Neuroimaging in deep brain stimulation: Bridging technical progress with clinical practice

Recent advancements in neuroimaging have revolutionized the field of deep brain stimulation (DBS), enabling unprecedented precision in target identification, surgical planning, and post-operative assessment. This review synthesizes the latest innovations in MRI-based and multimodal imaging approaches, with a focus on high-field MRI, susceptibility-weighted imaging (SWI), quantitative susceptibility mapping (QSM), and novel image processing techniques including connectomics. We discuss how these technologies have enhanced visualization of deep brain nuclei and vascular structures, improved the integration of anatomical and functional data, and enabled more individualized DBS therapy. Key challenges, including imaging safety with implanted devices and the limitations of current imaging in functional mapping, are critically evaluated. By emphasizing recent breakthroughs and future prospects, this review provides a roadmap for harnessing neuroimaging to optimize DBS outcomes and expand its therapeutic potential.