Deep Brain Stimulation for Parkinson's Disease: A Potential Game-Changer?

Abstract

Parkinson's Disease (PD) is a neurological disorder characterised by tremor, rigidity, akinesia and postural instability. Parkinson's disease care has relied on levodopa for 50 years. Motor problems persist for years after therapy begins for most people. A major 20th century innovation is Deep Brain Stimulation (DBS). The FDA approved Deep Brain Stimulation (DBS) as an adjuvant neuromodulatory therapy for movement problems in medically refractory Parkinson's disease. The standard DBS method uses a stereotactically placed four-contact stimulating electrode and a subcutaneous wire to connect it to an Implanted Pulse Generator (IPG) on the chest wall beneath the clavicle. Electrodes are usually placed in the Subthalamic Nucleus (STN) or Globus Pallidus internus (GPi) in Parkinson's disease.^[1] A physician remotely modifies IPG stimulation parameters to improve symptom relief and minimise side effects using a portable device. Deep brain stimulation of the STN or GPi improves Parkinson's patients' quality of life.^[2,3] Precision lead location and stimulation programming make DBS surgery effective. Thus, it is best performed by a skilled team of neurosurgeons, neurologists, neurophysiologists and treatment-focused support staff. DBS is effective in PD because it's reversible and flexible. Due to its efficacy, it is regularly studied in various disorders and the FDA-approved indications may grow shortly.