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• Vol.53 No.11
• CLINICA NEUROL, 53: 1053−1055, 2013
• Vol.53 No.11 contents

Symposium 2

DBS therapy for Parkinson's disease -Our approach-

Sumito Sato, M.D., Ph.D.¹⁾, Yoko Takiyama, M.D., Ph.D.²⁾, Yutaka Ogino, M.D., Ph.D.³⁾, Katsushige Watanabe, M.D., Ph.D.⁴⁾, Tohru Terao, M.D.⁵⁾, Chihiro Matsumoto, M.D.¹⁾, Satomi Chiken, Ph.D.⁶⁾, Atsushi Nambu, M.D., Ph.D.⁶⁾, Kazutoshi Nishiyama, M.D., Ph.D.²⁾, Toshihiro Kumabe, M.D., Ph.D.¹⁾ and Kiyotaka Fujii, M.D., Ph.D.¹⁾

¹⁾Department of Neurosurgery, Kitasato University School of Medicine
²⁾Department of Neurology, Kitasato University School of Medicine
³⁾Department of Neurology, National Hakone Hospital
⁴⁾Department of Neurosurgery, Tokyo Metropolitan Matsuzawa Hospital
⁵⁾Department of Neurosurgery, Atsugi City Hospital
⁶⁾Division of System Neurophysiology, National Institute for Physiological Sciences

It is controversial whether the STN or the GPi, the main targets of DBS therapy in patients with Parkinson's disease, is the appropriate target. We select GPi-DBS in patients judged by our cognitive function test battery to be at high-risk for cognitive decline after STN-DBS. While DBS surgery is usually performed under local anesthesia for the precise placement of DBS electrodes, general anesthesia might be useful in patients intolerant of long-lasting surgical stress. Our monkey experiments revealed that the most medial part of the STN receives direct input from the limbic cortex, suggesting that the spread of stimulation to these limbic territories may elicit adverse emotional effects. Other monkey experiments on the physiological mechanism of DBS suggest that high-frequency GPi stimulation disrupts information flow through the GPi.
Full Text of this Article in Japanese PDF (703K)

(CLINICA NEUROL, 53: 1053−1055, 2013)
key words: DBS, STN, GPi, cognitive function

(Received: 30-May-13)