Abstract
Deep brain stimulation (DBS) was first used to treat essential tremor and the movement disorders associated with Parkinson disease. Its success led to its consideration as treatment for a wide variety of applications, including other neurologic as well as psychiatric and cognitive impairments. Extensive research conducted over the past 20 years has attempted to explain the as-yet uncertain mechanisms of DBS, with a focus on its effects on neuronal and astrocytic activity at the cellular, regional, and network level within the basal ganglia thalamocortical circuitry. Based on experimental evidence and theoretical considerations, five potentially co-occurring mechanisms have been proposed. DBS may produce local changes in the stimulated brain nuclei, as well as distal changes in efferent outputs and target nuclei.
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