Deep Brain Stimulation of the Subthalamic Nucleus and Globus Pallidus for Parkinson's Disease.

Abstract

The concept of deep brain stimulation (DBS) for Parkinson's disease (PD) was introduced over 20 years ago, but our understanding of the nuances of this procedure continues to improve. The average motor outcomes of internal segment of the globus pallidus (GPi) and subthalamic nucleus (STN) DBS appear to be similar, although GPi DBS may allow greater recovery of verbal fluency and may provide greater relief of depression symptoms and improvement in the quality of life, and STN DBS appears more likely to result in decrease in levodopa equivalent doses. Despite the lack of consensus on whether STN or GPi DBS is most appropriate for a given clinical phenotype, the general expansion of patient selection criteria to include younger and older patients and the advent of real-time imaging-confirmed that DBS electrode placement are making life-changing treatment available to greater numbers of movement disorder patients.