Deep Brain Stimulation of the Globus Pallidus Pars Interna and Subthalamic Nucleus in Parkinson's Disease: Pros and Cons

2008 ◽  
pp. 277-289 ◽  
Author(s):  
Jorge Guridi ◽  
Maria C. Rodriguez-Oroz ◽  
Jose A. Obeso
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Pros And Cons ◽  
Pars Interna ◽  
Deep Brain ◽  
Stimulation Of

Cognition and Depression Following Deep Brain Stimulation of the Subthalamic Nucleus and Globus Pallidus Pars Internus in Parkinson’s Disease: A Meta-Analysis

2015 ◽  
Vol 25 (4) ◽  
pp. 439-454 ◽  
Author(s):  
Hannah L. Combs ◽  
Bradley S. Folley ◽  
David T. R. Berry ◽  
Suzanne C. Segerstrom ◽  
Dong Y. Han ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Meta Analysis ◽  
Deep Brain ◽  
Stimulation Of

L-DOPA-INDUCED DYSKINESIA AND STEREOTACTIC SURGERY FOR PARKINSON'S DISEASE

Neurosurgery ◽  
2008 ◽  
Vol 62 (2) ◽  
pp. 311-325 ◽  
Author(s):  
Jorge Guridi ◽  
Jose A. Obeso ◽  
Maria C. Rodriguez-Oroz ◽  
Andres M. Lozano ◽  
Miguel Manrique
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Globus Pallidus Internus ◽  
The Impact ◽  
Deep Brain ◽  
Stimulation Of

Abstract OBJECTIVE To assess the impact of different surgical targets and techniques, such as ablation and deep brain stimulation, to treat patients with L-dopa-induced dyskinesia (LID), a major therapeutic complication of Parkinson's disease. METHODS This review analyzes the effects of early surgical procedures to treat hyperkinesia and the current methods and targets used to combat LID in Parkinson's disease, which are mainly thalamotomy, pallidotomy, and deep brain stimulation of the globus pallidus internus and the subthalamic nucleus. RESULTS Available information indicates that surgery of the globus pallidus internus and thalamus (the pallidal receiving area) and of the subthalamic nucleus has a pronounced antidyskinetic effect. This effect is associated with a concomitant improvement in the parkinsonian (“off”-medication) state. Although it is more profound with pallidal and subthalamic surgery, such an effect can also be observed to some extent with thalamic surgery. The latter is attributable to the fact that surgery of the ventralis intermedius is primarily effective for treating tremor. An integral pallidothalamic pathway is needed for dyskinesia to be expressed. Thus, LID is less frequent after subthalamotomy or deep brain stimulation of the subthalamic nucleus through a functional effect mediated by the physiological normalization of the motor system and by an indirect effect associated with a reduction in the daily dose of L-dopa. CONCLUSION Surgery is the only treatment available for Parkinson's disease that can predictably improve both the parkinsonian motor syndrome and LID. The exact mechanisms involved in these effects are not well understood. Pallidal and thalamic surgery affecting pallidal relays reduce LID frequency by disrupting the pallidothalamic circuit, probably eliminating the neuronal activity associated with dyskinesia. Alternatively, the antidyskinetic effect of subthalamic nucleus surgery may in part be attributable to a reduction in the L-dopa dose as well as to the stabilization of the basal ganglia circuits after the surgical procedure.

scholarly journals Impulsivities and Parkinson's Disease: Delay Aversion Is Not Worsened by Deep Brain Stimulation of the Subthalamic Nucleus

PLoS ONE ◽  
2012 ◽  
Vol 7 (9) ◽  
pp. e43261 ◽  
Author(s):  
Diana M. E. Torta ◽  
Vincenzo Vizzari ◽  
Lorys Castelli ◽  
Maurizio Zibetti ◽  
Michele Lanotte ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Delay Aversion ◽  
Deep Brain ◽  
Stimulation Of
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