title: Management and outcome of pallidal deep brain stimulation in severe Huntington's disease.
abstract: Neurodegenerative movement disorders, such as Huntington's disease (HD), have become a promising field for Deep Brain Stimulation (DBS). This study aims to contribute to the establishment of a well-grounded database including both expected and unexpected effects of pallidal DBS in HD, and to discuss the ethical and legal restrictions of DBS in cognitively limited patients. Evaluation of the outcome data indicates that pallidal DBS exerted an independent effect on motor symptoms but probably also on the patient's cognitive and affective state. The cognitive decline, however, that characterizes the late stage of neurodegenerative disorders implicates ethical and legal problems given the patients' inability to give informed consent to DBS.
authors.affiliation: Department of Psychiatry and Psychotherapy, University-Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany. daniel.huys@uk-koeln.de
authors.forename: D
authors.initials: D
authors.lastname: Huys
authors.forename: C
authors.initials: C
authors.lastname: Bartsch
authors.forename: P
authors.initials: P
authors.lastname: Poppe
authors.forename: D
authors.initials: D
authors.lastname: Lenartz
authors.forename: W
authors.initials: W
authors.lastname: Huff
authors.forename: J
authors.initials: J
authors.lastname: Prütting
authors.forename: L
authors.initials: L
authors.lastname: Timmermann
authors.forename: J
authors.initials: J
authors.lastname: Klosterkötter
authors.forename: M
authors.initials: M
authors.lastname: Maarouf
authors.forename: T
authors.initials: T
authors.lastname: Rommel
authors.forename: A
authors.initials: A
authors.lastname: Hartmann
authors.forename: V
authors.initials: V
authors.lastname: Sturm
authors.forename: J
authors.initials: J
authors.lastname: Kuhn
mesh_terms: D000328:Adult; D019090:Case Management; D003071:Cognition / Q000502:physiology; D046690:Deep Brain Stimulation / Q000009:adverse effects / Q000379:methods*; D003863:Depression / Q000209:etiology / Q000628:therapy; D004567:Electrodes, Implanted; D005260:Female; D005917:Globus Pallidus / Q000502:physiology*; D006801:Humans; D006816:Huntington Disease / Q000523:psychology / Q000628:therapy*; D001523:Mental Disorders / Q000209:etiology / Q000628:therapy; D009069:Movement Disorders / Q000209:etiology / Q000628:therapy; D009483:Neuropsychological Tests; D018570:Risk Assessment; D013238:Stereotaxic Techniques; D016896:Treatment Outcome