Deep Brain Stimulation in Parkinson’s Disease

Abstract

Before the era of L‑Dopa, surgical ventures (pallidotomy and thalamotomy) were applied in the treatment of Parkinson’s disease (PD). The first experience of deep brain stimulation (DBS) was carried out by Heath and Pool for chronic pain in mid‑1950s. From those times, DBS is placed a legitimate position in PD treatment whereas that it is in principle “reversible lesion” – in the state of previous ones where the condition was “irreversible lesion” – in the target nuclei. The latter are globus pallidus inserta or subthalamic nucleus and DBS does not interfere with the use of other future therapies. The touchstone for DBS surgery is “the right patient” by “the experienced team” at “the right time” so that the last three can provide magnificent benefits. Indeed both acute and the long‑term results ends up with a dramatic and stable improvement of a patient’s having DBS. The outlet of this article is to build an awareness of the roles of DBS in PD with clinical evaluation, electrophysiological bases, importance of surgical techniques with unilateral – bilateral approaches, postoperative follow‑up early, and late acquirement of DBS and the gainings of the interdisciplinary – team approach.