Parkinson’s disease (PD): deep brain stimulation (DBS)

Evidence-based neurology checklist on parkinson’s disease (pd): deep brain stimulation (dbs): Target areas Globus pallidus interna (GPi) Substantia nigra (STN): this provides better off-phase motor improvement than GPi Thalamus: if there is severe disabling tremor and the STN is not possible…

Target areas

  • Globus pallidus interna (GPi)
  • Substantia nigra (STN): this provides better off-phase motor improvement than GPi
  • Thalamus: if there is severe disabling tremor and the STN is not possible

Indications

Contraindications

Benefits

Complications

Poor prognostic features

References

  1. Parkinson's disease: Diagnosis and management in primary and secondary care. NICE Clinical Guideline [CG35]. June 2006.
  2. Pahwa R, Factor SA, Lyons KE, et al. Practice parameter: treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2006; 66:983-995.
  3. Odekerken VJ, Boel JA, Schmand BA, et al; NSTAPS study group. GPi vs STN deep brain stimulation for Parkinson disease: Three-year follow-up. Neurology 2016; 86:755-761.
  4. Sharma VD, Bona AR, Mantovani A, et al. cystic lesions as a rare complication of deep brain stimulation. Mov Disord Clin Pract 2016; 3:87-90.
  5. Schlenstedt C, Shalash A, Muthuraman M, Falk D, Witt K, Deuschl G. Effect of high-frequency subthalamic neurostimulation on gait and freezing of gait in Parkinson's disease: a systematic review and meta-analysis. Eur J Neurol 2017; 24:18-26. 
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