**9. Pain**

For patients with pain, the analysis of DBS outcome is more challenging than in motor movement disorders due to rationality of pain self-assessment. Though nociceptive pain can usually be kept in check with opiate medication, DBS targets in the thalamus or cingulum are considered for patients with severe refractory neuropathic pain [30, 71, 72].

### **10. Positive influence of the DBS treatment**

There are a number of side effects via medication that is highly reduced by neuromodulation technique. Seizure frequencies and mortality were decreased, but the results were not evaluated. Successful results of DBS on movement disorder and vagal nerve stimulation for epilepsy [73, 74]. DBS is a best way to treat extrapyramidal motor disorder namely dyskinesia, tremors, rigidity, and dystonia [75–77]. GPi-DBS, in primary generalized dystonia, was proved to be very successful, and it can be used as an effective treatment option [78]. Although with mild treatment side effects, a number of studies have shown positive treatment outcome in chronic disorders of consciousness with unknown mechanism of action [79]. DBS is found to beneficial in enhancing altered learning and memory. In rodents' model of dementia, mesial temporal DBS has shown positive results. Improvement in visual memory is seen in patients who underwent unilateral amygdalohippocampal DBS [80]. DBS helps in regaining of learning, memory, and altered communication skills in patients of postbrain injury with disorders of consciousness [81].

### **11. Negative influence of the treatment**

Severe harmful effects of DBS are seen on dominant side of hippocampal region. Bilateral hippocampal DBS may cause memory dysfunction in epilepsy patients. Though DBS, is supposed to be safe, the adverse events can be seen in 7.5–8.5% of patients. The major adverse effects being, infections, intraoperative seizures and other complications [7].

**39**

*Deep Brain Stimulation Approach in Neurological Diseases*

fore, there is lack of competitiveness in DBS technology [30].

Evolutions in technologies have led to the advancement in pain management in DBS. Several technologies related to spinal cord stimulation like Expanded MRI labeling, pulse modifier (generator as well as shrinker), dorsal root ganglia stimulating leads, and so on have benefited a lot due to high-frequency and high-density strategies of software [82–85]. The major problem in DBS is the inappropriate dose, for which no new technology has been developed for the past two decades; there-

DBS is a neurosurgical procedure that utilizes lead-implanted electrodes that is placed chronically in the target areas of the brain well connected to pulse generator, which excites the neuronal circuits [1, 4, 5]. It is an invasive neuromodulation technique that was emanated in early 1960s [1]. Recently, DBS has become a huge practice in treatment of various movement disorders along with some psychiatric disorders [4, 5]. As compared to other neurosurgical options, lower chances of complications are seen with this technique [5]. Although with mild treatment side effects, a number of studies have shown positive treatment outcome in chronic disorders of consciousness with unknown mechanism of action [79]. Growth in DBS in respect to pathway and its impact on neuronal circuit has been mainly propelled by preclinical, neurophysiological, and computational research. Significant needs and prospect have evolved innovative techniques and technologies that have improved tolerability as well as research design, but DBS is still growing in many areas to manage cerebral diseases safely

I would like to thank Dr. D Joshi, Dr. R N Chaurasia, Dr. V N Mishra, and Institute of Medical Sciences for their support and encouragement. There was no

*DOI: http://dx.doi.org/10.5772/intechopen.91756*

**12. Evolution in DBS technologies**

**13. Summary**

and efficiently.

**Acknowledgements**

**Conflict of interest**

**Abbreviations**

funding provided for this study.

The authors have no conflict of interest.

TMS transcranial magnetic stimulation

rTMS repetitive transcranial magnetic stimulation

GPi-DBS globus pallidus internus deep brain stimulation

DBS deep brain stimulation VNS vagal nerve stimulation

SCS spinal cord stimulation

AD Alzheimer's disease NMDA N-methyl-d-aspartate
