Luc |last4=Krystkowiak |first4=Pierre |last5=Benabid |first5=Alim-Louis |last6=Cornu |first6=Philippe |last7=Lagrange |first7=Christelle |last8=Tézenas du Montcel |first8=Sophie |last9=Dormont |first9=Didier |last10=Grand |first10=Sylvie |last11=Blond |first11=Serge |last12=Detante |first12=Olivier |last13=Pillon |first13=Bernard |last14=Ardouin |first14=Claire |last15=Agid |first15=Yves |date=2005-02-03 |title=Bilateral Deep-Brain Stimulation of the Globus Pallidus in Primary Generalized Dystonia |url=http://www.nejm.org/doi/10.1056/NEJMoa042187 |journal=New England Journal of Medicine |language=en |volume=352 |issue=5 |pages=459–467 |doi=10.1056/NEJMoa042187 |pmid=15689584 |issn=0028-4793}}</ref><ref name="nejm.org">{{Cite journal |last1=Kupsch |first1=Andreas |last2=Benecke |first2=Reiner |last3=Müller |first3=Jörg |last4=Trottenberg |first4=Thomas |last5=Schneider |first5=Gerd-Helge |last6=Poewe |first6=Werner |last7=Eisner |first7=Wilhelm |last8=Wolters |first8=Alexander |last9=Müller |first9=Jan-Uwe |last10=Deuschl |first10=Günther |last11=Pinsker |first11=Marcus O. |last12=Skogseid |first12=Inger Marie |last13=Roeste |first13=Geir Ketil |last14=Vollmer-Haase |first14=Juliane |last15=Brentrup |first15=Angela |date=2006-11-09 |title=Pallidal Deep-Brain Stimulation in Primary Generalized or Segmental Dystonia |url=http://www.nejm.org/doi/abs/10.1056/NEJMoa063618 |journal=New England Journal of Medicine |language=en |volume=355 |issue=19 |pages=1978–1990 |doi=10.1056/NEJMoa063618 |pmid=17093249 |issn=0028-4793}}</ref>
|[https://web.archive.org/web/20161002171031/http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfhde/hde.cfm?id=H020007 FDA]
|-
|Obsessive-Compulsive Disorder
|February 19, 2009
|Humanitarian Device Exemption for adjunctive treatment of severe, treatment-resistant OCD.
|Nucleus Accumbens (NAc)
|Reductions in OCD symptoms in severe cases.<ref>{{Cite journal |last1=Nuttin |first1=Bart J. |last2=Gabriëls |first2=Loes A. |last3=Cosyns |first3=Paul R. |last4=Meyerson |first4=Björn A. |last5=Andréewitch |first5=Sergej |last6=Sunaert |first6=Stefan G. |last7=Maes |first7=Alex F. |last8=Dupont |first8=Patrick J. |last9=Gybels |first9=Jan M. |last10=Gielen |first10=Frans |last11=Demeulemeester |first11=Hilde G. |date=June 2003 |title=Long-term Electrical Capsular Stimulation in Patients with Obsessive-Compulsive Disorder |url=https://journals.lww.com/00006123-200306000-00002 |journal=Neurosurgery |language=en |volume=52 |issue=6 |pages=1263–1274 |doi=10.1227/01.NEU.0000064565.49299.9A |pmid=12762871 |issn=0148-396X|url-access=subscription }}</ref>
|[https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfhde/hde.cfm?id=375533 FDA]
|-
|Epilepsy
|April 27, 2018
|Approved for bilateral stimulation of the anterior nucleus of the thalamus (ANT) as an adjunctive therapy to reduce the frequency of seizures in adults with partial-onset seizures.
|Anterior nucleus of the thalamus (ANT)
|Significant reduction in seizure frequency in patients receiving DBS.<ref>{{Cite journal |last1=Fisher |first1=Robert |last2=Salanova |first2=Vicenta |last3=Witt |first3=Thomas |last4=Worth |first4=Robert |last5=Henry |first5=Thomas |last6=Gross |first6=Robert |last7=Oommen |first7=Kalarickal |last8=Osorio |first8=Ivan |last9=Nazzaro |first9=Jules |last10=Labar |first10=Douglas |last11=Kaplitt |first11=Michael |last12=Sperling |first12=Michael |last13=Sandok |first13=Evan |last14=Neal |first14=John |last15=Handforth |first15=Adrian |date=May 2010 |title=Electrical stimulation of the anterior nucleus of thalamus for treatment of refractory epilepsy |url=https://onlinelibrary.wiley.com/doi/10.1111/j.1528-1167.2010.02536.x |journal=Epilepsia |language=en |volume=51 |issue=5 |pages=899–908 |doi=10.1111/j.1528-1167.2010.02536.x |pmid=20331461 |issn=0013-9580|url-access=subscription }}</ref>
|[https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpma/pma.cfm?id=P960009S219 FDA]
|}