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. 2008 Apr;5(2):309–319. doi: 10.1016/j.nurt.2008.01.006

Deep brain stimulation for Parkinson’s disease

Patricia Limousin 1,✉, Irene Martinez-Torres 1
PMCID: PMC5084172  PMID: 18394572

Summary

The surgical treatment of Parkinson’s disease has been through a revival phase over the last 20 years with the development of deep brain stimulation (DBS). Thalamic DBS was developed first and has proven to be a very effective treatment for tremor. The limitation is the lack of effect on other symptoms. Other targets were therefore investigated, and the procedure was applied to the subthalamic nucleus (STN) and the internal globus pallidus (GPi). STN stimulation can improve a wide range of symptoms and is currently the preferred target for many patients. Nevertheless, the morbidity seems higher than with other targets, and the selection criteria have to be quite strict. When STN DBS is not advised, thalamic DBS remains an option for patients with severe tremor, and GPi stimulation for those with severe dyskinesias. DBS remains a symptomatic treatment for a limited number of patients; it does not seem to alter the disease progression, and many patients are not suitable. There is, therefore, the need for further research into other targets and other approaches.

Key Words: Parkinson’s disease, deep brain stimulation, subthalamic nucleus, globus pallidus pars interna, thalamus

References

  • 1.Sem-Jacobsen CW. Depth electrographic stimulation and treatment of patients with Parkinson’s disease including neurosurgical technique. Acta Neurol Scand. 1965;13:365–377. doi: 10.1111/j.1600-0404.1965.tb01899.x. [DOI] [PubMed] [Google Scholar]
  • 2.Bechtereva NP, Bondarchuk AN, Smimov VM, Meliucheva LA. Therapeutic electric stimulation of deep brain structures [In Russian] Vopr Neirokhir. 1972;36:7–12. [PubMed] [Google Scholar]
  • 3.Benabid AL, Pollak P, Louveau A, Henry S, de Rougemont J. Combined (thalamotomy and stimulation) stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson disease. Appl Neurophysiol. 1987;50:344–346. doi: 10.1159/000100803. [DOI] [PubMed] [Google Scholar]
  • 4.Benabid AL, Pollak P, Gervason C, et al. Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus. Lancet. 1991;337:403–406. doi: 10.1016/0140-6736(91)91175-T. [DOI] [PubMed] [Google Scholar]
  • 5.Pollak P, Benabid AL, Gross C, et al. Effects of the stimulation of the subthalamic nucleus in Parkinson disease [In French] Rev Neurol (Paris) 1993;149:175–176. [PubMed] [Google Scholar]
  • 6.Limousin P, Pollak P, Benazzouz A, et al. Effect on parkinsonian signs and symptoms of bilateral subthalamic nucleus stimulation. Lancet. 1995;345:91–95. doi: 10.1016/S0140-6736(95)90062-4. [DOI] [PubMed] [Google Scholar]
  • 7.Siegfried J, Lippitz B. Bilateral chronic electrostimulation of ventroposterolateral pallidum: a new therapeutic approach for alleviating all parkinsonian symptoms. Neurosurgery. 1994;35:1126–1130. doi: 10.1227/00006123-199412000-00016. [DOI] [PubMed] [Google Scholar]
  • 8.Laitinen LV, Bergenheim AT, Hariz MI. Leksell’s posteroventral pallidotomy in the treatment of Parkinson’s disease. J Neurosurg. 1992;76:53–61. doi: 10.3171/jns.1992.76.1.0053. [DOI] [PubMed] [Google Scholar]
  • 9.Bergman H, Wichmann T, DeLong MR. Reversal of experimental parkinsonism by lesions of the subthalamic nucleus. Science. 1990;249:1436–1438. doi: 10.1126/science.2402638. [DOI] [PubMed] [Google Scholar]
  • 10.Aziz TZ, Peggs D, Agarwal E, Sambrook MA, Crossman AR. Subthalamic nucleotomy alleviates parkinsonism in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-exposed primate. Br J Neurosurg. 1992;6:575–582. doi: 10.3109/02688699209002375. [DOI] [PubMed] [Google Scholar]
  • 11.Benazzouz A, Gross C, Féger J, Boraud T, Bioulac B. Reversal of rigidity and improvement in motor performance by subthalamic high-frequency stimulation in MPTP-treated monkeys. Eur J Neurosci. 1993;5:382–389. doi: 10.1111/j.1460-9568.1993.tb00505.x. [DOI] [PubMed] [Google Scholar]
  • 12.Maltête D, Navarro S, Welter ML, et al. Subthalamic stimulation in Parkinson disease: with or without anesthesia? Arch Neurol. 2004;61:390–392. doi: 10.1001/archneur.61.3.390. [DOI] [PubMed] [Google Scholar]
  • 13.Hariz MI, Krack P, Melvill R, et al. A quick and universal method for stereotactic visualization of the subthalamic nucleus before and after implantation of deep brain stimulation electrodes. Stereotact Funct Neurosurg. 2003;80:96–101. doi: 10.1159/000075167. [DOI] [PubMed] [Google Scholar]
  • 14.Garonzik IM, Hua SE, Ohara S, Lenz F. Intraoperative microelectrode and semi-microelectrode recording during the physiological localization of the thalamic nucleus ventral intermediate. Mov Disord. 2002;17(Suppl 3):S135–S144. doi: 10.1002/mds.10155. [DOI] [PubMed] [Google Scholar]
  • 15.Hutchison WD, Allan RJ, Opitz H, et al. Neurophysiological identification of the subthalamic nucleus in surgery for Parkinson’s disease. Ann Neurol. 1998;44:622–628. doi: 10.1002/ana.410440407. [DOI] [PubMed] [Google Scholar]
  • 16.Hariz MI. Safety and risk of microelectrode recording in surgery for movement disorders. Stereotact Funct Neurosurg. 2002;78:146–157. doi: 10.1159/000068960. [DOI] [PubMed] [Google Scholar]
  • 17.Chen CC, Pogosyan A, Zrinzo L, et al. Intra-operative recordings of local field potentials can help localize the subthalamic nucleus in Parkinson’s disease surgery. Exp Neurol. 2006;198:214–221. doi: 10.1016/j.expneurol.2005.11.019. [DOI] [PubMed] [Google Scholar]
  • 18.Volkmann J, Sturm V, Weiss P, et al. Bilateral high-frequency stimulation of the internal globus pallidus in advanced Parkinson’s disease. Ann Neurol. 1998;44:953–961. doi: 10.1002/ana.410440615. [DOI] [PubMed] [Google Scholar]
  • 19.Kumar R, Lang AE, Rodriguez-Oroz MC, et al. Deep brain stimulation of the globus pallidus pars interna in advanced Parkinson’s disease. Neurology. 2000;55(Suppl 6):S34–S39. [PubMed] [Google Scholar]
  • 20.Lyons KE, Wilkinson S, Tröster AI, Pahwa R. Long-term efficacy of globus pallidus stimulation for the treatment of Parkinson’s disease. Sterotact Funct Neurosurg. 2002;79:214–220. doi: 10.1159/000070834. [DOI] [PubMed] [Google Scholar]
  • 21.Loher TJ, Burgunder JM, Pohle T, Weber S, Sommerhalder R, Krauss JK. Long-term pallidal deep brain stimulation in patients with advanced Parkinson disease: 1-year follow-up study. J Neurosurg. 2002;96:844–853. doi: 10.3171/jns.2002.96.5.0844. [DOI] [PubMed] [Google Scholar]
  • 22.Krack P, Batir A, Van Blercom N, et al. Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med. 2003;349:1925–1934. doi: 10.1056/NEJMoa035275. [DOI] [PubMed] [Google Scholar]
  • 23.Herzog J, Volkmann J, Krack P, et al. Two-year follow-up of subthalamic deep brain stimulation in Parkinson’s disease. Mov Disord. 2003;18:1332–1337. doi: 10.1002/mds.10518. [DOI] [PubMed] [Google Scholar]
  • 24.Volkmann J, Allert N, Voges J, Sturm V, Schnitzler A, Freund HJ. Long-term results of bilateral pallidal stimulation in Parkinson’s disease. Ann Neurol. 2004;55:871–875. doi: 10.1002/ana.20091. [DOI] [PubMed] [Google Scholar]
  • 25.Krause M, Fogel W, Mayer P, Kloss M, Tronnier V. Chronic inhibition of the subthalamic nucleus in Parkinson’s disease. J Neurol Sci. 2004;219:119–124. doi: 10.1016/j.jns.2004.01.004. [DOI] [PubMed] [Google Scholar]
  • 26.Schüpbach WMM, Chastan N, Welter ML, et al. Stimulation of the subthalamic nucleus in Parkinson’s disease: a 5 year follow up. J Neurol Neurosurg Psychiatry. 2005;76:1640–1644. doi: 10.1136/jnnp.2005.063206. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 27.Østergaard K, Sunde NA. Evolution of Parkinson’s disease during 4 years of bilateral deep brain stimulation of the subthalamic nucleus. Mov Disord. 2006;21:624–631. doi: 10.1002/mds.20776. [DOI] [PubMed] [Google Scholar]
  • 28.Wider C, Pollo C, Bloch J, Burkhard PR, Vingerhoets FJG. Long-term outcome of 50 consecutive Parkinson’s disease patients treated with subthalamic nucleus deep brain stimulation. Parkinsonism Relat Disord 2007 September 5 [Epub ahead of print]. [DOI] [PubMed]
  • 29.Blomstedt P, Hariz MI. Hardware-related complications of deep brain stimulation: a ten year experience. Acta Neurochir (Wien) 2005;147:1061–1064. doi: 10.1007/s00701-005-0576-5. [DOI] [PubMed] [Google Scholar]
  • 30.Koller W, Pahwa R, Busenbark K, et al. High-frequency unilateral thalamic stimulation in the treatment of essential and parkinsonian tremor. Ann Neurol. 1997;42:292–299. doi: 10.1002/ana.410420304. [DOI] [PubMed] [Google Scholar]
  • 31.Tasker RR. Deep brain stimulation is preferable to thalamotomy for tremor suppression. Surg Neurol. 1998;49:145–53. doi: 10.1016/S0090-3019(97)00459-X. [DOI] [PubMed] [Google Scholar]
  • 32.Limousin P, Speelman JD, Gielen F, Janssens M. Multicentre European study of thalamic stimulation in parkinsonian and essential tremor. J Neurol Neurosurg Psychiatry. 1999;66:289–296. doi: 10.1136/jnnp.66.3.289. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 33.Rehncrona S, Johnels B, Widner H, Törnqvist AL, Hariz M, Sydow O. Long-term efficacy of thalamic deep brain stimulation for tremor: double-blind assessments. Mov Disord. 2003;18:163–170. doi: 10.1002/mds.10309. [DOI] [PubMed] [Google Scholar]
  • 34.Hariz GM, Bergenheim AT, Hariz MI, Lindberg M. Assessment of ability/disability in patients treated with chronic thalamic stimulation for tremor. Mov Disord. 1998;13:78–83. doi: 10.1002/mds.870130117. [DOI] [PubMed] [Google Scholar]
  • 35.Pollak P, Fraix V, Krack P, et al. Treatment results: Parkinson’s disease. Mov Disord. 2002;17(Suppl 3):S75–S83. doi: 10.1002/mds.10146. [DOI] [PubMed] [Google Scholar]
  • 36.Defebvre L, Blatt JL, Blond S, Bourriez JL, Gieu JD, Destée A. Effect of thalamic stimulation on gait in Parkinson disease. Arch Neurol. 1996;53:898–903. doi: 10.1001/archneur.1996.00550090108016. [DOI] [PubMed] [Google Scholar]
  • 37.Woods SP, Fields JA, Lyons KE, et al. Neuropsychological and quality of life changes following unilateral thalamic deep brain stimulation in Parkinson’s disease: a one-year follow-up. Acta Neurochir. 2001;143:1273–1277. doi: 10.1007/s007010100024. [DOI] [PubMed] [Google Scholar]
  • 38.Hariz MI, Krack P, Alesch F, et al. Multicentre European study of thalamic stimulation for parkinsonian tremor: a 6-year follow-up. J Neurol Neurosurg Psychiatry 2007 Sep 26 [Epub ahead of print]. [DOI] [PubMed]
  • 39.Krack P, Pollak P, Limousin P, Benazzouz A, Benabid AL. Stimulation of subthalamic nucleus alleviates tremor in Parkinson’s disease. Lancet. 1997;350:1675–1675. doi: 10.1016/S0140-6736(97)24049-3. [DOI] [PubMed] [Google Scholar]
  • 40.Fraix V, Pollak P, Moro E, et al. Subthalamic nucleus stimulation in tremor dominant parkinsonian patients with previous thalamic surgery. J Neurol Neurosurg Psychiatry. 2005;76:246–248. doi: 10.1136/jnnp.2003.022707. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 41.Caparros-Lefebvre D, Blond S, Pécheux N, Pasquier F, Petit H. Neuropsychological evaluation before and after thalamic stimulation in 9 patients with Parkinson’s disease [In French] Rev Neurol (Paris) 1992;148:117–122. [PubMed] [Google Scholar]
  • 42.Schuurman PR, Bruins J, Merkus MP, Bosch DA, Speelman JD. A comparison of neuropsychological effects of thalamotomy and thalamic stimulation. Neurology. 2002;59:1232–1239. doi: 10.1212/01.wnl.0000031425.37014.55. [DOI] [PubMed] [Google Scholar]
  • 43.Hariz MI, Shamsgovara P, Johansson F, Hariz G, Fodstad H. Tolerance and tremor rebound following long-term chronic thalamic stimulation for parkinsonian and essential tremor. Stereotact Funct Neurosurg. 1999;72:208–218. doi: 10.1159/000029728. [DOI] [PubMed] [Google Scholar]
  • 44.Ghika J, Villemure JG, Fankhauser H, Favre J, Assal G, Ghika-Schmid F. Efficiency and safety of bilateral contemporaneous pallidal stimulation (deep brain stimulation) in levodopa-responsive patients with Parkinson’s disease with severe motor fluctuations: a 2-year follow-up review. J Neurosurg. 1998;89:713–718. doi: 10.3171/jns.1998.89.5.0713. [DOI] [PubMed] [Google Scholar]
  • 45.Durif F, Lemaire JJ, Debilly B, Dordain G. Long-term follow-up of globus pallidus chronic stimulation in advanced Parkinson’s disease. Mov Disord. 2002;17:803–807. doi: 10.1002/mds.10128. [DOI] [PubMed] [Google Scholar]
  • 46.Deep Brain Stimulation for Parkinson’s Disease Study Group Deep-brain stimulation of the subthalamic nucleus or the pars interna of the globus pallidus in Parkinson’s disease. N Engl J Med. 2001;345:956–963. doi: 10.1056/NEJMoa000827. [DOI] [PubMed] [Google Scholar]
  • 47.Rodriguez-Oroz MC, Obeso JA, Lang AE, et al. Bilateral deep brain stimulation in Parkinson’s disease: a multicentre study with 4 years follow-up. Brain. 2005;128:2240–2249. doi: 10.1093/brain/awh571. [DOI] [PubMed] [Google Scholar]
  • 48.Rodrigues JP, Walters SE, Watson P, Stell R, Mastaglia FL. Globus pallidus stimulation in advanced Parkinson’s disease. J Clin Neurosci. 2007;14:208–215. doi: 10.1016/j.jocn.2005.11.023. [DOI] [PubMed] [Google Scholar]
  • 49.Krack P, Pollak P, Limousin P, et al. Opposite motor effects of pallidal stimulation in Parkinson’s disease. Ann Neurol. 1998;43:180–192. doi: 10.1002/ana.410430208. [DOI] [PubMed] [Google Scholar]
  • 50.Bejjani B, Damier P, Arnulf I, et al. Pallidal stimulation for Parkinson’s disease: two targets? Neurology. 1997;49:1564–1569. doi: 10.1212/wnl.49.6.1564. [DOI] [PubMed] [Google Scholar]
  • 51.Rodrigues JP, Walters SE, Watson P, Stell R, Mastaglia FL. Globus pallidus stimulation improves both motor and nonmotor aspects of quality of life in advanced Parkinson’s disease. Mov Disord. 2007;22:1866–1870. doi: 10.1002/mds.21427. [DOI] [PubMed] [Google Scholar]
  • 52.Anderson VC, Burchiel KJ, Hogarth P, Favre J, Hammerstad J. Pallidal vs subthalamic nucleus deep brain stimulation in Parkinson’s disease. Arch Neurol. 2005;62:554–560. doi: 10.1001/archneur.62.4.554. [DOI] [PubMed] [Google Scholar]
  • 53.Volkmann J, Allert N, Voges J, Weiss PH, Freund HJ, Sturm V. Safety and efficacy of pallidal or subthalamic nucleus stimulation in advanced PD. Neurology. 2001;56:548–551. doi: 10.1212/wnl.56.4.548. [DOI] [PubMed] [Google Scholar]
  • 54.Limousin P, Krack P, Pollak P, et al. Electrical stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med. 1998;339:1105–1111. doi: 10.1056/NEJM199810153391603. [DOI] [PubMed] [Google Scholar]
  • 55.Rodriguez-Oroz MC, Zamarbide I, Guridi J, Palmero MR, Obeso JA. Efficacy of deep brain stimulation of the subthalamic nucleus in Parkinson’s disease 4 years after surgery: double blind and open label evaluation. J Neurol Neursurg Psychiatry. 2004;75:1382–1385. doi: 10.1136/jnnp.2003.031294. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 56.Deuschl G, Schade-Brittinger C, Krack P, et al. A Randomized trial of deep brain stimulation for Parkinson’s disease. N Engl J Med. 2006;355:896–908. doi: 10.1056/NEJMoa060281. [DOI] [PubMed] [Google Scholar]
  • 57.Kleiner-Fisman G, Fisman D, Sime E, Saint-Cyr JA, Lozano A, Lang A. Long-term follow up of bilateral deep brain stimulation of the subthalamic nucleus in patients with advanced Parkinson disease. J Neurosurg. 2003;99:489–495. doi: 10.3171/jns.2003.99.3.0489. [DOI] [PubMed] [Google Scholar]
  • 58.Krack P, Pollak P, Limousin P, Benazzouz A, Deuschl G, Benabid AL. From off-period dystonia to peak-dose chorea: the clinical spectrum of varying subthalamic nucleus activity. Brain. 1999;122:1133–1146. doi: 10.1093/brain/122.6.1133. [DOI] [PubMed] [Google Scholar]
  • 59.Klostermann F, Ehlen F, Vesper J, et al. Effects of subthalamic deep brain stimulation on dysarthrophonia in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2007 Aug 31 [Epub ahead of print]. [DOI] [PubMed]
  • 60.Funkiewiez A, Ardouin C, Caputo E, et al. Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2004;75:834–839. doi: 10.1136/jnnp.2002.009803. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 61.Aybek S, Gronchi-Perrin A, Berney A, et al. Long-term cognitive profile and incidence of dementia after STN-DBS in Parkinson’s disease. Mov Disord. 2007;22:974–981. doi: 10.1002/mds.21478. [DOI] [PubMed] [Google Scholar]
  • 62.Wallace BA, Ashkan K, Heise CE, et al. Survival of midbrain dopaminergic cells after lesion or deep brain stimulation of the subthalamic nucleus in MPTP-treated monkeys. Brain. 2007;130:2129–2145. doi: 10.1093/brain/awm137. [DOI] [PubMed] [Google Scholar]
  • 63.Lagrange E, Krack P, Moro E, et al. Bilateral subthalamic nucleus stimulation improves health-related quality of life in PD. Neurology. 2002;59:1976–1978. doi: 10.1001/archneur.59.12.1976. [DOI] [PubMed] [Google Scholar]
  • 64.Lezcano E, Gómez-Esteban JC, Zarranz JJ, et al. Improvement in quality of life in patients with advanced Parkinson’s disease following bilateral deep-brain stimulation in subthalamic nucleus. Eur J Neurol. 2004;11:451–454. doi: 10.1111/j.1468-1331.2004.00804.x. [DOI] [PubMed] [Google Scholar]
  • 65.Lyons KE, Pahwa R. Long-term benefits in quality of life provided by bilateral subthalamic stimulation in patients with Parkinson disease. J Neurosurg. 2005;103:252–255. doi: 10.3171/jns.2005.103.2.0252. [DOI] [PubMed] [Google Scholar]
  • 66.Drapier S, Raoul S, Drapier D, et al. Only physical aspects of quality of life are significantly improved by bilateral subthalamic stimulation in Parkinson’s disease. J Neurol. 2005;252:583–588. doi: 10.1007/s00415-005-0704-4. [DOI] [PubMed] [Google Scholar]
  • 67.Martínez-Martín P, Valldeoriola F, Tolosa E, et al. Bilateral subthalamic nucleus stimulation and quality of life in advanced Parkinson’s disease. Mov Disord. 2002;17:372–377. doi: 10.1002/mds.10044. [DOI] [PubMed] [Google Scholar]
  • 68.Derost PP, Ouschchane I, Morand D, et al. Is DBS-STN appropriate to treat severe Parkinson’s disease in an elderly population? Neurology. 2007;68:1345–1355. doi: 10.1212/01.wnl.0000260059.77107.c2. [DOI] [PubMed] [Google Scholar]
  • 69.Ory-Magne F, Brefel-Courbon C, Simonetta-Moreau M. Does ageing influence deep brain stimulation outcomes in Parkinson’s disease? Mov Disord. 2007;22:1457–1463. doi: 10.1002/mds.21547. [DOI] [PubMed] [Google Scholar]
  • 70.Schüpbach M, Gargiulo M, Welter ML, et al. Neurosurgery in Parkinson disease: a distressed mind in a repaired body? Neurology. 2006;66:1811–1816. doi: 10.1212/01.wnl.0000234880.51322.16. [DOI] [PubMed] [Google Scholar]
  • 71.Zibetti M, Torre E, Cinquepalmi A, et al. Motor and nonmotor symptom follow-up in parkinsonian patients after deep brain stimulation of the subthalamic nucleus. Eur Neurol. 2007;58:218–223. doi: 10.1159/000107943. [DOI] [PubMed] [Google Scholar]
  • 72.Cicolin A, Lopiano L, Zibetti, et al. Effects of deep brain stimulation of the subthalamic nucleus on sleep architecture in parkinsonian patients. Sleep Med. 2004;5:207–210. doi: 10.1016/j.sleep.2003.10.010. [DOI] [PubMed] [Google Scholar]
  • 73.Witjas T, Kaphan E, Regis J, et al. Effects of chronic subthalamic stimulation on nonmotor fluctuations in Parkinson’s disease. Mov Disord. 2007;22:1729–1734. doi: 10.1002/mds.21602. [DOI] [PubMed] [Google Scholar]
  • 74.Winge K, Nielsen KK, Stimpel H, Lokkegaard A, Jensen SR, Werdelin L. Lower urinary tract symptoms and bladder control in advanced Parkinson’s disease: effects of deep brain stimulation in the subthalamic nucleus. Mov Disord. 2007;22:220–225. doi: 10.1002/mds.21253. [DOI] [PubMed] [Google Scholar]
  • 75.Seif C, Herzog J, Van der Horst C, et al. Effect of subthalamic deep brain stimulation on the function of the urinary bladder. Ann Neurol. 2004;55:118–120. doi: 10.1002/ana.10806. [DOI] [PubMed] [Google Scholar]
  • 76.Fraix V, Houeto JL, Lagrange C, SPARK Study Group et al. Clinical and economic results of bilateral subthalamic nucleus stimulation in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2006;77:443–449. doi: 10.1136/jnnp.2005.077677. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 77.Valldeoriola F, Morsi O, Tolosa E, Rumià J, Martì MJ, Martìnez-Martìn P. Prospective comparative study on cost-effectiveness of subthalamic stimulation and best medical treatment in advanced Parkinson’s disease. Mov Disord. 2007;22:2183–2191. doi: 10.1002/mds.21652. [DOI] [PubMed] [Google Scholar]
  • 78.Mandat TS, Hurwitz T, Honey CR. Hypomania as an adverse effect of subthalamic nucleus stimulation: report of two cases. Acta Neurochir (Wien) 2006;148:895–897. doi: 10.1007/s00701-006-0795-4. [DOI] [PubMed] [Google Scholar]
  • 79.Bordini BJ, Grag A, Gallagher CL, Bell B, Garell PC. Neuropsychological effects of bilateral deep brain stimulation of the subthalamic nucleus in Parkinson’s disease. Stereotact Funct Neurosurg. 2007;85:113–120. doi: 10.1159/000098526. [DOI] [PubMed] [Google Scholar]
  • 80.Contarino MF, Daniele A, Sibilia AH, et al. cognitive outcome 5 years after bilateral chronic stimulation of subthalamic nucleus in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2007;78:248–252. doi: 10.1136/jnnp.2005.086660. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 81.Parson TD, Rogers SA, Braaten AJ, Woods SP, Tröster AI. Cognitive sequelae of subthalamic nucleus deep brain stimulation in Parkinson’s disease: a meta-analysis. Lancet Neurol. 2006;5:578–588. doi: 10.1016/S1474-4422(06)70475-6. [DOI] [PubMed] [Google Scholar]
  • 82.Hariz MI, Johansson F, Shamsgovara P, Johansson E, Hariz GM, Fagerlund M. Bilateral subthalamic nucleus stimulation in a parkinsonian patient with preoperative deficits in speech and cognition: persistent improvement in mobility but increased dependency: a case study. Mov Disord. 2000;15:136–139. doi: 10.1002/1531-8257(200001)15:1<136::AID-MDS1021>3.0.CO;2-5. [DOI] [PubMed] [Google Scholar]
  • 83.Peppe A, Pierantozzi M, Bassi A, et al. Stimulation of the subthalamic nucleus compared with the globus pallidus internus in patients with Parkinson disease. J Neurosurg. 2004;101:195–200. doi: 10.3171/jns.2004.101.2.0195. [DOI] [PubMed] [Google Scholar]
  • 84.Krause M, Fogel W, Heck A, et al. Deep brain stimulation for the treatment of Parkinson’s disease: subthalamic nucleus versus globus pallidus intemus. J Neurol Neurosurg Psychiatry. 2001;70:464–470. doi: 10.1136/jnnp.70.4.464. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 85.Krack P, Pollak P, Limousin P, et al. Subthalamic nucleus or internal pallidal stimulation in young onset Parkinson’s disease. Brain. 1998;121:451–457. doi: 10.1093/brain/121.3.451. [DOI] [PubMed] [Google Scholar]
  • 86.Esselink RA, de Bie RM, de Haan RJ, et al. Unilateral pallidotomy versus bilateral subthalamic nucleus stimulation in PD: a randomized trial. Neurology. 2004;62:201–207. doi: 10.1212/01.wnl.0000103235.12621.c3. [DOI] [PubMed] [Google Scholar]
  • 87.Welter ML, Houeto JL, Tezenas du Montcel S, et al. Clinical predictive factors of subthalamic stimulation in Parkinson’s disease. Brain. 2002;125:575–583. doi: 10.1093/brain/awf050. [DOI] [PubMed] [Google Scholar]
  • 88.Witjas T, Baunez C, Henry JM, et al. Addiction in Parkinson’s disease: impact of subthalamic nucleus deep brain stimulation. Mov Disord. 2005;20:1052–1055. doi: 10.1002/mds.20501. [DOI] [PubMed] [Google Scholar]
  • 89.Bandini F, Primavera A, Pizzorno M, Cocito L. Using STN DBS and medication reduction as a strategy to treat pathological gambling in Parkinson’s disease. Parkinsonism Relat Disord. 2007;13:369–371. doi: 10.1016/j.parkreldis.2006.07.011. [DOI] [PubMed] [Google Scholar]
  • 90.Ardouin C, Voon V, Worbe Y, et al. Pathological gambling in Parkinson’s disease improves on chronic subthalamic nucleus stimulation. Mov Disord. 2006;21:1941–1946. doi: 10.1002/mds.21098. [DOI] [PubMed] [Google Scholar]
  • 91.Houeto JL, Mesnage V, Mallet L, et al. Behavioural disorders, Parkinson’s disease and subthalamic stimulation. J Neurol Neurosurg Psychiatry. 2002;72:701–707. doi: 10.1136/jnnp.72.6.701. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 92.Schüpbach WM, Maltête D, Houeto JL. Neurosurgery at an earlier stage of Parkinson’s disease: a randomized, controlled trial. Neurology. 2007;68:267–271. doi: 10.1212/01.wnl.0000250253.03919.fb. [DOI] [PubMed] [Google Scholar]
  • 93.Defer G-L, Widner H, Marié RM, Rémy P, Levivier M. Core Assessment Program for Surgical Interventional Therapies in Parkinson’s Disease (CAPSIT-PD) Mov Disord. 1999;14:572–584. doi: 10.1002/1531-8257(199907)14:4<572::AID-MDS1005>3.0.CO;2-C. [DOI] [PubMed] [Google Scholar]
  • 94.Plaha P, Gill SS. Bilateral deep brain stimulation of the pedunculopontine nucleus for Parkinson’s disease. Neuroreport. 2005;148:895–897. doi: 10.1097/01.wnr.0000187637.20771.a0. [DOI] [PubMed] [Google Scholar]
  • 95.Mazzone P, Lozano A, Stanzione P, et al. Implantation of human pedunculopontine nucleus: a safe and clinically relevant target in Parkinson’s disease. Neuroreport. 2005;16:1877–1881. doi: 10.1097/01.wnr.0000187629.38010.12. [DOI] [PubMed] [Google Scholar]
  • 96.Stefani A, Lozano AM, Peppe A, et al. Bilateral deep brain stimulation of the pedunculopontine and subthalamic nuclei in severe Parkinson’s disease. Brain. 2007;130:1595–1607. doi: 10.1093/brain/awl346. [DOI] [PubMed] [Google Scholar]
  • 97.Zrinzo L, Zrinzo LV, Hariz M. the pedunculopontine and peripeduncular nuclei: a tale of two structures. Brain. 2007;130:e73–e73. doi: 10.1093/brain/awm079. [DOI] [PubMed] [Google Scholar]
  • 98.Yelnik J. PPN or PPD, what is the target for deep brain stimulation in Parkinson’s disease? Brain. 2007;130:e79–e79. doi: 10.1093/brain/awm138. [DOI] [PubMed] [Google Scholar]
  • 99.Gill SS, Patel NK, Hotton GR, et al. Direct brain infusion of glial cell line-derived neurotrophic factor in Parkinson disease. Nat Med. 2003;9:589–595. doi: 10.1038/nm850. [DOI] [PubMed] [Google Scholar]
  • 100.Kaplitt MG, Feigin A, Tang C, et al. Safety and tolerability of gene therapy with an adeno-associated virus (AAV) borne GAD gene for Parkinson’s disease: an open label, phase I trial. Lancet. 2007;369:2097–2105. doi: 10.1016/S0140-6736(07)60982-9. [DOI] [PubMed] [Google Scholar]

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