Deep brain stimulation for Parkinson's disease: Surgical technique and perioperative management
Identifieur interne : 000377 ( France/Analysis ); précédent : 000376; suivant : 000378Deep brain stimulation for Parkinson's disease: Surgical technique and perioperative management
Auteurs : Andre Machado [États-Unis] ; Ali R. Rezai [États-Unis] ; Brian H. Kopell [États-Unis] ; Robert E. Gross [États-Unis] ; Ashwini D. Sharan [États-Unis] ; Alim-Louis Benabid [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2006-06.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Chirurgie.
English descriptors
- KwdEn :
- Antiparkinson Agents (therapeutic use), Brain (anatomy & histology), Brain (surgery), Brain Mapping (methods), Clinical management, Deep Brain Stimulation (methods), Deep brain stimulation, Diagnosis, Differential, Electrodes, Implanted, Functional Laterality (physiology), Humans, Levodopa (therapeutic use), Magnetic Resonance Imaging, Nervous system diseases, Neuromodulation, Neurosurgical Procedures (methods), Parkinson Disease (diagnosis), Parkinson Disease (drug therapy), Parkinson Disease (therapy), Parkinson disease, Parkinson's disease, Patient Selection, Perioperative, Postoperative Care, Preoperative Care, Stereotaxic Techniques, Surgery, Technique, deep brain stimulation (DBS), neuromodulation, stereotaxis.
- MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- anatomy & histology : Brain.
- diagnosis : Parkinson Disease.
- drug therapy : Parkinson Disease.
- methods : Brain Mapping, Deep Brain Stimulation, Neurosurgical Procedures.
- physiology : Functional Laterality.
- surgery : Brain.
- therapy : Parkinson Disease.
- Diagnosis, Differential, Electrodes, Implanted, Humans, Magnetic Resonance Imaging, Patient Selection, Postoperative Care, Preoperative Care, Stereotaxic Techniques.
Abstract
Deep brain stimulation (DBS) is a widely accepted therapy for medically refractory Parkinson's disease (PD). Both globus pallidus internus (GPi) and subthalamic nucleus (STN) stimulation are safe and effective in improving the symptoms of PD and reducing dyskinesias. STN DBS is the most commonly performed surgery for PD as compared to GPi DBS. Ventral intermediate nucleus (Vim) DBS is infrequently used as an alternative for tremor predominant PD patients. Patient selection is critical in achieving good outcomes. Differential diagnosis should be emphasized as well as neurological and nonneurological comorbidities. Good response to a levodopa challenge is an important predictor of favorable long‐term outcomes. The DBS surgery is typically performed in an awake patient and involves stereotactic frame application, CT/MRI imaging, anatomical targeting, physiological confirmation, and implantation of the DBS lead and pulse generator. Anatomical targeting consists of direct visualization of the target in MR images, formula‐derived coordinates based on the anterior and posterior commissures, and reformatted anatomical stereotactic atlases. Physiological verification is achieved most commonly via microelectrode recording followed by implantation of the DBS lead and intraoperative test stimulation to assess benefits and side effects. The various aspects of DBS surgery will be presented. © 2006 Movement Disorder Society
Url:
- https://api.istex.fr/document/C0295B22031412D6423ED6BFAD1B1AF7792214A4/fulltext/pdf
- http://www.hal.inserm.fr/inserm-00390678
DOI: 10.1002/mds.20959
Affiliations:
- France, États-Unis
- Auvergne-Rhône-Alpes, Géorgie (États-Unis), Ohio, Pennsylvanie, Rhône-Alpes, Wisconsin
- Grenoble
- Centre hospitalier universitaire Grenoble Alpes
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<term>Deep Brain Stimulation (methods)</term>
<term>Deep brain stimulation</term>
<term>Diagnosis, Differential</term>
<term>Electrodes, Implanted</term>
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<term>Levodopa (therapeutic use)</term>
<term>Magnetic Resonance Imaging</term>
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<term>Parkinson Disease (diagnosis)</term>
<term>Parkinson Disease (drug therapy)</term>
<term>Parkinson Disease (therapy)</term>
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<term>Parkinson's disease</term>
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<term>Preoperative Care</term>
<term>Stereotaxic Techniques</term>
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<front><div type="abstract" xml:lang="en">Deep brain stimulation (DBS) is a widely accepted therapy for medically refractory Parkinson's disease (PD). Both globus pallidus internus (GPi) and subthalamic nucleus (STN) stimulation are safe and effective in improving the symptoms of PD and reducing dyskinesias. STN DBS is the most commonly performed surgery for PD as compared to GPi DBS. Ventral intermediate nucleus (Vim) DBS is infrequently used as an alternative for tremor predominant PD patients. Patient selection is critical in achieving good outcomes. Differential diagnosis should be emphasized as well as neurological and nonneurological comorbidities. Good response to a levodopa challenge is an important predictor of favorable long‐term outcomes. The DBS surgery is typically performed in an awake patient and involves stereotactic frame application, CT/MRI imaging, anatomical targeting, physiological confirmation, and implantation of the DBS lead and pulse generator. Anatomical targeting consists of direct visualization of the target in MR images, formula‐derived coordinates based on the anterior and posterior commissures, and reformatted anatomical stereotactic atlases. Physiological verification is achieved most commonly via microelectrode recording followed by implantation of the DBS lead and intraoperative test stimulation to assess benefits and side effects. The various aspects of DBS surgery will be presented. © 2006 Movement Disorder Society</div>
</front>
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<name sortKey="Rezai, Ali R" sort="Rezai, Ali R" uniqKey="Rezai A" first="Ali R." last="Rezai">Ali R. Rezai</name>
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<country name="France"><noRegion><name sortKey="Benabid, Alim Ouis" sort="Benabid, Alim Ouis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name>
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