New targets for DBS.
Identifieur interne : 001093 ( Main/Exploration ); précédent : 001092; suivant : 001094New targets for DBS.
Auteurs : Alim Louis Benabid [France] ; Napoleon TorresSource :
- Parkinsonism & related disorders [ 1873-5126 ] ; 2012.
English descriptors
- KwdEn :
- Animals, Deep Brain Stimulation (methods), Humans, Hypothalamic Area, Lateral (physiology), Obesity (physiopathology), Obesity (therapy), Obsessive-Compulsive Disorder (physiopathology), Obsessive-Compulsive Disorder (therapy), Parkinson Disease (physiopathology), Parkinson Disease (therapy), Subthalamic Nucleus (physiology), Ventromedial Hypothalamic Nucleus (physiology).
- MESH :
- methods : Deep Brain Stimulation.
- physiology : Hypothalamic Area, Lateral, Subthalamic Nucleus, Ventromedial Hypothalamic Nucleus.
- physiopathology : Obesity, Obsessive-Compulsive Disorder, Parkinson Disease.
- therapy : Obesity, Obsessive-Compulsive Disorder, Parkinson Disease.
- Animals, Humans.
Abstract
The specific effect of DBS at high frequency, discovered during a VIM thalamotomy, was extended to the older targets of ablative neurosurgery such as the pallidum, for tremor in Parkinson's disease (PD), dyskinesias, essential tremor, as well as the internal capsule to treat psychiatric disorders (OCD). A second wave of targets came from basic research, enabled by the low morbidity, reversibility, and adaptability of DBS. This was the case for the subthalamic nucleus (STN) which improves the triad of dopaminergic symptoms, and the pedunculopontine nucleus (PPN) for gait disorders in PD. The new concepts of the role of basal ganglia in psychiatric disorders indicate the subgenual cortex CG 25 for severe resistant depression, the accumbens nucleus for depression, anorexia nervosa, and addiction, and the thalamus intralaminar nuclei for minimally conscious states. Serendipity and a scientific approach have provided several instances where targets have produced unexpected effects (such as STN in OCD), as well as limbic effects observed during attempts at VMH stimulation for obesity: this might offer a novel way to treat mild cognitive impairment, or memory deficits reported in Alzheimer's disease. While these might provide solutions for as yet unsolved problems, attention must be paid to ethical considerations.
DOI: 10.1016/S1353-8020(11)70009-8
PubMed: 22166437
Affiliations:
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Le document en format XML
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<front><div type="abstract" xml:lang="en">The specific effect of DBS at high frequency, discovered during a VIM thalamotomy, was extended to the older targets of ablative neurosurgery such as the pallidum, for tremor in Parkinson's disease (PD), dyskinesias, essential tremor, as well as the internal capsule to treat psychiatric disorders (OCD). A second wave of targets came from basic research, enabled by the low morbidity, reversibility, and adaptability of DBS. This was the case for the subthalamic nucleus (STN) which improves the triad of dopaminergic symptoms, and the pedunculopontine nucleus (PPN) for gait disorders in PD. The new concepts of the role of basal ganglia in psychiatric disorders indicate the subgenual cortex CG 25 for severe resistant depression, the accumbens nucleus for depression, anorexia nervosa, and addiction, and the thalamus intralaminar nuclei for minimally conscious states. Serendipity and a scientific approach have provided several instances where targets have produced unexpected effects (such as STN in OCD), as well as limbic effects observed during attempts at VMH stimulation for obesity: this might offer a novel way to treat mild cognitive impairment, or memory deficits reported in Alzheimer's disease. While these might provide solutions for as yet unsolved problems, attention must be paid to ethical considerations.</div>
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