title: [DBS therapy for Parkinson's disease - our approach].
abstract: It is controversial whether the STN or the GPi, the main targets of DBS therapy in patients with Parkinson's disease, is the appropriate target. We select GPi-DBS in patients judged by our cognitive function test battery to be at high-risk for cognitive decline after STN-DBS. While DBS surgery is usually performed under local anesthesia for the precise placement of DBS electrodes, general anesthesia might be useful in patients intolerant of long-lasting surgical stress. Our monkey experiments revealed that the most medial part of the STN receives direct input from the limbic cortex, suggesting that the spread of stimulation to these limbic territories may elicit adverse emotional effects. Other monkey experiments on the physiological mechanism of DBS suggest that high-frequency GPi stimulation disrupts information flow through the GPi.
authors.affiliation: Department of Neurosurgery, Kitasato University School of Medicine.
authors.forename: Sumito
authors.initials: S
authors.lastname: Sato
authors.forename: Yoko
authors.initials: Y
authors.lastname: Takiyama
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ogino
authors.forename: Katsushige
authors.initials: K
authors.lastname: Watanabe
authors.forename: Tohru
authors.initials: T
authors.lastname: Terao
authors.forename: Chihiro
authors.initials: C
authors.lastname: Matsumoto
authors.forename: Satomi
authors.initials: S
authors.lastname: Chiken
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nambu
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Nishiyama
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kumabe
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Fujii
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D000772:Anesthesia, Local; D000818:Animals; D003071:Cognition; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D006801:Humans; D008251:Macaca; D008297:Male; D010300:Parkinson Disease / Q000523:psychology / Q000628:therapy*; D012306:Risk