Deep brain stimulation in the treatment of Parkinson's disease
Pichon Riviere A, Augustovski F, Cernadas C, Ferrante D, Regueiro A, Garcia Marti S
Record ID 32005000622
Spanish
Authors' objectives:
The aim of this study was to summarise the available evidence on deep brain stimulation in the treatment of Parkinson's disease.
Authors' results and conclusions:
Although there are not enough studies that would allow to clearly identify which patients have the best chances of benefiting from this intervention, it could be said that it is for those with idiopathic Parkinson's disease without significant cognitive impairment, with on-off motor fluctuations with periods of severe immobility; presence of off dystonias and levodopa-induced dyskinesias that can not be controlled with medication.
In any case DBS can only be performed in state-of-the-art centers, which have functional neurosurgery units with physicians experienced in the use of this technique and who have adequate sterotactic equipment and advanced imaging diagnostic techniques.
Authors' recommendations:
Deep brain stimulation (DBS) procedures offer results that are at least equivalent to those of ablative techniques. In the thalamus, tremor would improve in over 90% of patients, and these improvement would be complete or almost complete in 60- 80% of the cases.
In the globus pallidus, it would reduce or make dyskinesias and contralateral tremors disappear between 45 and 65% of patients, also improving their rigidity. When applied to the subthalamic nucleus, it is the procedure that renders the best results on symptoms which are disease specific, including tremor, rigidity, bradykinesia, gait and voice. It also allows an important medication reduction. The improvement in the voice, balance and gait are more prominent when it is implanted bilaterally. By reducing the medication, it is also possible to improve dyskinesias and fluctuations.
Authors' methods:
Overview
Details
Project Status:
Completed
URL for project:
http://www.iecs.org.ar/
Year Published:
2003
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Argentina
MeSH Terms
- Stereotaxic Techniques
- Subthalamic Nucleus
- Deep Brain Stimulation
- Globus Pallidus
- Parkinson Disease
Contact
Organisation Name:
Institute for Clinical Effectiveness and Health Policy
Contact Address:
Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name:
info@iecs.org.ar
Contact Email:
info@iecs.org.ar
Copyright:
Institute for Clinical Effectiveness and Health Policy (IECS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.