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The role of deep brain stimulation in Parkinson s disease: an overview and update
on new developments
#MMPMID28331322
Fang JY
; Tolleson C
Neuropsychiatr Dis Treat
2017[]; 13
(?): 723-732
PMID28331322
show ga
Parkinson's disease (PD) is a progressive neurodegenerative disorder
characterized by the loss of neuronal dopamine production in the brain. Oral
therapies primarily augment the dopaminergic pathway. As the disease progresses,
more continuous delivery of therapy is commonly needed. Deep brain stimulation
(DBS) has become an effective therapy option for several different neurologic and
psychiatric conditions, including PD. It currently has US Food and Drug
Administration approval for PD and essential tremor, as well as a humanitarian
device exception for dystonia and obsessive-compulsive disorder. For PD
treatment, it is currently approved specifically for those patients suffering
from complications of pharmacotherapy, including motor fluctuations or
dyskinesias, and a disease process of at least 4 years of duration. Studies have
demonstrated superiority of DBS and medical management compared to medical
management alone in selected PD patients. Optimal patient selection criteria,
choice of target, and programming methods for PD and the other indications for
DBS are important topics that continue to be explored and remain works in
progress. In addition, new hardware options, such as different types of leads,
and different software options have recently become available, increasing the
potential for greater efficacy and/or reduced side effects. This review gives an
overview of therapeutic management in PD, specifically highlighting DBS and some
of the recent changes with surgical therapy.
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