Neural stimulation for Parkinson's disease: current therapies and future directions.
Neural stimulation has rapidly become an integral tool in the treatment of Parkinson's disease and other movement disorders. Today it serves as an important adjunct to medical therapy that continues to gain applicability to patients in whom the disease has progressed significantly. Studies have demonstrated efficacy in several deep-brain targets, with prolonged benefit exceeding 5-year follow-up times. Continuing study is teaching us more about the mechanism of deep-brain stimulation effect. New targets, which may treat the disease more successfully, are being examined. In this review, the history of deep-brain stimulation, the rationale for the known targets of stimulation; the clinical evidence demonstrating their benefit and, finally, future perspectives on new treatments that are being investigated and may have an impact on the field are discussed.
Neimat
Joseph S
JS
Toronto Western Hospital, Toronto, Ontario M5T 2S8, Canada. jneimat@gmail.com
Hamani
Clement
C
Lozano
Andres M
AM
D001921:Brain / Q000503:physiopathology / Q000528:radiation effects; D002986:Clinical Trials as Topic; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods / Q000639:trends*; D005104:Expert Testimony; D006801:Humans; D010300:Parkinson Disease / Q000628:therapy*; D018579:Patient Selection; D012306:Risk