The treatment of Parkinson's disease with deep brain stimulation: current issues.
Deep brain stimulation has become a well-established symptomatic treatment for Parkinson's disease during the last 25 years. Besides improving motor symptoms and long-term motor complications, positive effects on patients' mobility, activities of daily living, emotional well-being and health-related quality of life have been recognized. Apart from that, numerous clinical trials analyzed effects on non-motor symptoms and side effects of deep brain stimulation. Several technical issues and stimulation paradigms have been and are still being developed to optimize the therapeutic effects, minimize the side effects and facilitate handling. This review summarizes current therapeutic issues, i.e., patient and target selection, surgical procedure and programming paradigms. In addition it focuses on neuropsychological effects and side effects of deep brain stimulation.
Center for Movement Disorders and Neuromodulation, Department of Neurology, University Hospital Düsseldorf, Germany & Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
Alexia-Sabine
AS
Moldovan
Center for Movement Disorders and Neuromodulation, Department of Neurology, University Hospital Düsseldorf, Germany & Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
Stefan Jun
SJ
Groiss
Center for Movement Disorders and Neuromodulation, Department of Neurology, University Hospital Düsseldorf, Germany & Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
Saskia
S
Elben
Center for Movement Disorders and Neuromodulation, Department of Neurology, University Hospital Düsseldorf, Germany & Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
Martin
M
Südmeyer
Center for Movement Disorders and Neuromodulation, Department of Neurology, University Hospital Düsseldorf, Germany & Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
Alfons
A
Schnitzler
Center for Movement Disorders and Neuromodulation, Department of Neurology, University Hospital Düsseldorf, Germany & Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University Düsseldorf, Germany.
Lars
L
Wojtecki
Parkinson's disease; deep brain stimulation; subthalamic nucleus