-
- Fusako Yokochi.
- Department of Neurology, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu-shi, Tokyo 183-0042, Japan.
- Brain Nerve. 2009 Apr 1; 61 (4): 473-83.
AbstractDeep brain stimulation (DBS) has proved highly effective in the treatment for Parkinson's disease and dystonia. Presently, many types of dopamine agonists, monoamine oxidase B (MAOB) inhibitors, catechol-O-methyltransferase (COMT) inhibitor or other antiparkinsonian drugs are being developed. However, it is still very difficult to medically treat motor complications associated with levodopa therapy. Surgical intervention using DBS was possible to stimulate the subthalamic nucleus as the treatment of Parkinson's disease. Stimulation of the subthalamic nucleus improves the cardinal parkinsonian symptoms and motor complication associated with levodopa treatment. DBS is a reversible treatment and the original status could be observed by turning off the stimulation. This procedure enables the observation of clinical outcomes or brain mechanisms under both the conditions of turned on and turned off stimulations. On the other hand, dystonia is heterogeneous and refractory and hence, it has been difficult to medically treat it. Since there was no effective treatment available for patients with generalized dystonia, these patients became disabled. However, recently, bilateral pallidal DBS has been shown to markedly improve the conditions of patients with generalized dystonia, and it has proven to be a reliable treatment. There are two characteristic clinical effects of pallidal DBS on dystonia. It improves primary hereditary generalized dystonia, particularly DYT 1, more prominently than secondary dystonia and its beneficial effects are observed over a period of time course. The beneficial effects of pallidal DBS in patients with dystonia are not immediate but progress over weeks to months. The brain mechanism underlying the improvement of pallidal DBS in dystonia has been unclear. Many studies on DBS in Parkinson's disease and dystonia have been carried out to elucidate the clinical outcomes and/or the underlying neurophysiological mechanisms. In this review, the clinical outcomes of DBS for Parkinson's disease and dystonia will be focused on.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:
![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.