Deep Brain Stimulation for Parkinson Disease
Identifieur interne : 000C30 ( Ncbi/Checkpoint ); précédent : 000C29; suivant : 000C31Deep Brain Stimulation for Parkinson Disease
Auteurs : Jeff M. Bronstein ; Michele Tagliati ; Ron L. Alterman ; Andres M. Lozano ; Jens Volkmann ; Alessandro Stefani ; Fay B. Horak ; Michael S. Okun ; Kelly D. Foote ; Paul Krack ; Rajesh Pahwa ; Jaimie M. Henderson ; Marwan I. Hariz ; Roy A. Bakay ; Ali Rezai ; William J. Marks ; Elena Moro ; Jerrold L. Vitek ; Frances M. Weaver ; Robert E. Gross ; Mahlon R. DelongSource :
- Archives of neurology [ 0003-9942 ] ; 2010.
Abstract
To provide recommendations to patients, physicians, and other health care providers on several issues involving deep brain stimulation (DBS) for Parkinson disease (PD).
An international consortium of experts organized, reviewed the literature, and attended the workshop. Topics were introduced at the workshop, followed by group discussion.
A draft of a consensus statement was presented and further edited after plenary debate. The final statements were agreed on by all members.
(1) Patients with PD without significant active cognitive or psychiatric problems who have medically intractable motor fluctuations, intractable tremor, or intolerance of medication adverse effects are good candidates for DBS. (2) Deep brain stimulation surgery is best performed by an experienced neurosurgeon with expertise in stereotactic neurosurgery who is working as part of a interprofessional team. (3) Surgical complication rates are extremely variable, with infection being the most commonly reported complication of DBS. (4) Deep brain stimulation programming is best accomplished by a highly trained clinician and can take 3 to 6 months to obtain optimal results. (5) Deep brain stimulation improves levodopa-responsive symptoms, dyskinesia, and tremor; benefits seem to be long-lasting in many motor domains. (6) Subthalamic nuclei DBS may be complicated by increased depression, apathy, impulsivity, worsened verbal fluency, and executive dysfunction in a subset of patients. (7) Both globus pallidus pars interna and subthalamic nuclei DBS have been shown to be effective in addressing the motor symptoms of PD. (8) Ablative therapy is still an effective alternative and should be considered in a select group of appropriate patients.
Url:
DOI: 10.1001/archneurol.2010.260
PubMed: 20937936
PubMed Central: 4523130
Affiliations:
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<author><name sortKey="Tagliati, Michele" sort="Tagliati, Michele" uniqKey="Tagliati M" first="Michele" last="Tagliati">Michele Tagliati</name>
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<author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name>
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<author><name sortKey="Bronstein, Jeff M" sort="Bronstein, Jeff M" uniqKey="Bronstein J" first="Jeff M." last="Bronstein">Jeff M. Bronstein</name>
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<author><name sortKey="Tagliati, Michele" sort="Tagliati, Michele" uniqKey="Tagliati M" first="Michele" last="Tagliati">Michele Tagliati</name>
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<author><name sortKey="Alterman, Ron L" sort="Alterman, Ron L" uniqKey="Alterman R" first="Ron L." last="Alterman">Ron L. Alterman</name>
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<author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name>
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<author><name sortKey="Volkmann, Jens" sort="Volkmann, Jens" uniqKey="Volkmann J" first="Jens" last="Volkmann">Jens Volkmann</name>
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<author><name sortKey="Stefani, Alessandro" sort="Stefani, Alessandro" uniqKey="Stefani A" first="Alessandro" last="Stefani">Alessandro Stefani</name>
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<author><name sortKey="Foote, Kelly D" sort="Foote, Kelly D" uniqKey="Foote K" first="Kelly D." last="Foote">Kelly D. Foote</name>
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<author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name>
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<author><name sortKey="Pahwa, Rajesh" sort="Pahwa, Rajesh" uniqKey="Pahwa R" first="Rajesh" last="Pahwa">Rajesh Pahwa</name>
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<author><name sortKey="Henderson, Jaimie M" sort="Henderson, Jaimie M" uniqKey="Henderson J" first="Jaimie M." last="Henderson">Jaimie M. Henderson</name>
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<author><name sortKey="Rezai, Ali" sort="Rezai, Ali" uniqKey="Rezai A" first="Ali" last="Rezai">Ali Rezai</name>
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<author><name sortKey="Marks, William J" sort="Marks, William J" uniqKey="Marks W" first="William J." last="Marks">William J. Marks</name>
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<author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name>
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<author><name sortKey="Vitek, Jerrold L" sort="Vitek, Jerrold L" uniqKey="Vitek J" first="Jerrold L." last="Vitek">Jerrold L. Vitek</name>
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<author><name sortKey="Weaver, Frances M" sort="Weaver, Frances M" uniqKey="Weaver F" first="Frances M." last="Weaver">Frances M. Weaver</name>
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<author><name sortKey="Gross, Robert E" sort="Gross, Robert E" uniqKey="Gross R" first="Robert E." last="Gross">Robert E. Gross</name>
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<series><title level="j">Archives of neurology</title>
<idno type="ISSN">0003-9942</idno>
<idno type="eISSN">1538-3687</idno>
<imprint><date when="2010">2010</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P1">To provide recommendations to patients, physicians, and other health care providers on several issues involving deep brain stimulation (DBS) for Parkinson disease (PD).</p>
</sec>
<sec id="S2"><title>Data Sources and Study Selection</title>
<p id="P2">An international consortium of experts organized, reviewed the literature, and attended the workshop. Topics were introduced at the workshop, followed by group discussion.</p>
</sec>
<sec id="S3"><title>Data Extraction and Synthesis</title>
<p id="P3">A draft of a consensus statement was presented and further edited after plenary debate. The final statements were agreed on by all members.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">(1) Patients with PD without significant active cognitive or psychiatric problems who have medically intractable motor fluctuations, intractable tremor, or intolerance of medication adverse effects are good candidates for DBS. (2) Deep brain stimulation surgery is best performed by an experienced neurosurgeon with expertise in stereotactic neurosurgery who is working as part of a interprofessional team. (3) Surgical complication rates are extremely variable, with infection being the most commonly reported complication of DBS. (4) Deep brain stimulation programming is best accomplished by a highly trained clinician and can take 3 to 6 months to obtain optimal results. (5) Deep brain stimulation improves levodopa-responsive symptoms, dyskinesia, and tremor; benefits seem to be long-lasting in many motor domains. (6) Subthalamic nuclei DBS may be complicated by increased depression, apathy, impulsivity, worsened verbal fluency, and executive dysfunction in a subset of patients. (7) Both globus pallidus pars interna and subthalamic nuclei DBS have been shown to be effective in addressing the motor symptoms of PD. (8) Ablative therapy is still an effective alternative and should be considered in a select group of appropriate patients.</p>
</sec>
</div>
</front>
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<affiliations><list></list>
<tree><noCountry><name sortKey="Alterman, Ron L" sort="Alterman, Ron L" uniqKey="Alterman R" first="Ron L." last="Alterman">Ron L. Alterman</name>
<name sortKey="Bakay, Roy A" sort="Bakay, Roy A" uniqKey="Bakay R" first="Roy A." last="Bakay">Roy A. Bakay</name>
<name sortKey="Bronstein, Jeff M" sort="Bronstein, Jeff M" uniqKey="Bronstein J" first="Jeff M." last="Bronstein">Jeff M. Bronstein</name>
<name sortKey="Delong, Mahlon R" sort="Delong, Mahlon R" uniqKey="Delong M" first="Mahlon R." last="Delong">Mahlon R. Delong</name>
<name sortKey="Foote, Kelly D" sort="Foote, Kelly D" uniqKey="Foote K" first="Kelly D." last="Foote">Kelly D. Foote</name>
<name sortKey="Gross, Robert E" sort="Gross, Robert E" uniqKey="Gross R" first="Robert E." last="Gross">Robert E. Gross</name>
<name sortKey="Hariz, Marwan I" sort="Hariz, Marwan I" uniqKey="Hariz M" first="Marwan I." last="Hariz">Marwan I. Hariz</name>
<name sortKey="Henderson, Jaimie M" sort="Henderson, Jaimie M" uniqKey="Henderson J" first="Jaimie M." last="Henderson">Jaimie M. Henderson</name>
<name sortKey="Horak, Fay B" sort="Horak, Fay B" uniqKey="Horak F" first="Fay B." last="Horak">Fay B. Horak</name>
<name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name>
<name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name>
<name sortKey="Marks, William J" sort="Marks, William J" uniqKey="Marks W" first="William J." last="Marks">William J. Marks</name>
<name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name>
<name sortKey="Okun, Michael S" sort="Okun, Michael S" uniqKey="Okun M" first="Michael S." last="Okun">Michael S. Okun</name>
<name sortKey="Pahwa, Rajesh" sort="Pahwa, Rajesh" uniqKey="Pahwa R" first="Rajesh" last="Pahwa">Rajesh Pahwa</name>
<name sortKey="Rezai, Ali" sort="Rezai, Ali" uniqKey="Rezai A" first="Ali" last="Rezai">Ali Rezai</name>
<name sortKey="Stefani, Alessandro" sort="Stefani, Alessandro" uniqKey="Stefani A" first="Alessandro" last="Stefani">Alessandro Stefani</name>
<name sortKey="Tagliati, Michele" sort="Tagliati, Michele" uniqKey="Tagliati M" first="Michele" last="Tagliati">Michele Tagliati</name>
<name sortKey="Vitek, Jerrold L" sort="Vitek, Jerrold L" uniqKey="Vitek J" first="Jerrold L." last="Vitek">Jerrold L. Vitek</name>
<name sortKey="Volkmann, Jens" sort="Volkmann, Jens" uniqKey="Volkmann J" first="Jens" last="Volkmann">Jens Volkmann</name>
<name sortKey="Weaver, Frances M" sort="Weaver, Frances M" uniqKey="Weaver F" first="Frances M." last="Weaver">Frances M. Weaver</name>
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