Deep Brain Stimulation Target Selection for Parkinson's Disease.
Identifieur interne : 000102 ( Main/Exploration ); précédent : 000101; suivant : 000103Deep Brain Stimulation Target Selection for Parkinson's Disease.
Auteurs : Christopher R. Honey ; Clement Hamani ; Suneil K. Kalia [Canada] ; Tejas Sankar ; Marina Picillo [Canada] ; Renato P. Munhoz [Canada] ; Alfonso Fasano [Canada] ; Michel Panisset [Canada]Source :
- The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques [ 0317-1671 ] ; 2017.
English descriptors
- KwdEn :
- MESH :
- anatomy & histology : Brain.
- methods : Deep Brain Stimulation.
- physiology : Brain.
- therapy : Parkinson Disease.
- Humans.
Abstract
During the "DBS Canada Day" symposium held in Toronto July 4-5, 2014, the scientific committee invited experts to discuss three main questions on target selection for deep brain stimulation (DBS) of patients with Parkinson's disease (PD). First, is the subthalamic nucleus (STN) or the globus pallidus internus (GPi) the ideal target? In summary, both targets are equally effective in improving the motor symptoms of PD. STN allows a greater medications reduction, while GPi exerts a direct antidyskinetic effect. Second, are there further potential targets? Ventral intermediate nucleus DBS has significant long-term benefit for tremor control but insufficiently addresses other motor features of PD. DBS in the posterior subthalamic area also reduces tremor. The pedunculopontine nucleus remains an investigational target. Third, should DBS for PD be performed unilaterally, bilaterally or staged? Unilateral STN DBS can be proposed to asymmetric patients. There is no evidence that a staged bilateral approach reduces the incidence of DBS-related adverse events.
DOI: 10.1017/cjn.2016.22
PubMed: 26976064
Affiliations:
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Honey</name><affiliation><nlm:affiliation>1Division of Neurosurgery,University of British Columbia,Vancouver,British Columbia.</nlm:affiliation><wicri:noCountry code="subField">British Columbia</wicri:noCountry></affiliation></author><author><name sortKey="Hamani, Clement" sort="Hamani, Clement" uniqKey="Hamani C" first="Clement" last="Hamani">Clement Hamani</name><affiliation><nlm:affiliation>2Research Imaging Centre,Centre for Addiction and Mental Health,Toronto.</nlm:affiliation><wicri:noCountry code="subField">Toronto</wicri:noCountry></affiliation></author><author><name sortKey="Kalia, Suneil K" sort="Kalia, Suneil K" uniqKey="Kalia S" first="Suneil K" last="Kalia">Suneil K. Kalia</name><affiliation wicri:level="4"><nlm:affiliation>3Department of Surgery,Division of Neurosurgery,University of Toronto.</nlm:affiliation><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Sankar, Tejas" sort="Sankar, Tejas" uniqKey="Sankar T" first="Tejas" last="Sankar">Tejas Sankar</name><affiliation><nlm:affiliation>5Division of Neurosurgery,Walter C. MacKenzie Health Sciences Centre,University of Alberta,Edmonton,Alberta.</nlm:affiliation><wicri:noCountry code="subField">Alberta</wicri:noCountry></affiliation></author><author><name sortKey="Picillo, Marina" sort="Picillo, Marina" uniqKey="Picillo M" first="Marina" last="Picillo">Marina Picillo</name><affiliation wicri:level="2"><nlm:affiliation>4Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease,Toronto Western Hospital,University Health Network,Toronto,Ontario.</nlm:affiliation><country>Canada</country><placeName><region type="province">Ontario</region></placeName><wicri:cityArea>4Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease,Toronto Western Hospital,University Health Network,Toronto</wicri:cityArea></affiliation></author><author><name sortKey="Munhoz, Renato P" sort="Munhoz, Renato P" uniqKey="Munhoz R" first="Renato P" last="Munhoz">Renato P. Munhoz</name><affiliation wicri:level="2"><nlm:affiliation>4Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease,Toronto Western Hospital,University Health Network,Toronto,Ontario.</nlm:affiliation><country>Canada</country><placeName><region type="province">Ontario</region></placeName><wicri:cityArea>4Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease,Toronto Western Hospital,University Health Network,Toronto</wicri:cityArea></affiliation></author><author><name sortKey="Fasano, Alfonso" sort="Fasano, Alfonso" uniqKey="Fasano A" first="Alfonso" last="Fasano">Alfonso Fasano</name><affiliation wicri:level="2"><nlm:affiliation>4Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease,Toronto Western Hospital,University Health Network,Toronto,Ontario.</nlm:affiliation><country>Canada</country><placeName><region type="province">Ontario</region></placeName><wicri:cityArea>4Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease,Toronto Western Hospital,University Health Network,Toronto</wicri:cityArea></affiliation></author><author><name sortKey="Panisset, Michel" sort="Panisset, Michel" uniqKey="Panisset M" first="Michel" last="Panisset">Michel Panisset</name><affiliation wicri:level="1"><nlm:affiliation>6Division of Neurology,Department of Medicine,Hôpital Notre-Dame,University of Montreal Health Centre,Montréal,Québec,Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>6Division of Neurology,Department of Medicine,Hôpital Notre-Dame,University of Montreal Health Centre,Montréal,Québec</wicri:regionArea><wicri:noRegion>Québec</wicri:noRegion></affiliation></author></analytic><series><title level="j">The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques</title><idno type="ISSN">0317-1671</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Brain (anatomy & histology)</term><term>Brain (physiology)</term><term>Deep Brain Stimulation (methods)</term><term>Humans</term><term>Parkinson Disease (therapy)</term></keywords><keywords scheme="MESH" qualifier="anatomy & histology" xml:lang="en"><term>Brain</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Brain</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">During the "DBS Canada Day" symposium held in Toronto July 4-5, 2014, the scientific committee invited experts to discuss three main questions on target selection for deep brain stimulation (DBS) of patients with Parkinson's disease (PD). First, is the subthalamic nucleus (STN) or the globus pallidus internus (GPi) the ideal target? In summary, both targets are equally effective in improving the motor symptoms of PD. STN allows a greater medications reduction, while GPi exerts a direct antidyskinetic effect. Second, are there further potential targets? Ventral intermediate nucleus DBS has significant long-term benefit for tremor control but insufficiently addresses other motor features of PD. DBS in the posterior subthalamic area also reduces tremor. The pedunculopontine nucleus remains an investigational target. Third, should DBS for PD be performed unilaterally, bilaterally or staged? Unilateral STN DBS can be proposed to asymmetric patients. There is no evidence that a staged bilateral approach reduces the incidence of DBS-related adverse events.</div></front></TEI><affiliations><list><country><li>Canada</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><noCountry><name sortKey="Hamani, Clement" sort="Hamani, Clement" uniqKey="Hamani C" first="Clement" last="Hamani">Clement Hamani</name><name sortKey="Honey, Christopher R" sort="Honey, Christopher R" uniqKey="Honey C" first="Christopher R" last="Honey">Christopher R. Honey</name><name sortKey="Sankar, Tejas" sort="Sankar, Tejas" uniqKey="Sankar T" first="Tejas" last="Sankar">Tejas Sankar</name></noCountry><country name="Canada"><region name="Ontario"><name sortKey="Kalia, Suneil K" sort="Kalia, Suneil K" uniqKey="Kalia S" first="Suneil K" last="Kalia">Suneil K. Kalia</name></region><name sortKey="Fasano, Alfonso" sort="Fasano, Alfonso" uniqKey="Fasano A" first="Alfonso" last="Fasano">Alfonso Fasano</name><name sortKey="Munhoz, Renato P" sort="Munhoz, Renato P" uniqKey="Munhoz R" first="Renato P" last="Munhoz">Renato P. Munhoz</name><name sortKey="Panisset, Michel" sort="Panisset, Michel" uniqKey="Panisset M" first="Michel" last="Panisset">Michel Panisset</name><name sortKey="Picillo, Marina" sort="Picillo, Marina" uniqKey="Picillo M" first="Marina" last="Picillo">Marina Picillo</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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