EFFICACY OF DEEP BRAIN STIMULATION
| Autor: | Crina Radu, A. Dabu, C. Tudor, D. Teleanu |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2024 |
| Předmět: | |
| Zdroj: | Romanian Neurosurgery, Vol 38, Iss Special Issue (2024) |
| Druh dokumentu: | article |
| ISSN: | 1220-8841 2344-4959 |
| DOI: | 10.33962/roneuro-2024-123 |
| Popis: | During the last decade deep brain stimulation (DBS) has been established as a highly effective surgical therapy not only for advanced Parkinson’s disease, but also for dystonia or essential tremor. It is defined as a neuromodulatory technique that delivers adjustable electrical stimuli to different key targets such as the subthalamic nucleus (STN), the internal globus pallidus (GPI) or the ventral intermediate nucleus (VIM). This comparative analysis aims to guide in tailoring individual patient profiles, optimizing outcomes by selecting the most appropriate target area based on symptomatology and patient specific factors and has the end goal to improve motor function, quality of life and diminish possible side effects. The existing clinical trials were reviewed with results that showed no significant differences between the STN-DBS and GPI-DBS groups in Unified Parkinson’s Disease Rating Scale (UPDRS) III scores within 1st year post-surgery. STN-DBS allowed greater reduction in medication dosages for patients, whereas GPI-DBS provided greater relief from psychiatric symptoms. Dyskinesia scores were also greatly improved by GPI stimulation. Moreover, for patients with dystonia, both GPIDBS and STN- DBS were successful in improving quality of life, patients with primary dystonia having a better response overall in terms of efficacy of the procedures than those with secondary dystonia. 45 cases of STN-DBS and 5 cases of GPI- DBS procedures were safely performed in our clinic using a stereotactic frame with significant motor symptoms relief and medication reduction. In conclusion, further research comparing the side effects and quality of life is needed to refine target selection criteria and to optimize long-term management of patients with Parkinson’s disease and other movement disorders. References “Deep brain stimulation of globus pallidus internus and subthalamic nucleus in Parkinson’s disease: a multicenter, retrospective study of efficacy and safety.” Aug 2023 Volume 45, pages 177–185, (2024) “Deep brain stimulation treating dystonia: a systematic review of targets, body distributions and etiology classifications.” Nov 2021 Volume 15 – 2021. https://doi.org/10.3389/fnhum.2021.757579. “STN versus GPi Deep brain stimulation for action and rest tremor in parkinson’s disease.” Oct 2020 Volume 14 – 2020. https://doi.org/10.3389/fnhum.2020.578615. “STN versus GPi Deep brain stimulation for dyskinesia improvement in advanced Parkinson’s disease: A meta-analysis of randomized controlled trials.” 2021 Feb: 201:106450. doi: 10.1016/j.clineuro.2020.106450. “Where are we with deep brain stimulation? a review of scientific publications and ongoing research.” https://doi.org/10.1159/00052137. |
| Databáze: | Directory of Open Access Journals |
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