Northwestern Medical Journal (Feb 2023)
Deep brain stimulation in idiopathic Parkinson’s disease
Abstract
Parkinson’s disease (PD) is the second most common neurodegenerative and progressive neurological disorder characterized by tremors, rigidity, bradykinesia, and postural instability. Changes of disease in PD pathophysiology are observed in melanin-containing dopaminergic cells in the substantia nigra. While neuronal loss and gliosis are observed in this region, the remaining neurons may contain cytoplasmic inclusions called Lewy bodies. Deep Brain Stimulation (DBS), is the method of application with the highest patient satisfaction among device-assisted treatments in advanced PD. The DBS method is frequently preferred in cases where the disease progresses, drug treatment does not respond, and freezing and on-off dyskinesias begin. The most preferred method among these is subthalamic nucleus (STN) DBS. DBS treatment improves not only motor symptoms but also non-motor symptoms. The success of DBS is based on adequate response to levodopa, appropriate patient selection, successful neuroanatomical and radiological localization of the target area, and a team experienced in motion sickness. Many studies are being conducted to understand the mechanism of action of deep brain stimulation, the effectiveness of which has been proven by various studies. The excitation and suppressive effects provided by the electrodes are processed with a complex neuronal network and clinical results are obtained. In this article, deep brain stimulation tricks, choosing appropriate patients, and mechanisms of action in Parkinson’s disease will be summarized.
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