Deep Brain Stimulation in Parkinson's Disease

Overview

Journal Ther Adv Neurol Disord

Specialty Neurology

Date 2010 Dec 25

PMID 21180627

Citations 91

Authors

S J Groiss

L Wojtecki

M Sudmeyer

A Schnitzler

Affiliations

Soon will be listed here.

Abstract

During the last 15 years deep brain stimulation (DBS) has been established as a highly-effective therapy for advanced Parkinson's disease (PD). Patient selection, stereotactic implantation, postoperative stimulator programming and patient care requires a multi-disciplinary team including movement disorders specialists in neurology and functional neurosurgery. To treat medically refractory levodopa-induced motor complications or resistant tremor the preferred target for high-frequency DBS is the subthalamic nucleus (STN). STN-DBS results in significant reduction of dyskinesias and dopaminergic medication, improvement of all cardinal motor symptoms with sustained long-term benefits, and significant improvement of quality of life when compared with best medical treatment. These benefits have to be weighed against potential surgery-related adverse events, device-related complications, and stimulus-induced side effects. The mean disease duration before initiating DBS in PD is currently about 13 years. It is presently investigated whether the optimal timing for implantation may be at an earlier disease-stage to prevent psychosocial decline and to maintain quality of life for a longer period of time.

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References

Stefani A, Lozano A, Peppe A, Stanzione P, Galati S, Tropepi D . Bilateral deep brain stimulation of the pedunculopontine and subthalamic nuclei in severe Parkinson's disease. Brain. 2007; 130(Pt 6):1596-607. DOI: 10.1093/brain/awl346. View

Volkmann J, Allert N, Voges J, Sturm V, Schnitzler A, Freund H . Long-term results of bilateral pallidal stimulation in Parkinson's disease. Ann Neurol. 2004; 55(6):871-5. DOI: 10.1002/ana.20091. View

Andrade-Souza Y, Schwalb J, Hamani C, Hoque T, Saint-Cyr J, Lozano A . Comparison of 2-dimensional magnetic resonance imaging and 3-planar reconstruction methods for targeting the subthalamic nucleus in Parkinson disease. Surg Neurol. 2005; 63(4):357-62. DOI: 10.1016/j.surneu.2004.05.033. View

Dujardin K, Defebvre L, Krystkowiak P, Blond S, Destee A . Influence of chronic bilateral stimulation of the subthalamic nucleus on cognitive function in Parkinson's disease. J Neurol. 2001; 248(7):603-11. DOI: 10.1007/s004150170139. View

LeWitt P . Levodopa for the treatment of Parkinson's disease. N Engl J Med. 2008; 359(23):2468-76. DOI: 10.1056/NEJMct0800326. View

Temel Y, Ackermans L, Celik H, Spincemaille G, Van Der Linden C, Walenkamp G . Management of hardware infections following deep brain stimulation. Acta Neurochir (Wien). 2004; 146(4):355-61. DOI: 10.1007/s00701-004-0219-2. View

Schneider F, Habel U, Volkmann J, Regel S, Kornischka J, Sturm V . Deep brain stimulation of the subthalamic nucleus enhances emotional processing in Parkinson disease. Arch Gen Psychiatry. 2003; 60(3):296-302. DOI: 10.1001/archpsyc.60.3.296. View

Montgomery Jr E, Gale J . Mechanisms of action of deep brain stimulation(DBS) . Neurosci Biobehav Rev. 2007; 32(3):388-407. DOI: 10.1016/j.neubiorev.2007.06.003. View

Hariz M . Safety and risk of microelectrode recording in surgery for movement disorders. Stereotact Funct Neurosurg. 2003; 78(3-4):146-57. DOI: 10.1159/000068960. View

10.

Esselink R, de Bie R, de Haan R, Lenders M, Nijssen P, Staal M . Unilateral pallidotomy versus bilateral subthalamic nucleus stimulation in PD: a randomized trial. Neurology. 2004; 62(2):201-7. DOI: 10.1212/01.wnl.0000103235.12621.c3. View

11.

Fraix V, Houeto J, Lagrange C, Le Pen C, Krystkowiak P, Guehl D . Clinical and economic results of bilateral subthalamic nucleus stimulation in Parkinson's disease. J Neurol Neurosurg Psychiatry. 2006; 77(4):443-9. PMC: 2077508. DOI: 10.1136/jnnp.2005.077677. View

12.

Hariz M, Krack P, Alesch F, Augustinsson L, Bosch A, Ekberg R . Multicentre European study of thalamic stimulation for parkinsonian tremor: a 6 year follow-up. J Neurol Neurosurg Psychiatry. 2007; 79(6):694-9. DOI: 10.1136/jnnp.2007.118653. View

13.

Kumar R, Lozano A, Sime E, Halket E, Lang A . Comparative effects of unilateral and bilateral subthalamic nucleus deep brain stimulation. Neurology. 1999; 53(3):561-6. DOI: 10.1212/wnl.53.3.561. View

14.

Hilker R, Portman A, Voges J, Staal M, Burghaus L, van Laar T . Disease progression continues in patients with advanced Parkinson's disease and effective subthalamic nucleus stimulation. J Neurol Neurosurg Psychiatry. 2005; 76(9):1217-21. PMC: 1739814. DOI: 10.1136/jnnp.2004.057893. View

15.

Benabid A, Pollak P, Gao D, Hoffmann D, Limousin P, Gay E . Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment of movement disorders. J Neurosurg. 1996; 84(2):203-14. DOI: 10.3171/jns.1996.84.2.0203. View

16.

Hamani C, Richter E, Schwalb J, Lozano A . Bilateral subthalamic nucleus stimulation for Parkinson's disease: a systematic review of the clinical literature. Neurosurgery. 2005; 56(6):1313-21. DOI: 10.1227/01.neu.0000159714.28232.c4. View

17.

Voges J, Hilker R, Botzel K, Kiening K, Kloss M, Kupsch A . Thirty days complication rate following surgery performed for deep-brain-stimulation. Mov Disord. 2007; 22(10):1486-1489. DOI: 10.1002/mds.21481. View

18.

Deuschl G, Fogel W, Hahne M, Kupsch A, Muller D, Oechsner M . Deep-brain stimulation for Parkinson's disease. J Neurol. 2003; 249 Suppl 3:III/36-9. DOI: 10.1007/s00415-002-1308-x. View

19.

Hamani C, Richter E, Andrade-Souza Y, Hutchison W, Saint-Cyr J, Lozano A . Correspondence of microelectrode mapping with magnetic resonance imaging for subthalamic nucleus procedures. Surg Neurol. 2005; 63(3):249-53. DOI: 10.1016/j.surneu.2004.05.036. View

20.

Pilitsis J, Chu Y, Kordower J, Bergen D, Cochran E, Bakay R . Postmortem study of deep brain stimulation of the anterior thalamus: case report. Neurosurgery. 2008; 62(2):E530-2. DOI: 10.1227/01.neu.0000316024.81786.78. View