This Article Full Text (PDF) All Versions of this Article: 1756285609339382v1 2/6/379    most recent References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Groiss, S.J. Articles by Schnitzler, A. Social Bookmarking                         What's this?

Review: Deep brain stimulation in Parkinson’s disease

Department of Neurology, Center for Movement Disorders and Neuromodulation, Heinrich-Heine-University of Düsseldorf, Germany, Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University Düsseldorf, Germany, Department of Neurology, Center for Movement Disorders and Neuromodulation, Heinrich-Heine-University Düsseldorf, Germany alfons.schnitzler@ uni-duesseldorf.de

L. Wojtecki

Department of Neurology, Center for Movement Disorders and Neuromodulation, Heinrich-Heine-University of Düsseldorf, Germany, Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University of Düsseldorf, Germany

M. Südmeyer

Department of Neurology, Center for Movement Disorders and Neuromodulation, Heinrich-Heine-University of Düsseldorf, Germany, Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University of Düsseldorf, Germany

A. Schnitzler

Institute of Clinical Neuroscience and Medical Psychology, Heinrich-Heine-University of Düsseldorf, Germany, Department of Neurology, Center for Movement Disorders and Neuromodulation, Heinrich-Heine-University of Düsseldorf, Germany

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.

Key Words: deep brain stimulation • DBS • Parkinson’s disease • subthalamic nucleus • STN • GPi • VIM

This version was published on November 1, 2009

Therapeutic Advances in Neurological Disorders, Vol. 2, No. 6, 379-391 (2009)
DOI: 10.1177/1756285609339382


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?