Exploring the Adoption of Implantable Brain Stimulation into Standard of Care for Central Nervous System Disorders Proceedings of a Workshop (2024) / Chapter Skim
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1 Introduction and Background
1 Introduction and Background
Pages 1-6
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approved the use of implantable brain stimulation, specifically DBS, for the treatment of essential tremor and Parkinson's disease, respectively.4 Since then, the number of publications in the implantable brain stimulation field has increased rapidly and the technology has become a viable treatment option for various central nervous system disorders in addition to Parkinson's disease, tremor, 1 The planning committee's role was limited to planning the workshop, and the Proceedings of a Workshop was prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine, and they should not be construed as reflecting any group consensus.
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To date, implantable brain stimulation has been most integrated into the standard of care for Parkinson's disease, as it is used regularly to relieve symptoms such as tremor, on-off fluctuations, and dyskinesia. It works by stimulating the basal ganglia, which can result in an altered basal ganglion neuron firing rate and pattern, increased calcium and neurotransmitter release, and increased blood flow and neurogenesis (Lee et al., 2004; Tawfik et al., 2010; Wichmann et al., 2011)
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To better understand the current state of clinical use of the technology as well as patient and physician education and economic considerations related to the technology, on October 31, 2023, the Forum on Neuroscience and Nervous System Disorders of the National Academies of Sciences, Engineering, and Medicine held a workshop, Exploring the Adoption of Implantable Brain Stimulation into Standard of Care for Central Nervous System Disorders.5 Participants included clinicians and clinical researchers interested in the use of implantable brain stimulation to treat CNS disorders, several individuals who had differing experiences with implantable brain stimulation, representatives from federal regulatory and funding agencies, officers of advocacy organizations and health systems, and innovators and executives from companies that manufacture implantable devices for treating CNS disorders. Given that implantable brain stimulation is primarily used for movement disorders, a larger portion of the workshop and this proceedings focused on lessons learned from this disease space which may be useful to other CNS disorders moving forward.
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. Chapter 2 reviews the current state of knowledge regarding the clinical use of implantable brain stimulation for several CNS disorders and discusses lessons learned from approved neuromodulation therapies, cochlear and retinal implants, responsive neurostimulation for epilepsy, and DBS for OCD.
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Invited presentations and discussions may: • Review the current state of knowledge regarding the clinical utilization of implantable brain stimulation across various CNS disorders and consider the future potential to improve quality of life for patients. • Explore barriers and potential solutions to adopting implantable brain stimulation into standard of care, such as safety and efficacy, scalability, and regulatory support.
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PREPUBLICATION COPY -- Uncorrected Proofs
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