Deep brain stimulation in Parkinson’s disease

For the last 50 years, levodopa has been the cornerstone of Parkinson’s disease management. However, a majority of patients develop motor complications a few years after therapy onset. Deep brain stimulation has been approved by the FDA as an adjunctive treatment in Parkinson disease, especially aimed at controlling these complications. However, the exact mechanism of action of deep brain stimulation, the best nucleus to target as well as the best timing for surgery are still debatable. We here provide an in-depth and critical review of the current literature on this topic.

[1]  M. Okun,et al.  Parkinson’s disease DBS: what, when, who and why? The time has come to tailor DBS targets , 2010, Expert review of neurotherapeutics.

[2]  K. Lyons,et al.  The impact of bilateral subthalamic stimulation on non-motor symptoms of Parkinson's disease. , 2011, Parkinsonism & related disorders.

[3]  Joseph Jankovic,et al.  Movement disorders in cerebrovascular disease , 2013, The Lancet Neurology.

[4]  Y. Kajita,et al.  Long-term stimulation of the subthalamic nucleus in hemiparkinsonian rats: neuroprotection of dopaminergic neurons. , 2004, Journal of neurosurgery.

[5]  Roberto Eleopra,et al.  A decision tool to support appropriate referral for deep brain stimulation in Parkinson’s disease , 2009, Journal of Neurology.

[6]  J. Rozman,et al.  Tremor amplitude and tremor frequency variability in Parkinson's disease is dependent on activity and synchronisation of central oscillators in basal ganglia. , 2010, Medical hypotheses.

[7]  P. Hogarth,et al.  Pallidal vs subthalamic nucleus deep brain stimulation in Parkinson disease. , 2005, Archives of neurology.

[8]  P. Stanzione,et al.  Bilateral deep brain stimulation of the pedunculopontine and subthalamic nuclei in severe Parkinson's disease. , 2007, Brain : a journal of neurology.

[9]  P. A. House,et al.  Bilateral Deep Brain Stimulation vs Best Medical Therapy for Patients With Advanced Parkinson Disease: A Randomized Controlled Trial , 2009 .

[10]  Su-Youne Chang,et al.  High frequency stimulation abolishes thalamic network oscillations: an electrophysiological and computational analysis , 2011, Journal of neural engineering.

[11]  Ron Alterman,et al.  Subthalamic deep brain stimulation with a constant-current device in Parkinson's disease: an open-label randomised controlled trial , 2012, The Lancet Neurology.

[12]  D. Tank,et al.  Brain magnetic resonance imaging with contrast dependent on blood oxygenation. , 1990, Proceedings of the National Academy of Sciences of the United States of America.

[13]  G. Halliday,et al.  The Sydney multicenter study of Parkinson's disease: The inevitability of dementia at 20 years , 2008, Movement disorders : official journal of the Movement Disorder Society.

[14]  R. Turner,et al.  Dynamic magnetic resonance imaging of human brain activity during primary sensory stimulation. , 1992, Proceedings of the National Academy of Sciences of the United States of America.

[15]  Yen-Yu I. Shih,et al.  Neural Circuit Modulation During Deep Brain Stimulation at the Subthalamic Nucleus for Parkinson's Disease: What Have We Learned from Neuroimaging Studies? , 2013, Brain Connect..

[16]  M. Okun,et al.  Identifying candidates for deep brain stimulation in Parkinson's disease: the role of the primary care physician. , 2007, Geriatrics.

[17]  Yasin Temel,et al.  Impulse control and related disorders in Parkinson's disease patients treated with bilateral subthalamic nucleus stimulation: a review. , 2011, Parkinsonism & related disorders.

[18]  D. Bowers,et al.  Greater improvement in quality of life following unilateral deep brain stimulation surgery in the globus pallidus as compared to the subthalamic nucleus , 2009, Journal of Neurology.

[19]  M. Tagliati Turning tables , 2012, Neurology.

[20]  Adrian Danek,et al.  Neuropsychological and psychiatric changes after deep brain stimulation for Parkinson's disease: a randomised, multicentre study , 2008, The Lancet Neurology.

[21]  A. Priori,et al.  Rhythm-specific pharmacological modulation of subthalamic activity in Parkinson's disease , 2004, Experimental Neurology.

[22]  Atchar Sudhyadhom,et al.  REOPERATION FOR SUBOPTIMAL OUTCOMES AFTER DEEP BRAIN STIMULATION SURGERY , 2008, Neurosurgery.

[23]  Thomas Foltynie,et al.  Reducing hemorrhagic complications in functional neurosurgery: a large case series and systematic literature review. , 2012, Journal of neurosurgery.

[24]  J. Herzog,et al.  A tool to improve pre-selection for deep brain stimulation in patients with Parkinson’s disease , 2010, Journal of Neurology.

[25]  G. Deuschl,et al.  A randomized trial of deep-brain stimulation for Parkinson's disease. , 2006, The New England journal of medicine.

[26]  Laura Mancini,et al.  Functional imaging of subthalamic nucleus deep brain stimulation in Parkinson's disease , 2011, Movement disorders : official journal of the Movement Disorder Society.

[27]  P. Rabins,et al.  Psychiatric and neuropsychiatric adverse events associated with deep brain stimulation: A meta‐analysis of ten years' experience , 2007, Movement disorders : official journal of the Movement Disorder Society.

[28]  P. Warnke STN stimulation and neuroprotection in Parkinson’s disease—when beautiful theories meet ugly facts , 2005, Journal of Neurology, Neurosurgery & Psychiatry.

[29]  David W. Roberts,et al.  Deep Brain Stimulation Results in Local Glutamate and Adenosine Release: Investigation Into the Role of Astrocytes , 2010, Neurosurgery.

[30]  E. Růžička,et al.  Functional magnetic resonance imaging during deep brain stimulation: A pilot study in four patients with Parkinson's disease , 2001, Movement disorders : official journal of the Movement Disorder Society.

[31]  M. Eckman,et al.  Early versus delayed bilateral subthalamic deep brain stimulation for parkinson's disease: A decision analysis , 2010, Movement disorders : official journal of the Movement Disorder Society.

[32]  J. Dostrovsky,et al.  The Globus Pallidus, Deep Brain Stimulation, and Parkinson's Disease , 2002, The Neuroscientist : a review journal bringing neurobiology, neurology and psychiatry.

[33]  H. Bergman,et al.  Reversal of experimental parkinsonism by lesions of the subthalamic nucleus. , 1990, Science.

[34]  D. Bowers,et al.  The trajectory of apathy after deep brain stimulation: from pre-surgery to 6 months post-surgery in Parkinson's disease. , 2011, Parkinsonism & related disorders.

[35]  P. Brown,et al.  Reduction in subthalamic 8–35 Hz oscillatory activity correlates with clinical improvement in Parkinson's disease , 2006, The European journal of neuroscience.

[36]  H M M Smeding,et al.  Pathological Gambling after bilateral STN stimulation in Parkinson disease , 2008 .

[37]  M. Okun,et al.  Deep brain stimulation and the role of astrocytes , 2012, Molecular Psychiatry.

[38]  J. Noth,et al.  Deep brain stimulation of the subthalamic nucleus improves intrinsic alertness in Parkinson's disease , 2009, Movement disorders : official journal of the Movement Disorder Society.

[39]  Keith Wheatley,et al.  Deep brain stimulation plus best medical therapy versus best medical therapy alone for advanced Parkinson's disease (PD SURG trial): a randomised, open-label trial , 2010, The Lancet Neurology.

[40]  M. Okun,et al.  Enough is enough: moving on to deep brain stimulation in patients with fluctuating Parkinson disease. , 2009, Archives of neurology.

[41]  A. Benabid,et al.  Dopaminergic cells in the periaqueductal grey matter of MPTP-treated monkeys and mice; patterns of survival and effect of deep brain stimulation and lesion of the subthalamic nucleus. , 2010, Parkinsonism & related disorders.

[42]  A. Stefani,et al.  Effects of deep brain stimulation of the peduncolopontine area on working memory tasks in patients with Parkinson's disease. , 2010, Parkinsonism & related disorders.

[43]  B Piallat,et al.  Effects of pedunculopontine nucleus area stimulation on gait disorders in Parkinson's disease. , 2010, Brain : a journal of neurology.

[44]  H. Bergman,et al.  Pathological synchronization in Parkinson's disease: networks, models and treatments , 2007, Trends in Neurosciences.

[45]  J. Voges,et al.  Deep-brain stimulation: long-term analysis of complications caused by hardware and surgery—experiences from a single centre , 2006, Journal of Neurology, Neurosurgery & Psychiatry.

[46]  V. Dhawan,et al.  Network modulation in the treatment of Parkinson's disease. , 2006, Brain : a journal of neurology.

[47]  M. Delong,et al.  Milestones in research on the pathophysiology of Parkinson's disease , 2011, Movement disorders : official journal of the Movement Disorder Society.

[48]  R. Simpson,et al.  Management of device-related wound complications in deep brain stimulation surgery. , 2012, Journal of neurosurgery.

[49]  D. Standaert,et al.  Unilateral subthalamic nucleus deep brain stimulation improves sleep quality in Parkinson's disease. , 2012, Parkinsonism & related disorders.

[50]  S. Farmer Neural rhythms in Parkinson's disease. , 2002, Brain : a journal of neurology.

[51]  A. Cavanna,et al.  Impulse Control Disorders Following Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson's Disease: Clinical Aspects , 2011, Parkinson's disease.

[52]  C. McIntyre,et al.  Uncovering the mechanism(s) of action of deep brain stimulation: activation, inhibition, or both , 2004, Clinical Neurophysiology.

[53]  A. Benabid,et al.  Survival of midbrain dopaminergic cells after lesion or deep brain stimulation of the subthalamic nucleus in MPTP-treated monkeys. , 2007, Brain : a journal of neurology.

[54]  Joseph Jankovic,et al.  Pathophysiology and clinical assessment , 2013 .

[55]  R. S. Hinks,et al.  Time course EPI of human brain function during task activation , 1992, Magnetic resonance in medicine.

[56]  B. M. ter Haar Romeny,et al.  Structural and Resting State Functional Connectivity of the Subthalamic Nucleus: Identification of Motor STN Parts and the Hyperdirect Pathway , 2012, PloS one.

[57]  A. Lozano,et al.  The pedunculopontine nucleus as a target for deep brain stimulation , 2011, Journal of Neural Transmission.

[58]  P. Brown Abnormal oscillatory synchronisation in the motor system leads to impaired movement , 2007, Current Opinion in Neurobiology.

[59]  G. Friehs,et al.  Development and initial validation of a screening tool for Parkinson disease surgical candidates , 2004, Neurology.

[60]  L. Findley,et al.  The economic impact of Parkinson's disease. , 2007, Parkinsonism & related disorders.

[61]  E. McIntosh,et al.  Perspective on the economic evaluation of deep brain stimulation , 2011 .

[62]  Murray Grossman,et al.  Cognition following bilateral deep brain stimulation surgery of the subthalamic nucleus for Parkinson's disease , 2009, International journal of geriatric psychiatry.

[63]  J. Dostrovsky,et al.  Dependence of subthalamic nucleus oscillations on movement and dopamine in Parkinson's disease. , 2002, Brain : a journal of neurology.

[64]  J. Jankovic,et al.  Changes in cognitive‐emotional and physiological symptoms of depression following STN‐DBS for the treatment of Parkinson’s disease , 2012, European journal of neurology.

[65]  Nicola J. Ray,et al.  Local field potential beta activity in the subthalamic nucleus of patients with Parkinson's disease is associated with improvements in bradykinesia after dopamine and deep brain stimulation , 2008, Experimental Neurology.

[66]  M. Behbehani,et al.  Stimulation of the rat subthalamic nucleus is neuroprotective following significant nigral dopamine neuron loss , 2010, Neurobiology of Disease.

[67]  S. Hassin-Baer,et al.  Association of preoperative symptom profile with psychiatric symptoms following subthalamic nucleus stimulation in patients with Parkinson's disease. , 2009, The Journal of neuropsychiatry and clinical neurosciences.

[68]  O. Nilsen,et al.  Parkinson’s disease and nursing home placement: the economic impact of the need for care , 2009, European journal of neurology.

[69]  B Bioulac,et al.  Clinical and economic results of bilateral subthalamic nucleus stimulation in Parkinson’s disease , 2006, Journal of Neurology, Neurosurgery & Psychiatry.

[70]  Yasin Temel,et al.  Limbic effects of high-frequency stimulation of the subthalamic nucleus. , 2010, Vitamins and hormones.

[71]  M. Rizzone,et al.  Beyond nine years of continuous subthalamic nucleus deep brain stimulation in Parkinson's disease , 2011, Movement disorders : official journal of the Movement Disorder Society.

[72]  S. Fahn Description of Parkinson's Disease as a Clinical Syndrome , 2003, Annals of the New York Academy of Sciences.

[73]  R. Watts,et al.  The effects of deep brain stimulation on sleep in Parkinson’s disease , 2011, Therapeutic advances in neurological disorders.

[74]  M. Okun,et al.  Management of referred deep brain stimulation failures: a retrospective analysis from 2 movement disorders centers. , 2005, Archives of neurology.

[75]  B Conrad,et al.  A positron emission tomographic study of subthalamic nucleus stimulation in Parkinson disease: enhanced movement-related activity of motor-association cortex and decreased motor cortex resting activity. , 1999, Archives of neurology.

[76]  Anthony H V Schapira,et al.  Timing of Deep Brain Stimulation in Parkinson Disease: A Need for Reappraisal? , 2013, Annals of neurology.

[77]  A. Benabid,et al.  Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson's disease. , 2003, The New England journal of medicine.

[78]  Albert Gjedde,et al.  STN‐stimulation in Parkinson's disease restores striatal inhibition of thalamocortical projection , 2009, Human brain mapping.

[79]  Karl A. Sillay,et al.  Deep brain stimulator hardware-related infections: incidence and management in a large series. , 2008, Neurosurgery.

[80]  G. Deuschl,et al.  Stimulation of the subthalamic nucleus at an earlier disease stage of Parkinson's disease: concept and standards of the EARLYSTIM-study. , 2013, Parkinsonism & related disorders.

[81]  P. Stanzione,et al.  Deep Brain Stimulation of Pedunculopontine Tegmental Nucleus (PPTg) Promotes Cognitive and Metabolic Changes: A Target-Specific Effect or Response to a Low-Frequency Pattern of Stimulation? , 2010, Clinical EEG and neuroscience.

[82]  S Fahn,et al.  The spectrum of levodopa-induced dyskinesias. , 2000, Annals of neurology.

[83]  D. Brooks,et al.  Resting tremor in Parkinson disease: Is the pallidum to blame? , 2011, Annals of neurology.

[84]  C. Tanner,et al.  Epidemiology of Parkinson's disease and akinetic syndromes , 2000, Current opinion in neurology.

[85]  W D Heiss,et al.  STN-DBS activates the target area in Parkinson disease , 2008, Neurology.

[86]  Daniel Weintraub,et al.  Parkinson's disease--Part 1: Pathophysiology, symptoms, burden, diagnosis, and assessment. , 2008, The American journal of managed care.

[87]  J. Vitek,et al.  The persistent effects of unilateral pallidal and subthalamic deep brain stimulation on force control in advanced Parkinson's patients. , 2008, Parkinsonism & related disorders.

[88]  A. Bentivoglio,et al.  Motor and cognitive outcome in patients with Parkinson's disease 8 years after subthalamic implants. , 2010, Brain : a journal of neurology.

[89]  L. Baumgartner,et al.  Effect of deep brain stimulation on autonomic dysfunction in patients with Parkinson’s disease , 2011, Journal of Clinical Neuroscience.

[90]  Chris J Hass,et al.  A closer look at unilateral versus bilateral deep brain stimulation: results of the National Institutes of Health COMPARE cohort. , 2010, Journal of neurosurgery.

[91]  Y. Agid,et al.  Long‐term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson's disease , 2010, Movement disorders : official journal of the Movement Disorder Society.

[92]  C. Hass,et al.  Are two leads always better than one: An emerging case for unilateral subthalamic deep brain stimulation in Parkinson's disease , 2008, Experimental Neurology.

[93]  P. Brown,et al.  Cortico-cortical coupling in Parkinson's disease and its modulation by therapy. , 2005, Brain : a journal of neurology.

[94]  A. Lang,et al.  Ten-year outcome of subthalamic stimulation in Parkinson disease: a blinded evaluation. , 2011, Archives of neurology.

[95]  Grant D. Huang,et al.  Pallidal versus subthalamic deep-brain stimulation for Parkinson's disease. , 2010, The New England journal of medicine.

[96]  V. Sturm,et al.  Subthalamic Nucleus Stimulation Restores Glucose Metabolism in Associative and Limbic Cortices and in Cerebellum: Evidence from a FDG-PET Study in Advanced Parkinson's Disease , 2004, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[97]  J. Vitek Mechanisms of deep brain stimulation: Excitation or inhibition , 2002, Movement disorders : official journal of the Movement Disorder Society.

[98]  Clement Hamani,et al.  Unilateral pedunculopontine stimulation improves falls in Parkinson's disease. , 2010, Brain : a journal of neurology.

[99]  D. Bowers,et al.  Do Stable Patients With a Premorbid Depression History Have a Worse Outcome After Deep Brain Stimulation for Parkinson Disease? , 2011, Neurosurgery.

[100]  W. Ondo,et al.  Sleep problems in Parkinson’s disease patients , 2011 .

[101]  Alessandro E. P. Villa,et al.  Dopamine deficiency increases synchronized activity in the rat subthalamic nucleus , 2012, Brain Research.

[102]  Y. Agid,et al.  Neurosurgery at an earlier stage of Parkinson disease , 2007, Neurology.

[103]  R. P. Maguire,et al.  Disease progression continues in patients with advanced Parkinson’s disease and effective subthalamic nucleus stimulation , 2005, Journal of Neurology, Neurosurgery & Psychiatry.

[104]  S. Lewis,et al.  The incidence of seizures following Deep Brain Stimulating electrode implantation for movement disorders, pain and psychiatric conditions , 2009, British journal of neurosurgery.

[105]  Su-Youne Chang,et al.  Neurotransmitter release from high-frequency stimulation of the subthalamic nucleus. , 2004, Journal of neurosurgery.

[106]  A. Kupsch,et al.  Placebo-controlled chronic high-frequency stimulation of the subthalamic nucleus preserves dopaminergic nigral neurons in a rat model of progressive Parkinsonism , 2008, Experimental Neurology.

[107]  R. Jech Functional Imaging of Deep Brain Stimulation: fMRI, SPECT, and PET , 2008 .

[108]  J. Péron,et al.  Subthalamic nucleus stimulation affects fear and sadness recognition in Parkinson's disease. , 2010, Neuropsychology.

[109]  Klaus Seppi,et al.  Left hemispheric predominance of nigrostriatal dysfunction in Parkinson's disease. , 2012, Brain : a journal of neurology.

[110]  J. Jankovic,et al.  Respiratory problems in neurologic movement disorders. , 2010, Parkinsonism & related disorders.

[111]  M. Phelps,et al.  PET: the merging of biology and imaging into molecular imaging. , 2000, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[112]  Thomas D Parsons,et al.  Cognitive sequelae of subthalamic nucleus deep brain stimulation in Parkinson's disease: a meta-analysis , 2006, The Lancet Neurology.

[113]  André Parent,et al.  Parkinson's disease: Acquired frailty of archaic neural networks? , 2012, Journal of the Neurological Sciences.

[114]  G. Deuschl,et al.  Neurostimulation for Parkinson's disease with early motor complications. , 2013, The New England journal of medicine.

[115]  Bernhard Haslinger,et al.  Frequency-correlated decreases of motor cortex activity associated with subthalamic nucleus stimulation in Parkinson's disease , 2005, NeuroImage.

[116]  K. Dujardin,et al.  A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson's disease. , 2008, Brain : a journal of neurology.

[117]  K. Burchiel,et al.  Randomized trial of deep brain stimulation for Parkinson disease , 2012, Neurology.

[118]  A. Spottke,et al.  Longitudinal study of the socioeconomic burden of Parkinson’s disease in Germany , 2010, European journal of neurology.

[119]  K. Herholz,et al.  Brain receptor imaging. , 2010, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[120]  L. Metman,et al.  Deep brain stimulation for Parkinson's disease: Prevalence of adverse events and need for standardized reporting , 2008, Movement disorders : official journal of the Movement Disorder Society.

[121]  M. Gelabert-González,et al.  [Deep brain stimulation in Parkinson's disease]. , 2013, Revista de neurologia.

[122]  Francesc Valldeoriola,et al.  Prospective comparative study on cost‐effectiveness of subthalamic stimulation and best medical treatment in advanced Parkinson's disease , 2007, Movement disorders : official journal of the Movement Disorder Society.

[123]  Philip J. Hahn,et al.  Network perspectives on the mechanisms of deep brain stimulation , 2010, Neurobiology of Disease.

[124]  L. Timmermann,et al.  Review: management of Parkinson’s disease , 2013, Neuropsychiatric disease and treatment.

[125]  L. Bour,et al.  Subthalamic nucleus versus globus pallidus bilateral deep brain stimulation for advanced Parkinson's disease (NSTAPS study): a randomised controlled trial , 2013, The Lancet Neurology.

[126]  D. Bowers,et al.  Cognition and mood in Parkinson's disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: The COMPARE Trial , 2009, Annals of neurology.

[127]  Xu-dong Zhao,et al.  Long term high frequency stimulation of STN increases dopamine in the corpus striatum of hemiparkinsonian rhesus monkey , 2009, Brain Research.

[128]  Jack J Chen,et al.  Parkinson's disease: health-related quality of life, economic cost, and implications of early treatment. , 2010, The American journal of managed care.

[129]  Yong Hoon Lim,et al.  The effects of bilateral Subthalamic Nucleus Deep Brain Stimulation (STN DBS) on cognition in Parkinson disease , 2008, Journal of the Neurological Sciences.

[130]  Jean Régis,et al.  Effects of chronic subthalamic stimulation on nonmotor fluctuations in Parkinson's disease , 2007, Movement disorders : official journal of the Movement Disorder Society.

[131]  H. Freund,et al.  Evaluation of healthcare utilization and health status of patients with Parkinson's disease treated with deep brain stimulation of the subthalamic nucleus , 2002, Journal of Neurology.