title: Deep brain stimulation for the treatment of Parkinson's disease: efficacy and safety.
abstract: Deep brain stimulation (DBS) surgery has become increasingly utilized in the treatment of advanced Parkinson's disease. Over the past decade, a number of studies have demonstrated that DBS is superior to best medical management in appropriately selected patients. The primary targets for DBS in Parkinson's disease include the subthalamic nucleus and the internal segment of the globus pallidus, both of which improve the cardinal motor features in Parkinson's disease. Recent randomized studies have revealed that both targets are similarly effective in treating the motor symptoms of Parkinson's disease, but emerging evidence suggests that the globus pallidus may be the preferred target in many patients, based on differences in nonmotor outcomes. Here, we review appropriate patient selection, and the efficacy and safety of DBS therapy in Parkinson's disease. Best outcomes are achieved if the problems of the individual patient are considered when evaluating surgical candidates and considering whether the subthalamic nucleus or the globus pallidus internus should be targeted.
authors.affiliation: Departments of Neurosurgery, David Geffen School of Medicine at UCLA (University of California, Los Angeles), Los Angeles ; Bioengineering, David Geffen School of Medicine at UCLA (University of California, Los Angeles), Los Angeles.
authors.forename: Nader
authors.initials: N
authors.lastname: Pouratian
authors.forename: Sandeep
authors.initials: S
authors.lastname: Thakkar
authors.forename: Won
authors.initials: W
authors.lastname: Kim
authors.forename: Jeff M
authors.initials: JM
authors.lastname: Bronstein
keywords: Parkinson’s disease; deep brain stimulation; dyskinesia; globus pallidus; subthalamic nucleus