© 2018 Ramirez-Zamora, Giordano, Gunduz, Brown, Sanchez, Foote, Almeida, Starr, Bronte-Stewart, Hu, McIntyre, Goodman, Kumsa, Grill, Walker, Johnson, Vitek, Greene, Rizzuto, Song, Berger, Hampson, Deadwyler, Hochberg, Schiff, Stypulkowski, Worrell, Tiruvadi, Mayberg, Jimenez-Shahed, Nanda, Sheth, Gross, Lempka, Li, Deeb and Okun. The annual Deep Brain Stimulation (DBS) Think Tank provides a focal opportunity for a multidisciplinary ensemble of experts in the field of neuromodulation to discuss advancements and forthcoming opportunities and challenges in the field. The proceedings of the fifth Think Tank summarize progress in neuromodulation neurotechnology and techniques for the treatment of a range of neuropsychiatric conditions including Parkinson's disease, dystonia, essential tremor, Tourette syndrome, obsessive compulsive disorder, epilepsy and cognitive, and motor disorders. Each section of this overview of the meeting provides insight to the critical elements of discussion, current challenges, and identified future directions of scientific and technological development and application. The report addresses key issues in developing, and emphasizes major innovations that have occurred during the past year. Specifically, this year's meeting focused on technical developments in DBS, design considerations for DBS electrodes, improved sensors, neuronal signal processing, advancements in development and uses of responsive DBS (closed-loop systems), updates on National Institutes of Health and DARPA DBS programs of the BRAIN initiative, and neuroethical and policy issues arising in and from DBS research and applications in practice.