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Related Experiment Videos

Deep brain stimulation in movement disorders.

Ergun Y Uc1, Kenneth A Follett

  • 1Department of Neurology, University of Iowa, Iowa City, Iowa 52242, USA.

Seminars in Neurology
|March 29, 2007
PubMed
Summary
This summary is machine-generated.

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Deep brain stimulation (DBS) offers treatment for Parkinson's disease, essential tremor, and dystonia. While STN DBS is common for Parkinson's, optimal targets and mechanisms are still under investigation.

Area of Science:

  • Neurology
  • Neurosurgery

Background:

  • Deep brain stimulation (DBS) is a therapeutic option for advanced, medically intractable movement disorders like Parkinson's disease (PD), essential tremor (ET), and dystonia.
  • Patient selection requires rigorous motor, cognitive, and psychiatric evaluations to ensure suitability for the procedure.

Purpose of the Study:

  • To outline the established and potential targets for DBS in movement disorders.
  • To discuss the proposed mechanisms underlying DBS efficacy.
  • To highlight patient selection criteria and potential surgical risks.

Main Methods:

  • Review of current practices and literature regarding DBS targets and patient selection.
  • Discussion of neurophysiological mechanisms implicated in DBS.
  • Analysis of surgical risks and potential complications associated with DBS procedures.

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Main Results:

  • Established DBS targets include the ventral intermediate nucleus (VIM) for ET, and globus pallidus interna (GPI) and subthalamic nucleus (STN) for PD and dystonia.
  • STN DBS is increasingly utilized for PD, though optimal target determination is ongoing.
  • DBS is thought to modulate pathological network activity in cortico-basal ganglia-thalamic circuits.

Conclusions:

  • Careful patient selection is crucial, excluding individuals with dementia, major psychiatric disorders, or significant medical comorbidities.
  • While DBS carries a lower risk than lesioning techniques, surgical complications can occur, with bilateral procedures posing higher risks for speech, cognition, and gait disturbances.