Neurológia pre prax 5/2013

Deep brain stimulation in Parkinson´s disease

Deep brain stimulation is a neuromodulation therapy of late motor complications of Parkinson´s disease in suitable patient candidates. The most widely used anatomical target for DBS is the subthalamic nucleus. Effect of stimulation is reflected by the substantial improvement of the UPDRS III score – of about 30 to 70 %. The dopaminergic medication can usually be decreased by about 50 %, thanks to good effect of the procedure on motor function of PD patients. The intensity and duration of dyskinesias is usually reduced by about 60–70 %, off states by 60 %. DBS also significantly improves the quality of life. The globus pallidum internum can be considered as an alternative target. The indication, operation and neurostimulator setting are usually organised by a specialised multidisciplinary team. The future of DBS lays probably in operating on patients at an earlier stage, in new targets and processes that may improve the quality of the procedure (neuroimaging, advanced electrophysiology techniques).

Keywords: deep brain stimulation, Parkinson´s disease, deep brain stimulation targets.