The advances of Deep Brain Stimulation (DBS) for treatment of Parkinson s disease (PD)

André Eduardo De Almeida Franzoi,Andrei Koerbel,Ana Beatriz Bonchoski

doi:10.4322/2357-9730.86267

André Eduardo De Almeida Franzoi, Andrei Koerbel + Show 1 more

Open Access

https://doi.org/10.4322/2357-9730.86267

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Abstract

Advanced Parkinson's disease (PD) is characterized by the presence of motor fluctuations, various degrees of dyskinesia, and disability with functional impact on daily living and independence. Therapeutic management aims to extend levodopa (L-DOPA) benefit while minimizing motor complications and includes, in selected cases, the implementation of drug infusion and surgical techniques. The concept of deep brain stimulation (DBS) for PD was introduced over 20 years ago, but our understanding of the nuances of this procedure continues to improve. This review aims to demonstrate the advances of DBS in the treatment of PD patients. Keywords : Deep brain stimuation; previous pallidotomy; microrecording; Parkinson disease

Highlights

Advanced Parkinson’s disease (PD) is characterized by the presence of motor fluctuations, various degrees of dyskinesia, and disability with functional impact on daily living and independence
This review summarizes the main advances in deep brain stimulation (DBS) surgical technique in PD patients and our perspective for the future of the procedure
L-DOPA is considered the gold standard for treating PD motor symptoms, yet tremor response to L-DOPA is highly variable among PD patients throughout the disease course

Summary

Introduction

Advanced Parkinson’s disease (PD) is characterized by the presence of motor fluctuations, various degrees of dyskinesia, and disability with functional impact on daily living and independence. If STN is injured, it can increase the risk of developing psychiatric disorders, balism and dyskinesias Another important nucleus in PD is the Globus Pallidus (GP), mainly on the internal portion (GPi). Patients with advanced PD symptoms can be benefited for surgical procedures, including the implantation of electrodes in BG for continuous electric stimulation, “deep brain stimulation” (DBS)[4]. This technique was introduced in the 1990s and is accepted as an effective treatment for patients with PD, mainly in the advanced stage[5]

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