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Deep brain stimulation in Parkinson's disease.

Kelly E Lyons1, Rajesh Pahwa

  • 1Department of Neurology, University of Kansas Medical Center, 3599 Rainbow Boulevard, Mailstop 2012, Kansas City, KS 66160, USA. lyons.kelly@att.net

Current Neurology and Neuroscience Reports
|June 26, 2004
PubMed
Summary
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Deep brain stimulation (DBS) is increasingly used for advanced Parkinson's disease (PD). Targeting the globus pallidus or subthalamic nucleus offers long-term relief for all PD symptoms, though complications can occur.

Area of Science:

  • Neurosurgery
  • Neurology

Background:

  • Deep brain stimulation (DBS) is a growing surgical therapy for advanced Parkinson's disease (PD).
  • Thalamic DBS effectively treats tremor but not other PD symptoms like rigidity and bradykinesia.

Purpose of the Study:

  • To review the efficacy and safety of current surgical options for advanced Parkinson's disease.
  • To inform physicians and patients about the risks and benefits of DBS for PD.

Main Methods:

  • Review of current literature on deep brain stimulation (DBS) for Parkinson's disease (PD).
  • Analysis of complication rates and efficacy of different DBS targets (thalamus, globus pallidus, subthalamic nucleus).

Main Results:

  • Globus pallidus or subthalamic nucleus stimulation is effective for long-term management of all cardinal PD symptoms.

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  • Serious adverse events occur in 1-2% of patients, infections in 5-8%, and hardware complications in ~25%.

    • Conclusions:

    • Globus pallidus or subthalamic nucleus DBS are the preferred surgical treatments for advanced PD.
    • Patient outcomes are influenced by surgical center experience and complication rates.
    • Awareness of procedural volume and complication data is crucial for informed patient referral.