deep brain stimulation (DBS)

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Introduction

High-frequency continuous electrical stimulation to the subthalamic nucleus or nucleus accumbens through a surgically- implanted device.

Indications

* characteristics of good candidates[6]

Contraindications

* characteristics of poor candidates[6]

Advantages

Procedure

Mechanism of action

Complications

Management

Notes

  • Meditronics single source in 2006.

More general terms

References

  1. ↑ Deuschl G et al, A randomized trial of deep-brain stimulation for Parkinson's disease. N Engl J Med 2006, 355:896 PMID: https://www.ncbi.nlm.nih.gov/pubmed/16943492
  2. ↑ 2.0 2.1 2.2 Holtzheimer PE et al. Subcallosal cingulate deep brain stimulation for treatment- resistant unipolar and bipolar depression. Arch Gen Psychiatry 2012 Feb; 69:150. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22213770
  3. ↑ 3.0 3.1 Journal Watch, Massachusetts Medical Society, July 2, 2012 Weaver FM et al. Randomized trial of deep brain stimulation for Parkinson disease: Thirty-six-month outcomes. Neurology 2012 Jul 3; 79:55. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22722632
    Tagliati M. Turning tables: Should GPi become the preferred DBS target for Parkinson disease? Neurology 2012 Jul 3; 79:19 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22722627
  4. ↑ 4.0 4.1 Moreau C et al. Methylphenidate for gait hypokinesia and freezing in patients with Parkinson's disease undergoing subthalamic stimulation: A multicentre, parallel, randomised, placebo-controlled trial. Lancet Neurol 2012 Jun 1 PMID: https://www.ncbi.nlm.nih.gov/pubmed/22658702
  5. ↑ 5.0 5.1 Thobois S et al. Parkinsonian apathy responds to dopaminergic stimulation of D2/D3 receptors with piribedil. Brain 2013 May; 136:1568 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23543483
  6. ↑ 6.0 6.1 6.2 Medical Knowledge Self Assessment Program (MKSAP) 16 American College of Physicians, Philadelphia 2012
  7. ↑ 7.0 7.1 Follett KA, Weaver FM, Stern M et al Pallidal versus subthalamic deep-brain stimulation for Parkinson's disease. N Engl J Med. 2010 Jun 3;362(22):2077-91 PMID: https://www.ncbi.nlm.nih.gov/pubmed/20519680
  8. ↑ 8.0 8.1 Buhmann C et al. Effect of subthalamic nucleus deep brain stimulation on driving in Parkinson disease. Neurology 2014 Jan 7; 82:32 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24353336
  9. ↑ 9.0 9.1 DeLong MR et al. Effect of advancing age on outcomes of deep brain stimulation for Parkinson disease. JAMA Neurol 2014 Aug 25; <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25155481 <Internet> http://archneur.jamanetwork.com/article.aspx?articleid=1897094
  10. ↑ 10.0 10.1 Jung YJ et al. An 8-year follow-up on the effect of subthalamic nucleus deep brain stimulation on pain in Parkinson disease. JAMA Neurol 2015 Mar 23 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25799451 <Internet> http://archneur.jamanetwork.com/article.aspx?articleid=2210911
  11. ↑ 11.0 11.1 11.2 de Hemptinne C et al. Therapeutic deep brain stimulation reduces cortical phase- amplitude coupling in Parkinson's disease. Nat Neurosci 2015 May; 18:779 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25867121
    Williams ZM. Good vibrations with deep brain stimulation. Nat Neurosci 2015 Apr 28; 18:618. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25919960
  12. ↑ 12.0 12.1 FDA News Release. June 12, 2015 FDA approves brain implant to help reduce Parkinson's disease and essential tremor symptoms. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm451152.htm
  13. ↑ 13.0 13.1 Timmermann L et al. Multiple-source current steering in subthalamic nucleus deep brain stimulation for Parkinson's disease (the VANTAGE study): A non-randomised, prospective, multicentre, open-label study. Lancet Neurol 2015 Jul; 14:693 PMID: https://www.ncbi.nlm.nih.gov/pubmed/26027940
  14. ↑ Okun MS Deep-brain stimulation for Parkinson's disease. N Engl J Med. 2012 Oct 18;367(16):1529-38 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23075179
  15. ↑ 15.0 15.1 Lhommee E, Wojtecki L, Czernecki V et al. Behavioural outcomes of subthalamic stimulation and medical therapy versus medical therapy alone for Parkinson's disease with early motor complications (EARLYSTIM trial): Secondary analysis of an open-label randomised trial. Lancet Neurol. 2018 Mar;17(3):223-231. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29452685
  16. ↑ 16.0 16.1 Monaco K New DBS System Improves Parkinson's Symptoms. Sham-controlled INTREPID study assessed multiple-current Vercise System. MedPage Today. April 26, 2018 https://www.medpagetoday.com/meetingcoverage/aan/72557
    Vitek J, et al INTREPID: A prospective, double blinded, multicenter randomized controlled trial evaluating deep brain stimulation with a new multiple source, constant current rechargeable system in Parkinson's disease. American Academy of Neurology (AAN) 2018; Abstract ES Platform 001.
  17. ↑ 17.0 17.1 Schuepach WMM, Tonder L, Schnitzler A et al. Quality of life predicts outcome of deep brain stimulation in early Parkinson disease. Neurology 2019 Mar 5; 92:e1109-e1120 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30737338
  18. ↑ 18.0 18.1 George J Deep Brain Stimulation May Put Parkinson's Patients at Risk for Drowning.
    Proficient swimmers discover swimming skills impaired after DBS. MedPage Today. Nov. 27, 2019 https://www.medpagetoday.com/geriatrics/parkinsonsdisease/83610
    Waldvogel D et al Beware of deep water after subthalamic deep brain stimulation. Neurology. Nov 27, 2019; https://n.neurology.org/content/early/2019/11/26/WNL.0000000000008664
    American Academny of Neurology Beware of Swimming if You Use Deep Brain Stimulation for Parkinson's. Case Studies Show Good Swimmers Lose Ability when Device Is On. Press Release. Nov 27, 2019 https://www.aan.com/PressRoom/Home/PressRelease/2758
    FDA Safety Communication. July 30, 2020 Risk of loss of coordination during water-related activities in Parkinson's Patients with Deep Brain Stimulators: FDA Safety Communication. https://www.fda.gov/medical-devices/safety-communications/risk-loss-coordination-during-water-related-activities-parkinsons-patients-deep-brain-stimulators
  19. ↑ 19.0 19.1 George J Dementia and Deep-Brain Stimulation in Parkinson's - Prevalence, incidence may not be higher in DBS patients. MedPage Today July 2, 2020 https://www.medpagetoday.com/neurology/parkinsonsdisease/87402
    Bove F, Fraix V, Cavallieri F et al Dementia and subthalamic deep brain stimulation in Parkinson disease. A long-term overview. Neurology. July 1, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/32611633 https://n.neurology.org/content/early/2020/07/01/WNL.0000000000009822
  20. ↑ 20.0 20.1 20.2 20.3 George J How Long Do Deep Brain Stimulation Benefits Last?
    Parkinson's patients saw continued improvement in motor symptoms, quality of life. MedPage Today June 2, 2021 https://www.medpagetoday.com/neurology/parkinsonsdisease/92888
    Bove F et al Long-term Outcomes (15 Years) After Subthalamic Nucleus Deep Brain Stimulation in Patients with Parkinson Disease. Neurology 2021. June 2 34078713 https://n.neurology.org/content/early/2021/06/02/WNL.0000000000012246
    Chou K, Charles D Subthalamic Nucleus Deep Brain Stimulation: Uncomplicating Motor Complications for the Long Haul. Neurology 2021. June 2 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34078714 https://n.neurology.org/content/early/2021/06/02/WNL.0000000000012245
  21. ↑ 21.0 21.1 Schmidt SL et al. At home adaptive dual target deep brain stimulation in Parkinson disease with proportional control. Brain 2023 Dec 21; [e-pub]. PMID: https://www.ncbi.nlm.nih.gov/pubmed/38128546 https://academic.oup.com/brain/advance-article-abstract/doi/10.1093/brain/awad429/7490826
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