Neuromodulation is a rapidly changing clinical and research domain. The traditional dividing line between psychology, neurology, psychiatry and neurosurgery is progressively disappearing.
Until recently the neurosurgeon only treated those pathologies which were directly related to the brain. Now, however, a variety of conditions are being treated by neuromodulators that only seem to be indirectly related with the brain. For example, bladder problems, tinnitus, angina, heart failure, obesity, fibromyalgia, chronic fatigue syndrome etc., are being investigated to determine whether neuromodulation could be useful for these clinical entities.
The rapidly developing technology and the associated increase in neuroscientific insights will cause an explosive growth of functional brain-related pathologies amenable to neuromodulation.
An aging population creates a large group of people with an aging nervous system, and thus abnormalities associated with dementia as well as decreased neuronal control of peripheral organs will mandate novel approaches.
Partly under the influence of the media, disability, pain, and other symptoms are being depicted as unacceptable, and people do not accept inconveniences any more that were considered an integral aspect of aging before. The same trend is observed in younger people who do not accept when told that they must learn to live with a certain dysfunction. Where previously one could be given a possible answer that nothing can be done for this or that problem, this is changing dramatically. This pushes researchers to investigate novel indications, but also blurs the boundaries between treatment of pathologies and neuroenhancement. i.e. the improvement of normal performance by the application of neuromodulation
The same trend is observed in younger people who do not accept when told that they must learn to live with a certain dysfunction. Where previously one could be given a possible answer that nothing can be done for this or that problem, this is changing dramatically.
Due to the "decade of the brain" (1990-2000) a huge amount of fundamental neuroscientific information has been generated that permits possible answers to these questions via innovative 'translational research'. However, this requires an intense collaboration between clinicians and basic researchers, and the neurosurgeon is just one part in this interdisciplinary team of clinicians and non-clinicians, basic scientists and clinical researchers.