A Gap Analysis of Deep Brain Stimulation for Childhood‐Onset Movement Disorders

Abstract

BACKGROUND: Deep brain stimulation (DBS) is an established and increasingly utilized therapy for childhood-onset movement disorders. However, pediatric DBS poses unique challenges that are not adequately addressed by adult-derived paradigms. OBJECTIVE: To identify key gaps in the current use of DBS in childhood-onset movement disorders and to highlight emerging pediatric-specific strategies across the care pathway, including patient selection, targeting, surgical approaches, programming, and outcome assessment. METHODS: This educational review represents the opinions of seven clinicians and clinical researchers with extensive experience in pediatric DBS and was informed by a focused literature review of key domains identified by the authors as current gaps in the field. CONCLUSIONS: Despite substantial progress, important gaps persist across multiple domains of pediatric DBS, including the lack of standardized, pediatric-specific selection frameworks, limited biomarkers to guide therapy, challenges in defining meaningful outcomes, and significant global disparities in access. Emerging approaches, including individualized and genotype-informed strategies, advances in neuromodulation technology, and international collaboration, offer potential pathways to address these limitations. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.