Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson's disease.
Identifieur interne : 000941 ( Ncbi/Checkpoint ); précédent : 000940; suivant : 000942Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson's disease.
Auteurs : Alim Louis Benabid [France] ; Stephan Chabardes ; John Mitrofanis ; Pierre PollakSource :
- The Lancet. Neurology [ 1474-4422 ] ; 2009.
English descriptors
- KwdEn :
- Cohort Studies, Deep Brain Stimulation (adverse effects), Deep Brain Stimulation (contraindications), Electrodes (adverse effects), Humans, Muscle Rigidity (etiology), Muscle Rigidity (therapy), Neurosurgical Procedures (adverse effects), Parkinson Disease (complications), Parkinson Disease (psychology), Parkinson Disease (therapy), Prognosis, Quality of Life, Randomized Controlled Trials as Topic, Speech Disorders (etiology), Speech Disorders (therapy), Subthalamic Nucleus (physiology), Treatment Outcome, Tremor (etiology), Tremor (therapy).
- MESH :
- adverse effects : Deep Brain Stimulation, Electrodes, Neurosurgical Procedures.
- complications : Parkinson Disease.
- contraindications : Deep Brain Stimulation.
- etiology : Muscle Rigidity, Speech Disorders, Tremor.
- physiology : Subthalamic Nucleus.
- psychology : Parkinson Disease.
- therapy : Muscle Rigidity, Parkinson Disease, Speech Disorders, Tremor.
- Cohort Studies, Humans, Prognosis, Quality of Life, Randomized Controlled Trials as Topic, Treatment Outcome.
Abstract
High-frequency deep brain stimulation (DBS) of the subthalamic nucleus (STN-HFS) is the preferred surgical treatment for advanced Parkinson's disease. In the 15 years since its introduction into clinical practice, many studies have reported on its benefits, drawbacks, and insufficiencies. Despite limited evidence-based data, STN-HFS has been shown to be surgically safe, and improvements in dopaminergic drug-sensitive symptoms and reductions in subsequent drug dose and dyskinesias are well documented. However, the procedure is associated with adverse effects, mainly neurocognitive, and with side-effects created by spread of stimulation to surrounding structures, depending on the precise location of electrodes. Quality of life improves substantially, inducing sudden global changes in patients' lives, often requiring societal readaptation. STN-HFS is a powerful method that is currently unchallenged in the management of Parkinson's disease, but its long-term effects must be thoroughly assessed. Further improvements, through basic research and methodological innovations, should make it applicable to earlier stages of the disease and increase its availability to patients in developing countries.
DOI: 10.1016/S1474-4422(08)70291-6
PubMed: 19081516
Affiliations:
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pubmed:19081516Le document en format XML
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<front><div type="abstract" xml:lang="en">High-frequency deep brain stimulation (DBS) of the subthalamic nucleus (STN-HFS) is the preferred surgical treatment for advanced Parkinson's disease. In the 15 years since its introduction into clinical practice, many studies have reported on its benefits, drawbacks, and insufficiencies. Despite limited evidence-based data, STN-HFS has been shown to be surgically safe, and improvements in dopaminergic drug-sensitive symptoms and reductions in subsequent drug dose and dyskinesias are well documented. However, the procedure is associated with adverse effects, mainly neurocognitive, and with side-effects created by spread of stimulation to surrounding structures, depending on the precise location of electrodes. Quality of life improves substantially, inducing sudden global changes in patients' lives, often requiring societal readaptation. STN-HFS is a powerful method that is currently unchallenged in the management of Parkinson's disease, but its long-term effects must be thoroughly assessed. Further improvements, through basic research and methodological innovations, should make it applicable to earlier stages of the disease and increase its availability to patients in developing countries.</div>
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