Neurosurgery at an earlier stage of Parkinson disease

Schüpbach, W. M. Michael; Maltête, David; Houeto, Jean Luc; Montcel, Sophie Tezenas du; Mallet, Luc; Welter, Marie Laure; Gargiulo, Marcela; Béhar, C.; Bonnet, Anne Marie; Czernecki, Virginie; Pidoux, B.; Navarro, Soledad; Dormont, Didier; Cornu, Philippe; Agid, Yves

doi:10.1212/01.wnl.0000250253.03919.fb

Cited by 223 publications

(152 citation statements)

References 27 publications

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“…A multicenter study is in progress to evaluate the effect of STN DBS earlier in the course of the disease. 92 The potential and expected benefits of an earlier DBS approach should be to improve not only motor disability but also quality of life, by treating patients before personal, social, and professional degradation occurs.…”

Section: Patient Selectionmentioning

confidence: 99%

Deep Brain Stimulation for Parkinson’s Disease

2008

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Summary:The surgical treatment of Parkinson's disease has been through a revival phase over the last 20 years with the development of deep brain stimulation (DBS). Thalamic DBS was developed first and has proven to be a very effective treatment for tremor. The limitation is the lack of effect on other symptoms. Other targets were therefore investigated, and the procedure was applied to the subthalamic nucleus (STN) and the internal globus pallidus (GPi). STN stimulation can improve a wide range of symptoms and is currently the preferred target for many patients. Nevertheless, the morbidity seems higher than with other targets, and the selection criteria have to be quite strict. When STN DBS is not advised, thalamic DBS remains an option for patients with severe tremor, and GPi stimulation for those with severe dyskinesias. DBS remains a symptomatic treatment for a limited number of patients; it does not seem to alter the disease progression, and many patients are not suitable. There is, therefore, the need for further research into other targets and other approaches.

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Section: Patient Selectionmentioning

confidence: 99%

Deep Brain Stimulation for Parkinson’s Disease

2008

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“…Casos mais avançados da doença, refratários ao tratamento farmacológico, frequentemente recebem indicação para intervenções cirúrgicas, que consistem da lesão de regiões cerebrais profundas ou do implante de eletrodos para estimulação elétrica das mesmas regiões, uma abordagem conhecida como marca-passo neural. Embora os mecanismos responsáveis por tais tratamentos não estejam ainda esclarecidos, sua adoção pode chegar a praticamente eliminar certos sintomas motores da doença (Schupbach, 2007). Podem acarretar, entretanto, o aparecimento de efeitos colaterais negativos, como alucinações, déficits cognitivos, depressão e mudanças de personalidade.…”

Section: A Conquista Da Velhiceunclassified

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Ribeiro

2013

Estud. av.

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No encontro entre matemática, física, química, biologia, psicologias, filosofia e artes, as neurociências fascinam o público pela possibilidade de compreensão dos mecanismos das emoções, pensamentos e ações, doenças e loucuras, aprendizado e esquecimento, sonhos e imaginação, fenômenos que nos definem e constituem. Como interpretar as novas descobertas das neurociências? O presente artigo aborda alguns tópicos de amplo interesse social: o envelhecimento, a educação, as drogas, o retorno científico à psicanálise e o problema da consciência.

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“…After subthalamic implants, a number of studies showed in Parkinsonian patients a postoperative improvement of anxiety (Daniele et al, 2003;Houeto et al, 2006;Kalteis et al, 2006;Schupbach et al, 2007) or no change in anxiety symptoms (Drapier et al , 2006;York et al, 2008), while other studies reported the appearance or the worsening of anxiety (Rodriguez-Oroz et al 2005;Castelli et al, 2006).…”

Section: Anxiety: Clinical Presentation Evolution and Pathophysiologymentioning

confidence: 99%