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Deep Brain Stimulation in Parkinson’s Disease


Affiliations
1 Institute of Neurosciences, Kolkata, India
     

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Deep brain stimulation (DBS) is an universally accepted therapy for medically refractory Parkinson’s disease (PD). Both globus pallidus internus (GPi) and subthalamic nucleus (STN) stimulation are effective in improving the symptoms of PD and reducing dyskinesias. STN DBS is the most commonly performed operation for PD as compared to GPi DBS. Ventral intermediate nucleus (Vim) DBS is used occasionally in selected cases as an alternative for tremor predominant PD patients.

Patient selection is very much essential in achieving good outcomes. Good response to levodopa challenge is most important predictor of favourable long-term outcomes. The DBS surgery is typically performed in an awake state and involves stereotactic frame application, CT/MRI imaging, anatomical targeting, electrophysiological confirmation and intra-operative clinical monitoring for efficacy and adverse effects after intra-operative stimulation and implantation of the DBS lead and pulse generator.

Physiological verification is achieved by microelectrode recording followed by implantation of the DBS lead and intraoperative test stimulation to assess benefits and side effects. The various aspects of DBS surgery has been discussed.


Keywords

Deep Brain Stimulation (DBS), Parkinson’s Disease(PD), Stereotaxy.
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  • Mehanna and Lai: Deep brain stimulation in Parkinson’s disease. Translational Neurodegeneration 2013 2:22.

  • N K Patel, P Plaha, K O’Sullivan, et al. MRI directed bilateral stimulation of the subthalamic nucleus in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 2003 74: 1631-1637.doi: 10.1136/jnnp.74.12.1631

  • N A Hamid, R D Mitchell, P Mocroft. Targeting the subthalamic nucleus for deep brain stimulation: technical approach and fusion of pre- and postoperative MR images to define accuracy of lead placement. J. Neurol Neurosurg Psychiatry 2005 76: 409-414. doi: 10.1136/jnnp.2003.032029

  • M. Deogaonkar . J. L. Vitek. Springer-Verlag Berlin/ Heidelberg 2008. Globus Pallidus Stimulation for Parkinson’s Disease.

  • Andre Machado, Ali R. Rezai,Brian H. Kopell, Robert E. Gross, Ashwini D. Sharan, Alim-Louis Benabid, Deep Brain Stimulation for Parkinson’s Disease: Surgical Technique and Perioperative Management.Movement Disorders, Vol. 21, Suppl.14, 2006, pp. S247–S258

  • Albert J. Fenoy, and Richard K. Simpson Jr. Risks of common complications in deep brain stimulation surgery: management and avoidance, J Neurosurg 120:132–139, 2014

  • M Picillo, AM Lozano, N Kou, R Puppi Munhoz, Fasano A: Programming Deep Brain Stimulation for Parkinson’s Disease: The Toronto Western Hospital Algorithms. Brain Stimul. 2016 May-Jun;9(3):425-437. doi: 10.1016/j.brs.2016.02.004. Epub 2016 Feb 12.

  • Aparna Wagle Shukla, Pam Zeilman, Hubert Fernandez, Jawad A. Bajwa, and Raja Mehanna, “DBS Programming: An Evolving Approach for Patients with Parkinson’s Disease,” Parkinson’s Disease, vol. 2017, Article ID 8492619, 11 pages, 2017. https://doi.org/10.1155/2017/8492619.

  • DN Anderson, B Osting, J Vorwerk, Dorval AD, Butson CR:Optimized programming algorithm for cylindrical and directional deep brain stimulation electrodes: J Neural Eng. 2018 Apr;15(2):026005. doi: 10.1088/1741-2552/aaa14b.

  • AR Rezai, AG Machado, M Deogaonkar, H Azmi, C Kubu, Boulis NM. SURGERY FOR MOVEMENT DISORDERS: Neurosurgery. 2008 Feb;62 Suppl 2:809-38; discussion 838-9. doi: 10.1227/01.neu.0000316285.52865.53.

  • Andre G. Machado, Milind Deogaonkar, Scott Cooper,

  • Deep brain stimulation for movement disorders: Patient selection and technical options: Cleveland Clinic Journal of Medicine 2012 July;79(suppl 2): S19-S24


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  • Deep Brain Stimulation in Parkinson’s Disease

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Authors

Amit Kumar Ghosh
Institute of Neurosciences, Kolkata, India
Sutirtha Hazra
Institute of Neurosciences, Kolkata, India

Abstract


Deep brain stimulation (DBS) is an universally accepted therapy for medically refractory Parkinson’s disease (PD). Both globus pallidus internus (GPi) and subthalamic nucleus (STN) stimulation are effective in improving the symptoms of PD and reducing dyskinesias. STN DBS is the most commonly performed operation for PD as compared to GPi DBS. Ventral intermediate nucleus (Vim) DBS is used occasionally in selected cases as an alternative for tremor predominant PD patients.

Patient selection is very much essential in achieving good outcomes. Good response to levodopa challenge is most important predictor of favourable long-term outcomes. The DBS surgery is typically performed in an awake state and involves stereotactic frame application, CT/MRI imaging, anatomical targeting, electrophysiological confirmation and intra-operative clinical monitoring for efficacy and adverse effects after intra-operative stimulation and implantation of the DBS lead and pulse generator.

Physiological verification is achieved by microelectrode recording followed by implantation of the DBS lead and intraoperative test stimulation to assess benefits and side effects. The various aspects of DBS surgery has been discussed.


Keywords


Deep Brain Stimulation (DBS), Parkinson’s Disease(PD), Stereotaxy.

References





DOI: https://doi.org/10.24906/isc%2F2020%2Fv34%2Fi1%2F195944