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CC BY 4.0 · Arq Neuropsiquiatr 2024; 82(04): s00441786026
DOI: 10.1055/s-0044-1786026
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Fundamentals of deep brain stimulation for Parkinson's disease in clinical practice: part 1

Princípios da estimulação cerebral profunda na doença de Parkinson na prática clínica: parte 1
Camila Henriques de Aquino 
1   University of Calgary, Cumming School of Medicine, Department of Clinical Neurosciences, Calgary, AB, Canada.
2   University of Calgary, Hotchkiss Brain Institute, Calgary, AB, Canada.
3   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
,
Mariana Moscovich 
4   Christian-Albrechts University, Department of Neurology, Kiel, Germany.
,
Murilo Martinez Marinho 
3   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
,
Lorena Broseghini Barcelos 
3   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
,
André C. Felício 
5   Hospital Israelita Albert Einstein, São Paulo SP, Brazil.
,
Matthew Halverson 
6   University of Utah, Department of Neurology, Salt Lake City, Utah, United States.
,
Clement Hamani 
7   University of Toronto, Sunnybrook Hospital, Toronto, ON, Canada.
,
Henrique Ballalai Ferraz 
3   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
,
Renato Puppi Munhoz 
8   University of Toronto, Toronto Western Hospital, Toronto, ON, Canada.
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Abstract

Deep brain stimulation (DBS) is recognized as an established therapy for Parkinson's disease (PD) and other movement disorders in the light of the developments seen over the past three decades. Long-term efficacy is established for PD with documented improvement in the cardinal motor symptoms of PD and levodopa-induced complications, such as motor fluctuations and dyskinesias. Timing of patient selection is crucial to obtain optimal benefits from DBS therapy, before PD complications become irreversible. The objective of this first part review is to examine the fundamental concepts of DBS for PD in clinical practice, discussing the historical aspects, patient selection, potential effects of DBS on motor and non-motor symptoms, and the practical management of patients after surgery.

Resumo

Nas últimas três décadas, a estimulação cerebral profunda (ECP) se tornou um tratamento bem estabelecido para doença de Parkinson (DP) e outros transtornos do movimento. A eficácia a longo prazo na DP foi bem documentada para a melhora dos sintomas motores cardinais da DP e das complicações induzidas pelo uso do levodopa, como as flutuações motoras e as discinesias. O momento da seleção do paciente é crucial para se obter os benefícios ideais da ECP, antes que as complicações da DP se tornem irreversíveis. O objetivo desta primeira parte da revisão é examinar os conceitos fundamentais da ECP na prática clínica, discutindo os aspectos históricos, a seleção de pacientes, os potenciais efeitos da ECP nos sintomas motores e não motores da doença e o manejo prático dos pacientes após a cirurgia.

Keywords

Deep Brain Stimulation - Parkinson Disease - Neurosurgery

Palavras-chave

Estimulação Encefálica Profunda - Doença de Parkinson - Neurocirurgia

Authors' Contributions

CHA, MM: conceptualization, acquisition of data, drafting, review and editing the manuscript; MMM, LBB, ACF: drafting, review and editing the manuscript; MH: interpretation of data and manuscript revision; CH, HBF: drafting, review and editing the manuscript; RPM: conceptualization, acquisition of data, drafting, review and editing the manuscript. MM, CHA, RPM: These authors equally contributed to this work.




Publikationsverlauf

Eingereicht: 05. August 2023

Angenommen: 22. Februar 2024

Artikel online veröffentlicht:
23. April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Camila Henriques de Aquino, Mariana Moscovich, Murilo Martinez Marinho, Lorena Broseghini Barcelos, André C. Felício, Matthew Halverson, Clement Hamani, Henrique Ballalai Ferraz, Renato Puppi Munhoz. Fundamentals of deep brain stimulation for Parkinson's disease in clinical practice: part 1. Arq Neuropsiquiatr 2024; 82: s00441786026.
DOI: 10.1055/s-0044-1786026