Research Topic

The clinical and ethical practice of neuromodulation – deep brain stimulation and beyond

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About this Research Topic

Topic Editors:

Markus Christen (Empirical Ethics, University Zurich), Sabine Müller (Neuroethics, Charité Universitätsmedizin Berlin), Oguzkan Sürükü (Neurosurgery, University Hospital Zurich)

Neuromodulation is among the fastest-growing areas of medicine, ...

Topic Editors:

Markus Christen (Empirical Ethics, University Zurich), Sabine Müller (Neuroethics, Charité Universitätsmedizin Berlin), Oguzkan Sürükü (Neurosurgery, University Hospital Zurich)

Neuromodulation is among the fastest-growing areas of medicine, involving many diverse specialties and impacting hundreds of thousands of patients with numerous disorders worldwide. It can briefly be described as the science of how electrical, chemical and mechanical interventions can modulate the nervous system function. A prominent example of neuromodulation is deep brain stimulation (DBS), an intervention that reflects a fundamental shift in the understanding of neurological and psychiatric diseases: namely as resulting from a dysfunctional activity pattern in a defined neuronal network that can be normalized by targeted stimulation.

The application of DBS has grown remarkably and in summer 2012 it has been announced (20th Congress of the ESSFN) that 100,000 patients worldwide have obtained a DBS intervention in the past 25 years – most of them for treating movement disorders. It was estimated that it would take only ten years for the next 100 ‘000 patients since DBS is assessed for various novel neurological and psychiatric indications, stimulation in established indications at an earlier time may be more beneficial for the patient, and an increasing number of countries, centers and companies get involved in this field. A recent market study claims that the brain stimulation market is expected to achieve a similar market size to the Global Cardiac Devices market – so brain stimulation and DBS in particular will become a relevant factor in the health systems of many countries.

This Frontiers Research Topics aims to provide an overview on the current discussion beyond basic research in DBS and related brain stimulation technologies with a particular focus on practical clinical issues (e.g., patient selection, stimulation preferences, target estimations, surgery-related issues like atlas based targeting, imaging, and long-term follow-up), complex unintended effects of the intervention (personality changes, effects on social environment), ethical and legal challenges of a growing DBS practice, and economic considerations (e.g., infrastructure development, determinants of innovation of DBS systems). Researchers in clinical disciplines (e.g., neurology, neurosurgery, and psychiatry), neuroethics, social science, law, and economics who are working on broader clinical and social issues related to DBS and related neuromodulation technologies are welcome to contribute to this research topic.


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