TY - JOUR
T1 - Current Practice and the Future of Deep Brain Stimulation Therapy in Parkinson's Disease
AU - Almeida, Leonardo
AU - Deeb, Wissam
AU - Spears, Chauncey
AU - Opri, Enrico
AU - Molina, Rene
AU - Martinez-Ramirez, Daniel
AU - Gunduz, Aysegul
AU - Hess, Christopher W.
AU - Okun, Michael S.
N1 - Publisher Copyright:
© 2017 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Deep brain stimulation (DBS) is an effective therapy for Parkinson's disease patients experiencing motor fluctuations, medication-resistant tremor, and/or dyskinesia. Currently, the subthalamic nucleus and the globus pallidus internus are the two most widely used targets, with individual advantages and disadvantages influencing patient selection. Potential DBS patients are selected using the few existing guidelines and the available DBS literature, and many centers employ an interdisciplinary team review of the individual's risk-benefit profile. Programmed settings vary based on institution- or physician-specific protocols designed to maximize benefits and limit adverse effects. Expectations should be realistic and clearly defined during the evaluation process, and each bothersome symptom should be addressed in the context of building the risk-benefit profile. Current DBS research is focused on improved symptom control, the development of newer technologies, and the improved efficiency of stimulation delivery. Techniques deliver stimulation in a more personalized way, and methods of adaptive DBS such as closed-loop approaches are already on the horizon.
AB - Deep brain stimulation (DBS) is an effective therapy for Parkinson's disease patients experiencing motor fluctuations, medication-resistant tremor, and/or dyskinesia. Currently, the subthalamic nucleus and the globus pallidus internus are the two most widely used targets, with individual advantages and disadvantages influencing patient selection. Potential DBS patients are selected using the few existing guidelines and the available DBS literature, and many centers employ an interdisciplinary team review of the individual's risk-benefit profile. Programmed settings vary based on institution- or physician-specific protocols designed to maximize benefits and limit adverse effects. Expectations should be realistic and clearly defined during the evaluation process, and each bothersome symptom should be addressed in the context of building the risk-benefit profile. Current DBS research is focused on improved symptom control, the development of newer technologies, and the improved efficiency of stimulation delivery. Techniques deliver stimulation in a more personalized way, and methods of adaptive DBS such as closed-loop approaches are already on the horizon.
KW - Parkinson's disease
KW - closed-loop
KW - deep brain stimulation
UR - http://www.scopus.com/inward/record.url?scp=85019425433&partnerID=8YFLogxK
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U2 - 10.1055/s-0037-1601893
DO - 10.1055/s-0037-1601893
M3 - Article
C2 - 28511261
AN - SCOPUS:85019425433
SN - 0271-8235
VL - 37
SP - 205
EP - 214
JO - Seminars in Neurology
JF - Seminars in Neurology
IS - 2
ER -