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Lateralized effects of deep brain stimulation in Parkinson’s disease: evidence and controversies

The bilateral effects of deep brain stimulation (DBS) on motor and non-motor symptoms of Parkinson’s disease (PD) have been extensively studied and reviewed. However, the unilateral effects—in particular, the potential lateralized effects of left- versus right-sided DBS—have not been adequately reco...

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Autores principales: Lin, Zhengyu, Zhang, Chencheng, Li, Dianyou, Sun, Bomin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298477/
https://www.ncbi.nlm.nih.gov/pubmed/34294724
http://dx.doi.org/10.1038/s41531-021-00209-3
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author Lin, Zhengyu
Zhang, Chencheng
Li, Dianyou
Sun, Bomin
author_facet Lin, Zhengyu
Zhang, Chencheng
Li, Dianyou
Sun, Bomin
author_sort Lin, Zhengyu
collection PubMed
description The bilateral effects of deep brain stimulation (DBS) on motor and non-motor symptoms of Parkinson’s disease (PD) have been extensively studied and reviewed. However, the unilateral effects—in particular, the potential lateralized effects of left- versus right-sided DBS—have not been adequately recognized or studied. Here we summarized the current evidence and controversies in the literature regarding the lateralized effects of DBS on motor and non-motor outcomes in PD patients. Publications in English language before February 2021 were obtained from the PubMed database and included if they directly compared the effects of unilateral versus contralateral side DBS on motor or non-motor outcomes in PD. The current literature is overall of low-quality and is biased by various confounders. Researchers have investigated mainly PD patients receiving subthalamic nucleus (STN) DBS while the potential lateralized effects of globus pallidus interna (GPi) DBS have not been adequately studied. Evidence suggests potential lateralized effects of STN DBS on axial motor symptoms and deleterious effects of left-sided DBS on language-related functions, in particular, the verbal fluency, in PD. The lateralized DBS effects on appendicular motor symptoms as well as other neurocognitive and neuropsychiatric domains remain inconclusive. Future studies should control for varying methodological approaches as well as clinical and DBS management heterogeneities, including symptom laterality, stimulation parameters, location of active contacts, and lead trajectories. This would contribute to improved treatment strategies such as personalized target selection, surgical planning, and postoperative management that ultimately benefit patients.
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spelling pubmed-82984772021-08-05 Lateralized effects of deep brain stimulation in Parkinson’s disease: evidence and controversies Lin, Zhengyu Zhang, Chencheng Li, Dianyou Sun, Bomin NPJ Parkinsons Dis Review Article The bilateral effects of deep brain stimulation (DBS) on motor and non-motor symptoms of Parkinson’s disease (PD) have been extensively studied and reviewed. However, the unilateral effects—in particular, the potential lateralized effects of left- versus right-sided DBS—have not been adequately recognized or studied. Here we summarized the current evidence and controversies in the literature regarding the lateralized effects of DBS on motor and non-motor outcomes in PD patients. Publications in English language before February 2021 were obtained from the PubMed database and included if they directly compared the effects of unilateral versus contralateral side DBS on motor or non-motor outcomes in PD. The current literature is overall of low-quality and is biased by various confounders. Researchers have investigated mainly PD patients receiving subthalamic nucleus (STN) DBS while the potential lateralized effects of globus pallidus interna (GPi) DBS have not been adequately studied. Evidence suggests potential lateralized effects of STN DBS on axial motor symptoms and deleterious effects of left-sided DBS on language-related functions, in particular, the verbal fluency, in PD. The lateralized DBS effects on appendicular motor symptoms as well as other neurocognitive and neuropsychiatric domains remain inconclusive. Future studies should control for varying methodological approaches as well as clinical and DBS management heterogeneities, including symptom laterality, stimulation parameters, location of active contacts, and lead trajectories. This would contribute to improved treatment strategies such as personalized target selection, surgical planning, and postoperative management that ultimately benefit patients. Nature Publishing Group UK 2021-07-22 /pmc/articles/PMC8298477/ /pubmed/34294724 http://dx.doi.org/10.1038/s41531-021-00209-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Review Article
Lin, Zhengyu
Zhang, Chencheng
Li, Dianyou
Sun, Bomin
Lateralized effects of deep brain stimulation in Parkinson’s disease: evidence and controversies
title Lateralized effects of deep brain stimulation in Parkinson’s disease: evidence and controversies
title_full Lateralized effects of deep brain stimulation in Parkinson’s disease: evidence and controversies
title_fullStr Lateralized effects of deep brain stimulation in Parkinson’s disease: evidence and controversies
title_full_unstemmed Lateralized effects of deep brain stimulation in Parkinson’s disease: evidence and controversies
title_short Lateralized effects of deep brain stimulation in Parkinson’s disease: evidence and controversies
title_sort lateralized effects of deep brain stimulation in parkinson’s disease: evidence and controversies
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298477/
https://www.ncbi.nlm.nih.gov/pubmed/34294724
http://dx.doi.org/10.1038/s41531-021-00209-3
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