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Deep Brain Stimulation in the Treatment of Parkinson’s Disease

Parkinson’s disease (PD) is a common progressive neurodegenerative movement disorder. The cardinal feature of Parkinson's is neuronal degeneration causing a dopamine deficit in the brain which leads to a host of clinical features in the patient. However, consensus over specific clinical criteri...

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Autores principales: Shah, Heeya, Usman, Omer, Ur Rehman, Habib, Jhaveri, Sharan, Avanthika, Chaithanya, Hussain, Kamran, Islam, Hamza, I.S.K, Sailesh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531694/
https://www.ncbi.nlm.nih.gov/pubmed/36211107
http://dx.doi.org/10.7759/cureus.28760
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author Shah, Heeya
Usman, Omer
Ur Rehman, Habib
Jhaveri, Sharan
Avanthika, Chaithanya
Hussain, Kamran
Islam, Hamza
I.S.K, Sailesh
author_facet Shah, Heeya
Usman, Omer
Ur Rehman, Habib
Jhaveri, Sharan
Avanthika, Chaithanya
Hussain, Kamran
Islam, Hamza
I.S.K, Sailesh
author_sort Shah, Heeya
collection PubMed
description Parkinson’s disease (PD) is a common progressive neurodegenerative movement disorder. The cardinal feature of Parkinson's is neuronal degeneration causing a dopamine deficit in the brain which leads to a host of clinical features in the patient. However, consensus over specific clinical criteria for diagnosis remains to be established. Parkinson’s does not have a cure yet, but a variety of diagnostic and treatment protocols have been developed over the years with a primary focus on pharmacological therapy. Anti-parkinsonian drugs such as levodopa lose their efficacy over time and are needed in higher doses as the disease inevitably progresses. An alternative to pharmacological therapy is deep brain stimulation (DBS). Deep brain stimulation involves transcranial placement of unilateral or bilateral leads (wires) most commonly in the sub-thalamic nucleus or the globus pallidus interna of the brain by stereotactic surgery. Given the multiple hypotheses explaining the different effects of DBS with sometimes conflicting mechanisms, it is difficult to pinpoint the exact way in which DBS operates. Nevertheless, it has proven to be significantly effective. DBS, although being a cost-effective treatment measure for Parkinson's patients, is not without limitations. A careful selection of patients is required preoperatively that determines the response and tolerance to the therapy in patients. This review aims to summarize the current literature on DBS in Parkinson's with a focus on the hypothesized mechanisms, selection criteria, advantages and its limitations.
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spelling pubmed-95316942022-10-06 Deep Brain Stimulation in the Treatment of Parkinson’s Disease Shah, Heeya Usman, Omer Ur Rehman, Habib Jhaveri, Sharan Avanthika, Chaithanya Hussain, Kamran Islam, Hamza I.S.K, Sailesh Cureus Internal Medicine Parkinson’s disease (PD) is a common progressive neurodegenerative movement disorder. The cardinal feature of Parkinson's is neuronal degeneration causing a dopamine deficit in the brain which leads to a host of clinical features in the patient. However, consensus over specific clinical criteria for diagnosis remains to be established. Parkinson’s does not have a cure yet, but a variety of diagnostic and treatment protocols have been developed over the years with a primary focus on pharmacological therapy. Anti-parkinsonian drugs such as levodopa lose their efficacy over time and are needed in higher doses as the disease inevitably progresses. An alternative to pharmacological therapy is deep brain stimulation (DBS). Deep brain stimulation involves transcranial placement of unilateral or bilateral leads (wires) most commonly in the sub-thalamic nucleus or the globus pallidus interna of the brain by stereotactic surgery. Given the multiple hypotheses explaining the different effects of DBS with sometimes conflicting mechanisms, it is difficult to pinpoint the exact way in which DBS operates. Nevertheless, it has proven to be significantly effective. DBS, although being a cost-effective treatment measure for Parkinson's patients, is not without limitations. A careful selection of patients is required preoperatively that determines the response and tolerance to the therapy in patients. This review aims to summarize the current literature on DBS in Parkinson's with a focus on the hypothesized mechanisms, selection criteria, advantages and its limitations. Cureus 2022-09-03 /pmc/articles/PMC9531694/ /pubmed/36211107 http://dx.doi.org/10.7759/cureus.28760 Text en Copyright © 2022, Shah et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Shah, Heeya
Usman, Omer
Ur Rehman, Habib
Jhaveri, Sharan
Avanthika, Chaithanya
Hussain, Kamran
Islam, Hamza
I.S.K, Sailesh
Deep Brain Stimulation in the Treatment of Parkinson’s Disease
title Deep Brain Stimulation in the Treatment of Parkinson’s Disease
title_full Deep Brain Stimulation in the Treatment of Parkinson’s Disease
title_fullStr Deep Brain Stimulation in the Treatment of Parkinson’s Disease
title_full_unstemmed Deep Brain Stimulation in the Treatment of Parkinson’s Disease
title_short Deep Brain Stimulation in the Treatment of Parkinson’s Disease
title_sort deep brain stimulation in the treatment of parkinson’s disease
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9531694/
https://www.ncbi.nlm.nih.gov/pubmed/36211107
http://dx.doi.org/10.7759/cureus.28760
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