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Deep Brain Stimulation of the Subthalamic Nucleus for the Treatment of Parkinson's Disease

  • Chapter
Deep Brain Stimulation in Neurological and Psychiatric Disorders

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Levodopa remains the gold standard for the treatment of Parkinson's disease (PD). However, its chronic use is associated with motor and psychiatric com plications causing significant disability. Thus, there is a need for alternative approaches including surgical treatment. Better understanding of basal ganglia circuitry and the availability of an experimental animal model of Parkinson's disease in the form of the 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP)-treated monkey have made evident the crucial role of the subthalamic nucleus (STN) in basal ganglia function. Deep brain stimulation (DBS) has become an acceptable treatment option, improving quality of life (QOL) for PD patients with medically intractable symptoms. Good pre-operative levodopa respon siveness and younger age appear to be the best predictors of surgical success, particularly with respect to improvement in motor function. Although benefits in mobility are achieved, complications are not infrequent, and risk—benefit ratio should be assessed on an individual basis for each patient depending on personal preferences, s ocioeconomic status, and local disease demographics. In this chapter, a comprehensive review of the current literature on the topic is pre sented in addition to our own results with STN DBS for the treatment of PD.

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Authors and Affiliations

  1. Raul Carrea Institute for Neurological Research (FLENI), Buenos Aires, Argentina

    Marcelo Merello

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  1. Marcelo Merello
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Editors and Affiliations

  1. Parkinson's Disease and Movement Disorders Center, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Daniel Tarsy MD  & Daniel Tarsy MD  & 

  2. Neuromodulation Research Center, Lerner Research Institute, The Cleveland Clinic Foundation, Cleveland, OH, USA

    Jerrold L. Vitek MD, PhD

  3. Department of Neurosurgery, University of California, San Francisco, CA, USA

    Philip A. Starr MD, PhD

  4. Departments of Neurology and Neurosurgery, McKnight Brain Institute, University of Florida, Gainesville, FL, USA

    Michael S. Okun MD

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© 2008 Humana Press, a part of Springer Science+Business Media, LLC

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Merello, M. (2008). Deep Brain Stimulation of the Subthalamic Nucleus for the Treatment of Parkinson's Disease. In: Tarsy, D., Vitek, J.L., Starr, P.A., Okun, M.S. (eds) Deep Brain Stimulation in Neurological and Psychiatric Disorders. Current Clinical Neurology. Humana Press. https://doi.org/10.1007/978-1-59745-360-8_14

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  • DOI: https://doi.org/10.1007/978-1-59745-360-8_14

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