Deep brain stimulation (DBS) is an established therapy for Parkinson’s Disease, essential tremor, dystonia, and epilepsy. DBS has more recently been tested in the context of treatment for major depressive disorder, anxiety, chronic pain, obsessive compulsive disorder, addiction, Alzheimer’s disease, eating disorders, and other indications. The first generation of DBS devices was only capable of applying stimulation in an open-loop, or continuous manner. A newer generation of devices allows for both sensing and stimulation in neural circuits, opening the door for long-term invasive recordings in humans in an ambulatory setting. Along with continued algorithm development and understanding of neural circuitry underlying disease, these devices have paved the way for closed-loop therapy, in which stimulation is applied in a non-continuous manner, often in response to a symptom-associated neural biomarker. While the implantation of these devices is often limited to clinical populations, they also allow for previously unattainable iEEG recordings and investigation of a wide range of behaviors in naturalistic environments.

In this Methods Collection, we feature current methods of advanced DBS in humans, such as the process by which symptom-associated biomarkers are identified, implementation of closed-loop therapy using (neural) biomarkers, and collection of neurophysiological data concurrently with behavioral and task data in the ambulatory setting using chronically implanted DBS devices. Contributions associated with any clinical indication using advanced DBS in humans are welcome.