title: Targeting the brain: considerations in 332 consecutive patients treated by deep brain stimulation (DBS) for severe neurological diseases.
abstract: Deep brain stimulation (DBS) extends the treatment of some severe neurological diseases beyond pharmacological and conservative therapy. Our experience extends the field of DBS beyond the treatment of Parkinson disease and dystonia, including several other diseases such as cluster headache and disruptive behavior. Since 1993, at the Istituto Nazionale Neurologico "Carlo Besta" in Milan, 580 deep brain electrodes were implanted in 332 patients. The DBS targets include Stn, GPi, Voa, Vop, Vim, CM-pf, pHyp, cZi, Nacc, IC, PPN, and Brodmann areas 24 and 25. Three hundred patients are still available for follow-up and therapeutic considerations. DBS gave a new therapeutic chance to these patients affected by severe neurological diseases and in some cases controlled life-threatening pathological conditions, which would otherwise result in the death of the patient such as in status dystonicus, status epilepticus and post-stroke hemiballismus. The balance of DBS in severe neurological disease is strongly positive even if further investigations and studies are needed to search for new applications and refine the selection criteria for the actual indications.
authors.affiliation: Fondazione IRCCS Istituto Neurologico "C. Besta", Via Celoria 11, 20133, Milan, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Franzini
authors.forename: Roberto
authors.initials: R
authors.lastname: Cordella
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Messina
authors.forename: Carlo Efisio
authors.initials: CE
authors.lastname: Marras
authors.forename: Luigi Michele
authors.initials: LM
authors.lastname: Romito
authors.forename: Alberto
authors.initials: A
authors.lastname: Albanese
authors.forename: Michele
authors.initials: M
authors.lastname: Rizzi
authors.forename: Nardo
authors.initials: N
authors.lastname: Nardocci
authors.forename: Giovanna
authors.initials: G
authors.lastname: Zorzi
authors.forename: Edvin
authors.initials: E
authors.lastname: Zekaj
authors.forename: Flavio
authors.initials: F
authors.lastname: Villani
authors.forename: Massimo
authors.initials: M
authors.lastname: Leone
authors.forename: Orsola
authors.initials: O
authors.lastname: Gambini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Broggi
mesh_terms: D000368:Aged; D001921:Brain / Q000502:physiology*; D046690:Deep Brain Stimulation / Q000295:instrumentation / Q000379:methods*; D004302:Dorsomedial Hypothalamic Nucleus / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005917:Globus Pallidus / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D010300:Parkinson Disease / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D011788:Quality of Life / Q000523:psychology; D012720:Severity of Illness Index; D013238:Stereotaxic Techniques / Q000295:instrumentation; D020531:Subthalamic Nucleus / Q000502:physiology; D016896:Treatment Outcome; D020651:Ventral Thalamic Nuclei / Q000502:physiology