Hilker R, Benecke R, Deuschl G, Fogel W, Kupsch A, Schrader C, Sixel-Döring F, Timmermann L, Volkmann J, Lange M
Zentrum der Neurologie und Neurochirurgie, Klinik für Neurologie, Goethe-Universität, Frankfurt am Main.
Nervenarzt. 2009 Jun;80(6):646-55. doi: 10.1007/s00115-009-2695-3.
Deep brain stimulation (DBS) has been shown to be effective for levodopa-responsive symptoms and tremor in Parkinson's disease (PD). The subthalamic nucleus (STN) is the preferred target for most patients suffering from late stage motor complications of the disorder. STN DBS is superior to best medical treatment concerning the control of motor fluctuations and the increase of on-time without dyskinesias. In contrast to DBS of the internal pallidum (GPi), STN stimulation also permits a reduction of the dopaminergic medication. Long-term data demonstrated sustained effectiveness of STN DBS despite progressive disease. DBS of the thalamic ventral intermediate nucleus (VIM) is an alternative target in older PD patients with severe PD tremor refractory to medication. In order to minimize potential risks and side effects, the use of DBS needs careful adherence to inclusion and exclusion criteria for eligible PD patients. This paper summarizes the current consensus recommendations of the German Deep Brain Stimulation Association for DBS in PD.
深部脑刺激(DBS)已被证明对帕金森病(PD)中左旋多巴反应性症状和震颤有效。丘脑底核(STN)是大多数患有该疾病晚期运动并发症患者的首选靶点。在控制运动波动和增加无运动障碍的“开”期时间方面,STN-DBS优于最佳药物治疗。与苍白球内侧部(GPi)的DBS相比,STN刺激还可以减少多巴胺能药物的使用。长期数据表明,尽管疾病进展,STN-DBS仍具有持续疗效。丘脑腹中间核(VIM)的DBS是老年PD患者中药物难治性严重PD震颤的替代靶点。为了将潜在风险和副作用降至最低,DBS的使用需要严格遵循符合条件的PD患者的纳入和排除标准。本文总结了德国深部脑刺激协会目前关于PD中DBS的共识建议。