On March 14, 1997, the Food and Drug Administration held a hearing on the use of deep brain stimulation as a treatment for essential tremor and Parkinson’s disease. By that time, excitement and fascination with the technology that could restore a body to its rightful state of controlled movement had spread through brain research laboratories and neurology clinics across the country and the world. Patients with all kinds of movement disorders had heard about deep brain stimulation, too, and were clamoring to be allowed to get the treatment. Organizations that support medical research for particular diseases were singing its praises, including some, like advocates for psychiatric disorders, that would seem a far cry from the tremor and Parkinson’s pleaders in the room that day..................By 2008, 40,000 people around the world had had electrode leads implanted into their brains to stimulate abnormal circuits, mostly to relieve Parkinson’s disease and tremor. People afflicted with the violent involuntary muscle contractions of dystonia had joined the ranks, and many hundreds of patients with other disabling forms of other disorders, from epilepsy to obsessive compulsive disorder to Tourette’s syndrome, were receiving the treatment experimentally. For those enrolled in early trials of deep brain stimulation for their conditions, the results were clearly encouraging and suggested that the human brain has more reserve than anyone imagined. Today, scientists are speculating that putting electrodes in the right spot in the brain might relieve chronic pain, ease intractable depression, enhance memory, alleviate chronic and debilitating headache, even help people lose weight. This book tells the story of how deep brain stimulation unfolded as a potential therapy for many disparate brain diseases. It is a cautionary tale of successes and failures and life
somewhere in the middle of all this technology. It’s about the science of brain circuitry and the scientists who are fighting to study this surgical technique in the right way and with the right patients to make sure that deep brain stimulation as a treatment is not abused, which could mean the end of a potentially important tool to help alleviate human suffering. And it’s about some of the patients who have braved the surgeries and walk around with electrodes in their brains and batteries in their chests, benefiting from its effects but always aware that the hardware could fail them.
And finally, it is a story about how research translates into a technology that has the potential to help people regain lives made unlivable by illness. It is about hope and caution.
Al momento, pur non esistendo "criteri di inclusione" validati per selezionare i soggetti affetti da distonia "generalizzata" o "focale" e suscettibili di trattamento chirurgico, possiamo considerare "buoni candidati" i soggetti che abbiano: 
una "distonia primaria" grave e causa di disabilità importante, con esclusione altre cause concomitanti di disabilità (es.: retrazioni osteoarticolari, ecc.)
condizioni generali buone con "rischi chirurgici" minori dei "rischi clinici"
valutazione obiettiva delle "aspettative" del paziente e dei famigliari, considerando realisticamente le possibilità riabilitative del paziente..........................................................
non mancano gli alert , sul sito stesso della DAna Foundation Duncan's Letter on Arts Education :
Using Deep Brain Stimulation on the Mind: Handle with Care
by Mahlon R. DeLong, M.D.Cerebrum
The success of deep brain stimulation in treating movement disorders has led to investigations of its use for psychiatric illnesses. While the technique shows early promise in the treatment of depression and obsessive-compulsive disorder, Mahlon DeLong, a pioneer in the field, cautions both doctors and patients to be aware of the risks in using this as yet unproven method of mind alteration..................................
orso castano : E' un vero e proprio intervento chirurgico , che non eclude rischi irreversibili. Peggio , se vogliamo, dei rischi dell'elettroschock!!
per chi volesse una sintesi delle terapie usate nelle distonie (l'articolo non e' recentissimo , ma e' ancora valido) clicca : P. Girlanda Le distonie: dalla clinica alla terapia
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