Criteria for deep-brain stimulation in Parkinson’s disease: review and analysis

  title={Criteria for deep-brain stimulation in Parkinson’s disease: review and analysis},
  author={Elena Moro and Anthony E. Lang},
  journal={Expert Review of Neurotherapeutics},
  pages={1695 - 1705}
  • E. Moro, A. Lang
  • Published 1 November 2006
  • Medicine, Psychology
  • Expert Review of Neurotherapeutics
Deep-brain stimulation is currently the most effective surgical treatment for advanced Parkinson’s disease. The relevant targets to date are the subthalamic nucleus and the globus pallidus internus, although the thalamus (ventralis intermedius nucleus) is preferred in tremor-dominant, aged Parkinson’s disease patients. Long-term benefit in cardinal parkinsonian signs, motor fluctuations and dyskinesia has been reported in 5-year follow-up studies of subthalamic nucleus deep-brain stimulation… 
Thalamic Stimulation for Parkinson’s Disease: Clinical Studies on DBS
Vim-DBS provides a long-term therapeutic benefit on the quality of life of tremor-dominant PD without affecting cognitive function, but cannot be recommended for non-tremor PD symptoms such as akinesia, gait disturbance, and motor fluctuation.
Medical management after subthalamic stimulation in Parkinson's disease: a phenotype perspective.
A clinical algorithm on medical management focused on the patient's phenotypic profile at the perioperative period is proposed and across the trials, the levodopa equivalent daily dose is reduced by 30 to 50% one year after surgery.
High-Frequency Stimulation for Parkinson’s Disease and Effects on Pathways in Basal Ganglia Network Model
The calculation results show that the cortico-basal-thalamic network is reliable, and through the use of feasible models, high-frequency stimulation of the three targets can improve the pathological thalamic rhythmicity.
Differential effects of deep brain stimulation and levodopa on brain activity in Parkinson’s disease
Modulatory effects of levodopa on brain activity of the putamen during finger movement execution were showed, which were not observed with deep brain stimulation, which underlines the specificity of the findings withlevodopa treatment.
Long-term Outcomes (15 Years) After Subthalamic Nucleus Deep Brain Stimulation in Patients With Parkinson Disease
STN-DBS is effective beyond 15 years from the intervention, notably with significant improvement in motor complications and stable reduction of dopaminergic drugs, and despite the natural continuous progression of PD with worsening of levodopa-resistant motor and nonmotor symptoms over the years, patients undergoing STN- DBS could maintain an improvement in QoL.
Neuropsychological performance after unilateral subthalamic deep brain stimulation in Parkinson's disease
of a dissertation at the University of Miami. The current study examined cognitive effects of unilateral subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson's disease (PD) patients.
Association of preoperative symptom profile with psychiatric symptoms following subthalamic nucleus stimulation in patients with Parkinson's disease.
Compared with patients who improved, patients who had deteriorated behaviorally had similar prevalence and severity of preoperative behavioral symptoms but significantly shorter disease duration.
Treatment options for non-motor symptoms in late-stage Parkinson's disease
The objective of this study was to review the treatment options for Parkinson's disease dementia, psychosis, falls, bone fractures, joint and skeletal deformities, pain, orthostatic hypotension, gastrointestinal abnormalities and urological dysfunction in late-stage Parkinson's Disease.
The Instrumental Activities of Daily Living in Parkinson’s Disease Patients Treated by Subthalamic Deep Brain Stimulation
STN-DBS in PD is a safe method for improvement of everyday functioning and IADL in the post-surgery phase and lower global cognition and lower LEDD are predictive of lower I ADL in both pre-sur Surgery and post-Surgery examinations.


Bilateral deep brain stimulation in Parkinson's disease: a multicentre study with 4 years follow-up.
This first multicentre study assessing the long-term efficacy of either STN or GPi stimulation shows a significant and substantial clinically important therapeutic benefit for at least 3-4 years in a large cohort of patients with severe Parkinson's disease.
Bilateral deep brain stimulation of the pedunculopontine nucleus for Parkinson's disease
It is demonstrated for the first time that low frequency stimulation of this nucleus significantly improves gait dysfunction and postural instability in both the ‘on’ and ‘off’ medication states.
Subthalamic nucleus deep brain stimulation for parkinson's disease after successful pallidotomy: Clinical and electrophysiological observations
Bilateral STN DBS is safe and efficacious in improving motor symptoms in patients with prior pallidotomy and should be considered as a go-to treatment for contralateral parkinsonism and dyskinesia.
Deep brain stimulation for Parkinson's disease
Deep brain simulation is a powerful new therapeutic approach for patients with Parkinson's disease, however, patient selection is critical for a valuable therapeutic result and much work remains to be done.
Stimulation of the subthalamic nucleus in Parkinson’s disease: a 5 year follow up
Despite moderate motor and cognitive decline, probably due to disease progression, the marked improvement in motor function observed postoperatively was sustained 5 years after neurosurgery.
Disease progression continues in patients with advanced Parkinson’s disease and effective subthalamic nucleus stimulation
This functional imaging study is the first to demonstrate a continuous decline of dopaminergic function in patients with advanced PD under clinically effective bilateral STN stimulation.
Deep brain stimulation: Preoperative issues
  • A. Lang, J. Houeto, V. Voon
  • Medicine, Psychology
    Movement disorders : official journal of the Movement Disorder Society
  • 2006
The Consensus on Deep Brain Stimulation for Parkinson's Disease outlines answers to a series of questions developed to address all aspects of deep brain stimulation preoperative decision‐making.
Deep brain stimulation in late stage Parkinson’s disease: a retrospective cost analysis in Germany
STNDBS pays off from the second year of stimulation while motor symptoms are significantly improved and the Unified Parkinon’s Disease Rating Scale (UPDRS III) was significantly improved.
Double-blind evaluation of subthalamic nucleus deep brain stimulation in advanced Parkinson's disease
STN DBS is a promising new surgical option for the treatment of advanced Parkinson's Disease and the marked clinical benefits obtained in these severely disabled patients outweighed the adverse effects.
A randomized trial of deep-brain stimulation for Parkinson's disease.
In this six-month study of patients under 75 years of age with severe motor complications of Parkinson's disease, neurostimulation of the subthalamic nucleus was more effective than medical management alone.