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Ther Adv Neurol Disord · Jan 2012
Nonmotor outcomes in Parkinson's disease: is deep brain stimulation better than dopamine replacement therapy?
- Rupam Borgohain, Rukmini Mridula Kandadai, Afshan Jabeen, and Meena A Kannikannan.
- Ther Adv Neurol Disord. 2012 Jan 1;5(1):23-41.
AbstractNonmotor symptoms are an integral part of Parkinson's disease and cause significant morbidity. Pharmacological therapy helps alleviate the disease but produces nonmotor manifestations. While deep brain stimulation (DBS) has emerged as the treatment of choice for motor dysfunction, the effect on nonmotor symptoms is not well known. Compared with pharmacological therapy, bilateral subthalamic nucleus (STN)-DBS or globus pallidum interna (GPi)-DBS has significant beneficial effects on pain, sleep, gastrointestinal and urological symptoms. STN-DBS is associated with a mild worsening in verbal fluency while GPi-DBS has no effect on cognition. STN-DBS may improve cardiovascular autonomic disturbances by reducing the dose of dopaminergic drugs. Because the motor effects of STN-DBS and GPi-DBS appear to be similar, nonmotor symptoms may determine the target choice in surgery of future patients.
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