Rinsho Shinkeigaku (Clinical Neurology)

Educational Lecture 3

Update on deep brain stimulation for movement disorders

Atsushi Umemura, M.D., Ph.D.1), Genko Oyama, M.D., Ph.D.2), Yasushi Shimo, M.D., Ph.D.1)2) and Nobutaka Hattori, M.D., Ph.D.2)

1)Department of Research and Therapeutics for Movement Disorders, Juntendo University
2)Department of Neurology, Juntendo University Graduate School of Medicine

Deep brain stimulation (DBS) has been widely performed for various medically refractory movement disorders. For Parkinson disease (PD), target of DBS is subthalamic nucleus (STN) or globus pallidus internus (GPi). There are some evidences to demonstrate its effectiveness on motor function and QOL. DBS effectively improves levodopa-responsive motor symptoms, and significantly reduces dyskinesia and motor fluctuations. STN DBS particularly decreases the need for dopaminergic medication. A combination of medical treatment and DBS would provide longer relief of motor symptoms than medical treatment only. Currently new evidence supporting early introduction of DBS for better future outcome is published. DBS of Vim thalamus has been indicated for intractable tremor with various etiologies. Recently posterior subthalamic area (PSA) is introduced as an alternative target to Vim for tremor. GPi DBS is also effective treatment option for generalized dystonia.
Full Text of this Article in Japanese PDF (890K)

(CLINICA NEUROL, 53: 911|914, 2013)
key words: deep brain stimulation, movement disorders, Parkinson's disease, intractable tremor, generalized dystonia

(Received: 31-May-13)