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2014 ; 11
(3
): 465-74
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English Wikipedia
Deep brain stimulation for movement disorders
#MMPMID24833244
Larson PS
Neurotherapeutics
2014[Jul]; 11
(3
): 465-74
PMID24833244
show ga
Deep brain stimulation (DBS) is an implanted electrical device that modulates
specific targets in the brain resulting in symptomatic improvement in a
particular neurologic disease, most commonly a movement disorder. It is preferred
over previously used lesioning procedures due to its reversibility,
adjustability, and ability to be used bilaterally with a good safety profile.
Risks of DBS include intracranial bleeding, infection, malposition, and hardware
issues, such migration, disconnection, or malfunction, but the risk of each of
these complications is low--generally ? 5% at experienced, large-volume centers.
It has been used widely in essential tremor, Parkinson's disease, and dystonia
when medical treatment becomes ineffective, intolerable owing to side effects, or
causes motor complications. Brain targets implanted include the thalamus (most
commonly for essential tremor), subthalamic nucleus (most commonly for
Parkinson's disease), and globus pallidus (Parkinson's disease and dystonia),
although new targets are currently being explored. Future developments include
brain electrodes that can steer current directionally and systems capable of
"closed loop" stimulation, with systems that can record and interpret regional
brain activity and modify stimulation parameters in a clinically meaningful way.
New, image-guided implantation techniques may have advantages over traditional
DBS surgery.