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Centro de Investigaciones Regionales Dr. Hideyo Noguchi, Universidad Autónoma de Yucatán

2021, Number 2

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Rev Biomed 2021; 32 (2)

Deep brain stimulation for Parkinson's disease: selection criteria, surgical approach, side effects, and controversies

Leal-Ortega R

Language: Spanish
References: 49
Page: 113-123
PDF size: 535.82 Kb.


ABSTRACT

Parkinson’s disease (PD) is the second most common neurodegenerative disease. It aff ects 6 million people worldwide and this amount will increase in the upcoming years. Management consists of a combination of drugs, physical therapy, and advanced therapies that include devices for parenteral use (apomorphine pumps and intestinal levodopa), ablative surgery, and functional surgery. Deep brain stimulation (DBS) is a modality in which electrical stimuli is delivered through electrodes implanted in deep nuclei of the brain that are connected to a pulse generator; it is a technique used worldwide with more than 150,000 operated patients. This procedure can control motor and some nonmotor symptoms that have been failed to control by medical treatment. Briefl y, a good candidate for DBS is one who has had PD for at least 5 years, a good response to levodopa, motor complications from treatment, and an adequate cognitive-psychiatric profi le. During the procedure, the neurosurgeon uses stereotactic coordinates to direct the electrodes to the selected nucleus while the neurologist monitors cell physiology so they can be placed in the exact site. There are signifi cant but preventable and treatable complications during the procedure and postoperatively. In 2016, our team performed the fi rst surgery of this type in Mérida, Yucatán with successful results. The aim of this paper is to do a descriptive review of the selection process, the surgical intervention, complications, and the controversies on the use of DBS for PD.


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