Deep brain stimulation for movement disorders. Considerations on 276 consecutive patients

Angelo Franzini, Roberto Cordella, Giuseppe Messina, Carlo Efisio Marras, Luigi Michele Romito, Francesco Carella, Alberto Albanese, Michele Rizzi, Nardo Nardocci, Giovanna Zorzi, Edvin Zekay, Giovanni Broggi

Research output: Contribution to journalArticle

Abstract

The links between Stn DBS and advanced Parkinson disease, and between GPi DBS and dystonia are nearly universally accepted by the neurologists and neurosurgeons. Nevertheless, in some conditions, targets such as the ventral thalamus and the Zona Incerta may be considered to optimize the results and avoid the side effects. Positive and negative aspects of current DBS treatments justify the research of new targets, new stimulation programs and new hardware. Since 1993, at the Istituto Nazionale Neurologico ''Carlo Besta'' in Milan, 580 deep brain electrodes were implanted in 332 patients. 276 patients were affected by movement disorders. The DBS targets included Stn, GPi, Voa, Vop, Vim, CM-pf, cZi, IC. The long-term follow-up is reported and related to the chosen target. DBS gave a new therapeutic option to patients affected by severe movement disorders, and in some cases resolved life-threatening pathological conditions that would otherwise result in the death of the patient, such as in status dystonicus, and post-stroke hemiballismus. Nevertheless, the potential occurrence of severe complications still limit a wider use of DBS. At today, the use of DBS in severe movement disorders is strongly positive even if further investigations and studies are needed to unveil potential new applications, and to refine the selection criteria for the actual indications and targets. The experience of different targets may be useful to guide and tailor the target choice to the individual clinical condition.

Original languageEnglish
Pages (from-to)1497-1510
Number of pages14
JournalJournal of Neural Transmission
Volume118
Issue number10
DOIs
Publication statusPublished - Oct 2011

Keywords

  • Deep brain stimulation
  • Movement disorders

ASJC Scopus subject areas

  • Biological Psychiatry
  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health

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