Tags

Type your tag names separated by a space and hit enter

Deep brain stimulation for Parkinson's disease: surgical technique and perioperative management.
Mov Disord. 2006 Jun; 21 Suppl 14:S247-58.MD

Abstract

Deep brain stimulation (DBS) is a widely accepted therapy for medically refractory Parkinson's disease (PD). Both globus pallidus internus (GPi) and subthalamic nucleus (STN) stimulation are safe and effective in improving the symptoms of PD and reducing dyskinesias. STN DBS is the most commonly performed surgery for PD as compared to GPi DBS. Ventral intermediate nucleus (Vim) DBS is infrequently used as an alternative for tremor predominant PD patients. Patient selection is critical in achieving good outcomes. Differential diagnosis should be emphasized as well as neurological and nonneurological comorbidities. Good response to a levodopa challenge is an important predictor of favorable long-term outcomes. The DBS surgery is typically performed in an awake patient and involves stereotactic frame application, CT/MRI imaging, anatomical targeting, physiological confirmation, and implantation of the DBS lead and pulse generator. Anatomical targeting consists of direct visualization of the target in MR images, formula-derived coordinates based on the anterior and posterior commissures, and reformatted anatomical stereotactic atlases. Physiological verification is achieved most commonly via microelectrode recording followed by implantation of the DBS lead and intraoperative test stimulation to assess benefits and side effects. The various aspects of DBS surgery will be presented.

Authors+Show Affiliations

Center for Neurological Restoration, Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. machada@ccf.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16810722

Citation

Machado, Andre, et al. "Deep Brain Stimulation for Parkinson's Disease: Surgical Technique and Perioperative Management." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 21 Suppl 14, 2006, pp. S247-58.
Machado A, Rezai AR, Kopell BH, et al. Deep brain stimulation for Parkinson's disease: surgical technique and perioperative management. Mov Disord. 2006;21 Suppl 14:S247-58.
Machado, A., Rezai, A. R., Kopell, B. H., Gross, R. E., Sharan, A. D., & Benabid, A. L. (2006). Deep brain stimulation for Parkinson's disease: surgical technique and perioperative management. Movement Disorders : Official Journal of the Movement Disorder Society, 21 Suppl 14, S247-58.
Machado A, et al. Deep Brain Stimulation for Parkinson's Disease: Surgical Technique and Perioperative Management. Mov Disord. 2006;21 Suppl 14:S247-58. PubMed PMID: 16810722.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Deep brain stimulation for Parkinson's disease: surgical technique and perioperative management. AU - Machado,Andre, AU - Rezai,Ali R, AU - Kopell,Brian H, AU - Gross,Robert E, AU - Sharan,Ashwini D, AU - Benabid,Alim-Louis, PY - 2006/7/1/pubmed PY - 2006/9/15/medline PY - 2006/7/1/entrez SP - S247 EP - 58 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 21 Suppl 14 N2 - Deep brain stimulation (DBS) is a widely accepted therapy for medically refractory Parkinson's disease (PD). Both globus pallidus internus (GPi) and subthalamic nucleus (STN) stimulation are safe and effective in improving the symptoms of PD and reducing dyskinesias. STN DBS is the most commonly performed surgery for PD as compared to GPi DBS. Ventral intermediate nucleus (Vim) DBS is infrequently used as an alternative for tremor predominant PD patients. Patient selection is critical in achieving good outcomes. Differential diagnosis should be emphasized as well as neurological and nonneurological comorbidities. Good response to a levodopa challenge is an important predictor of favorable long-term outcomes. The DBS surgery is typically performed in an awake patient and involves stereotactic frame application, CT/MRI imaging, anatomical targeting, physiological confirmation, and implantation of the DBS lead and pulse generator. Anatomical targeting consists of direct visualization of the target in MR images, formula-derived coordinates based on the anterior and posterior commissures, and reformatted anatomical stereotactic atlases. Physiological verification is achieved most commonly via microelectrode recording followed by implantation of the DBS lead and intraoperative test stimulation to assess benefits and side effects. The various aspects of DBS surgery will be presented. SN - 0885-3185 UR - https://www.unboundmedicine.com/medline/citation/16810722/Deep_brain_stimulation_for_Parkinson's_disease:_surgical_technique_and_perioperative_management_ L2 - https://doi.org/10.1002/mds.20959 DB - PRIME DP - Unbound Medicine ER -