Deep Brain Stimulation in Neurological and Psychiatric Disorders.

نویسندگان

  • Volker A Coenen
  • Florian Amtage
  • Jens Volkmann
  • Thomas E Schläpfer
چکیده

BACKGROUND Deep brain stimulation (DBS) is the chronic electrical stimulation of selected target sites in the brain through stereotactically implanted electrodes. More than 150 000 patients around the world have been treated to date with DBS for medically intractable conditions. The indications for DBS include movement disorders, epilepsy, and some types of mental illness. METHODS This review is based on relevant publications retrieved by a selective search in PubMed and the Cochrane Library, and on the current guidelines of the German Neurological Society (Deutsche Gesellschaft für Neurologie, DGN). RESULTS DBS is usually performed to treat neurological diseases, most often movement disorders and, in particular, Parkinson's disease. Multiple randomized controlled trials (RCTs) have shown that DBS improves tremor, dyskinesia, and quality of life in patients with Parkinson's disease by 25% to 50%, depending on the rating scales used. DBS for tremor usually involves stimulation in the cerebello-thalamo-cortical regulatory loop. In an RCT of DBS for the treatment of primary generalized dystonia, the patients who underwent DBS experienced a 39.3% improvement of dystonia, compared to only 4.9% in the control group. Two multicenter trials of DBS for depression were terminated early because of a lack of efficacy. CONCLUSION DBS is an established treatment for various neurological and psychiatric diseases. It has been incorporated in the DGN guidelines and is now considered a standard treatment for advanced Parkinson's disease. The safety and efficacy of DBS can be expected to improve with the application of new technical developments in electrode geometry and new imaging techniques. Controlled trials would be helpful so that DBS could be extended to further indications, particularly psychiatric ones.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Treatment of Neurological and Psychiatric Disorders with Deep Brain Stimulation Raising Hopes and Future Challenges

The technology of Neural Stimulation in recent years has become the focus of the research and treatment, although it has been around for many years. The potential use of stimulating the brain and nerves ranges from the spinal cord stimulation to the implantations of cochlear and bionic eyes with a large discrepancy between the clinical readiness for these various uses. Electrical high-frequency...

متن کامل

O10: Deep Brain Stimulation and Psychiatry

The use of deep brain stimulation in psychiatric disorders has received great interest owing to the small risk of the operation, the reversible nature of the technique, and the possibility of optimizing treatment postoperatively. Currently deep brain stimulation in psychiatry is investigated for obsessive-compulsive disorder, Gilles de la Tourette’s syndrome and major depression. This presentat...

متن کامل

Control of epileptic seizures by electrical low frequency deep brain stimulation: A review of probable mechanisms

Epilepsy is the most common neurological disease with no definitive method in treatment. Notably, the main way to treat and control epileptic seizures is drug therapy. However, about 20-30% of patients with epilepsy are drug resistant and require other therapeutic manners. Deep brain stimulation is a new therapeutic strategy for these patients. Conspicuously, there are no clear answers for basi...

متن کامل

Current perspectives on deep brain stimulation for severe neurological and psychiatric disorders

Deep brain stimulation (DBS) has become a well-accepted therapy to treat movement disorders, including Parkinson's disease, essential tremor, and dystonia. Long-term follow-up studies have demonstrated sustained improvement in motor symptoms and quality of life. DBS offers the opportunity to selectively modulate the targeted brain regions and related networks. Moreover, stimulation can be adjus...

متن کامل

Deep Brain Stimulation for Movement Disorders – A History of Success and Challenges to Conquer

Up to date, tens of thousands patients have undergone implantation of deep brain stimulation electrodes – mainly for the treatment of Parkinson’s disease, Essential Tremor, and Idiopathic Dystonia. Pizzolato and Mandat (2012) give a short and comprehensive review on the current status of deep brain stimulation for these movement disorders. For this special issue “The development of deep brain s...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Deutsches Arzteblatt international

دوره 112 31-32  شماره 

صفحات  -

تاریخ انتشار 2015