title: The rationale driving the evolution of deep brain stimulation to constant-current devices.
abstract: OBJECTIVE
  Deep brain stimulation (DBS) is an effective therapy for the treatment of a number of movement and neuropsychiatric disorders. The effectiveness of DBS is dependent on the density and location of stimulation in a given brain area. Adjustments are made to optimize clinical benefits and minimize side effects. Until recently, clinicians would adjust DBS settings using a voltage mode, where the delivered voltage remained constant. More recently, a constant-current mode has become available where the programmer sets the current and the stimulator automatically adjusts the voltage as impedance changes.
  
  
  METHODS
  We held an expert consensus meeting to evaluate the current state of the literature and field on constant-current mode versus voltage mode in clinical brain-related applications.
  
  
  CONCLUSIONS
  There has been little reporting of the use of constant-current DBS devices in movement and neuropsychiatric disorders. However, as impedance varies considerably between patients and over time, it makes sense that all new devices will likely use constant current.
authors.affiliation: Reed Neurological Research Center, Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
authors.forename: Jeff M
authors.initials: JM
authors.lastname: Bronstein
authors.forename: Michele
authors.initials: M
authors.lastname: Tagliati
authors.forename: Cameron
authors.initials: C
authors.lastname: McIntyre
authors.forename: Robert
authors.initials: R
authors.lastname: Chen
authors.forename: Tyler
authors.initials: T
authors.lastname: Cheung
authors.forename: Eric L
authors.initials: EL
authors.lastname: Hargreaves
authors.forename: Zvi
authors.initials: Z
authors.lastname: Israel
authors.forename: Michael
authors.initials: M
authors.lastname: Moffitt
authors.forename: Erwin B
authors.initials: EB
authors.lastname: Montgomery
authors.forename: Paul
authors.initials: P
authors.lastname: Stypulkowski
authors.forename: Jay
authors.initials: J
authors.lastname: Shils
authors.forename: Timothy
authors.initials: T
authors.lastname: Denison
authors.forename: Jerrold
authors.initials: J
authors.lastname: Vitek
authors.forename: Jens
authors.initials: J
authors.lastname: Volkman
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Wertheimer
authors.forename: Michael S
authors.initials: MS
authors.lastname: Okun
mesh_terms: D055592:Biophysical Phenomena / Q000502:physiology*; D001921:Brain / Q000502:physiology*; D001927:Brain Diseases / Q000628:therapy; D046690:Deep Brain Stimulation / Q000295:instrumentation* / Q000379:methods*; D017097:Electric Impedance; D006801:Humans; D013997:Time Factors
keywords: Deep brain stimulation; Parkinson's disease; impedance; voltage