Türk Nöroşirürji Dergisi
2021 , Vol 31 , Num 3
Deep Brain Stimulation in Parkinson's Disease-Patient Selection and Surgical Outcome
1Sağlık Bilimleri Üniversitesi, Hamidiye Tıp Fakültesi, Başakşehir Çam ve Sakura Şehir Hastanesi Beyin ve Sinir Cerrahisi Kliniği, İstanbul, Türkiye
Central neuromodulation methods may improve activities of daily living in Parkinson"s Disease. It is also possible to reduce motor
symptoms and dyskinesia and to extend the duration of dyskinesia-free well-being status. Deep brain stimulation is more effective
than the best medical therapy in patients with motor fluctuations. It is also more effective for tremor and dopamine-responsive
symptoms. However, DBS has a low success rate in patients with axial symptoms, balance impairment, and speech disorders.
Therefore, patient selection is very important and directly affects the outcome. The patients who will benefit the most are the ones
who are younger, have a good response to dopamine, present predominant extra-axial symptoms, and show preserved cognitive
function, and whose motor fluctuations are at an early phase. However, surgery is less beneficial in patients with comorbidity, old
age, uncontrolled psychiatric disease, social impairment, or severe dementia.
Anahtar Kelimeler :
Deep brain stimulation, Movement disorders, STN, Outcome