Randomized trial of deep brain stimulation for Parkinson disease

Weaver, Frances M.; Follett, Kenneth A.; Stern, Matthew B.; Luo, Ping; Harris, Crystal L.; Hur, Kwan; Marks, William J.; Rothlind, Johannes C.; Sagher, Oren; Moy, Claudia S.; Pahwa, Rajesh; Burchiel, Kim J.; Hogarth, Penelope; Lai, Eugene C.; Duda, John E.; Holloway, Kathryn L.; Samii, Ali; Horn, Stacy; Bronstein, Jeff M.; Stoner, Gatana; Starr, Philip A.; Simpson, Richard K.; Baltuch, Gordon H.; Salles, Antônio De; Huang, Grant D.; Reda, Domenic J.

doi:10.1212/wnl.0b013e31825dcdc1

Cited by 404 publications

(441 citation statements)

References 29 publications

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“…The improvement in PDQ-39 was similar for both targets at 6 months (25%-GPi and 27%-STN) but diminished over time to 8% in both groups (25).…”

Section: Disclosurementioning

confidence: 73%

Quality of life and depressive symptoms in parkinson's disease after subthalamic deep brain stimulation. a 2-year follow-up study

Tykocki¹,

Szalecki²,

Koziara³

et al. 2012

Turkish Neurosurgery

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AIm:To assess the correlation between quality of life (QoL), depressive symptoms and motor signs in patients with Parkinson disease after subthalamic deep brain stimulation (DBS STN). mAterIAl and methOds: 74 patients, average age 55.6 ± 7 and duration of disease 12.3 years± 3.8, treated with l STN DBS for PD were included in the study. All patients were evaluated with (UPDRS III), (PDQ-39) (BDI) at baseline and at 6, 12, and 24-month follow up. All patients were also stratified into three groups depending on UPDRS III improvement (<30%, 30-60%, >60%). BulGulAr: Tüm ölçeklerdeki puanlar başlangıca göre önemli ölçüde azaldı. PDQ-39'daki iyileşme 6 ayda %43,3 BDI'da %25,3 ; UPDRS-III %55,5 bulundu. 24 ayda motor sonuçlar QoL sırasıyla %15,6 ve %19,6 bozuldu. BDI değişmeden kaldı. PDQ-39 için başlangıçtaki ortalama skorlar grup I'da 67,4 ± 29,7; II 64,8±32,0; III 53,4±22,0 ve BDI için, grup I'de 17,4±12,04; II 14,0±9,7; III-15,1±10,55. Puanlar 6 aylık takipte DBS'de önemli ölçüde azaldı ve ortalama değişim şöyleydi: PDQ-39, grup I %42,7, II-%40,7, III %51,6; BDI grup I %23, II %28,1, III %23,3. sOnuÇ: DBS STN sonrasında PD'de depresif belirtiler, motor bulgularda azalma ve QoL'de artış yakından ilişkilidir. QoL artışı önemli ölçüde motor belirtilere bağlıdır.

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“…The improvement in PDQ-39 was similar for both targets at 6 months (25%-GPi and 27%-STN) but diminished over time to 8% in both groups (25).…”

Section: Disclosurementioning

confidence: 73%

Quality of life and depressive symptoms in parkinson's disease after subthalamic deep brain stimulation. a 2-year follow-up study

Tykocki¹,

Szalecki²,

Koziara³

et al. 2012

Turkish Neurosurgery

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“…Stimulation of the sensorimotor STN or GPi between 30 and 100 Hz is relatively ineffective for parkinsonian features, while benefit is seen around 100 Hz and above, using stimulation amplitudes of 2-4 V and pulse widths of 60-90 μs. The available data indicate that both STN and GPi DBS in patients with PD relieve tremor, rigidity, and bradykinesia [216][217][218][219][220][221], and may improve gait and postural control in some patients [222].…”

Section: Use Of Dbs In Pdmentioning

confidence: 99%

Deep Brain Stimulation for Movement Disorders of Basal Ganglia Origin: Restoring Function or Functionality?

2016

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Deep brain stimulation (DBS) is highly effective for both hypo-and hyperkinetic movement disorders of basal ganglia origin. The clinical use of DBS is, in part, empiric, based on the experience with prior surgical ablative therapies for these disorders, and, in part, driven by scientific discoveries made decades ago. In this review, we consider anatomical and functional concepts of the basal ganglia relevant to our understanding of DBS mechanisms, as well as our current understanding of the pathophysiology of two of the most commonly DBS-treated conditions, Parkinson's disease and dystonia. Finally, we discuss the proposed mechanism(s) of action of DBS in restoring function in patients with movement disorders. The signs and symptoms of the various disorders appear to result from signature disordered activity in the basal ganglia output, which disrupts the activity in thalamocortical and brainstem networks. The available evidence suggests that the effects of DBS are strongly dependent on targeting sensorimotor portions of specific nodes of the basal gangliathalamocortical motor circuit, that is, the subthalamic nucleus and the internal segment of the globus pallidus. There is little evidence to suggest that DBS in patients with movement disorders restores normal basal ganglia functions (e.g., their role in movement or reinforcement learning). Instead, it appears that high-frequency DBS replaces the abnormal basal ganglia output with a more tolerable pattern, which helps to restore the functionality of downstream networks.

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“…High frequency deep brain stimulation of the globus pallidus internus (GPI-DBS) has been shown to elicit significant anti-parkinsonian effects superior to best medical therapy reducing tremor, bradykinesia and rigidity, and suppressing levodopa-induced dyskinesias [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Interactive effects of GPI stimulation and levodopa on postural control in Parkinson's disease

et al. 2015

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Randomized trial of deep brain stimulation for Parkinson disease

Abstract: This study provides Class III evidence that improvement of motor symptoms of PD by DBS remains stable over 3 years and does not differ by surgical target. Neurology® 2012;79:55-65.

Cited by 404 publications

References 29 publications

Quality of life and depressive symptoms in parkinson's disease after subthalamic deep brain stimulation. a 2-year follow-up study

Quality of life and depressive symptoms in parkinson's disease after subthalamic deep brain stimulation. a 2-year follow-up study

Deep Brain Stimulation for Movement Disorders of Basal Ganglia Origin: Restoring Function or Functionality?

Interactive effects of GPI stimulation and levodopa on postural control in Parkinson's disease

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