OBJECTIVE: To provide recommendations to patients, physicians, and other health care providers on several issues involving deep brain stimulation (DBS) for Parkinson disease (PD). DATA SOURCES AND STUDY SELECTION: An international consortium of experts organized, reviewed the literature, and attended the workshop. Topics were introduced at the workshop, followed by group discussion. DATA EXTRACTION AND SYNTHESIS: A draft of a consensus statement was presented and further edited after plenary debate. The final statements were agreed on by all members. CONCLUSIONS: (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.
OBJECTIVE: To provide recommendations to patients, physicians, and other health care providers on several issues involving deep brain stimulation (DBS) for Parkinson disease (PD). DATA SOURCES AND STUDY SELECTION: An international consortium of experts organized, reviewed the literature, and attended the workshop. Topics were introduced at the workshop, followed by group discussion. DATA EXTRACTION AND SYNTHESIS: A draft of a consensus statement was presented and further edited after plenary debate. The final statements were agreed on by all members. CONCLUSIONS: (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.
Authors: Roongroj Bhidayasiri; Jeff M Bronstein; Shantanu Sinha; Scott E Krahl; Sinyeob Ahn; Eric J Behnke; Mark S Cohen; Robert Frysinger; Frank G Shellock Journal: Magn Reson Imaging Date: 2005-05 Impact factor: 2.546
Authors: Galit Kleiner-Fisman; Jan Herzog; David N Fisman; Filippo Tamma; Kelly E Lyons; Rajesh Pahwa; Anthony E Lang; Günther Deuschl Journal: Mov Disord Date: 2006-06 Impact factor: 10.338
Authors: H Russmann; J Ghika; J-G Villemure; B Robert; J Bogousslavsky; P R Burkhard; F J G Vingerhoets Journal: Neurology Date: 2004-11-23 Impact factor: 9.910
Authors: J L Houeto; V Mesnage; L Mallet; B Pillon; M Gargiulo; S Tezenas du Moncel; A M Bonnet; B Pidoux; D Dormont; P Cornu; Y Agid Journal: J Neurol Neurosurg Psychiatry Date: 2002-06 Impact factor: 10.154
Authors: Charles A Sansur; Robert C Frysinger; Nader Pouratian; Kai-Ming Fu; Markus Bittl; Rod J Oskouian; Edward R Laws; W Jeffrey Elias Journal: J Neurosurg Date: 2007-11 Impact factor: 5.115
Authors: Ruth M Pickering; Yvette A M Grimbergen; Una Rigney; Ann Ashburn; Gordon Mazibrada; Brian Wood; Peggy Gray; Graham Kerr; Bastiaan R Bloem Journal: Mov Disord Date: 2007-10-15 Impact factor: 10.338
Authors: Nathalie Van Den Berge; Vincent Keereman; Christian Vanhove; Bregt Van Nieuwenhuyse; Pieter van Mierlo; Robrecht Raedt; Kristl Vonck; Paul Boon; Roel Van Holen Journal: Mol Imaging Biol Date: 2015-06 Impact factor: 3.488
Authors: Judith Dams; Bernhard Bornschein; Jens Peter Reese; Annette Conrads-Frank; Wolfgang H Oertel; Uwe Siebert; Richard Dodel Journal: Pharmacoeconomics Date: 2011-12 Impact factor: 4.981
Authors: Eduard Minks; Pavel Jurák; Jan Chládek; Jan Chrastina; Josef Halámek; Daniel J Shaw; Martin Bareš Journal: J Neural Transm (Vienna) Date: 2014-05-09 Impact factor: 3.575