Advances in deep brain stimulation for movement disorders

Deep brain stimulation (DBS) has transformed the management of medication-refractory movement disorders, including Parkinson's disease, essential tremor, and dystonia. This letter highlights recent clinical and technological advances that enhance precision, safety, and accessibility. Innovations such as directional leads, adaptive (closed-loop) stimulation, and telemedicine-enabled remote programming enable personalized therapy and improved symptom control. Country-specific experiences illustrate these trends: China has rapidly expanded DBS centers with remote programming, European centers are adopting robotic-assisted implantation and cranialized generators, and emerging programs in Africa show promising early outcomes despite resource limitations. Multimodal imaging and intraoperative mapping have refined target accuracy, while ongoing research explores novel targets and broader indications. Our findings emphasize the importance of multidisciplinary care, evidence-based patient selection, and equitable access strategies to maximize DBS benefits. Ethical implementation and transparent reporting remain essential. By summarizing these developments, the letter underscores DBS's evolving role as a precision neuromodulation therapy improving motor function and quality of life.