New Guidelines Issued for Deep Brain Stimulation in
MONDAY, Oct. 18 (HealthDay News) -- A group of more than 50
experts on the treatment known as deep brain stimulation (DBS) have
agreed on new guidelines as to which Parkinson's disease patients
should receive DBS and how it should be applied.
An electrical stimulation technique targeting highly specific
parts of the brain, the intervention has been in use since the late
1990s to treat those for whom medicinal approaches fail to prevent
the loss of movement control, balance and coordination that
typically accompanies the disabling neurological disorder.
The new consensus was arrived at during a meeting in April 2009
and is designed to address any confusion regarding patient
selection and the specifics of electrode placement and supplemental
"We know that very little accessible information is out there to help a Parkinson's patient make an informed decision as to whether he or she would be a good candidate for deep brain stimulation," study lead author Jeff Bronstein, a University of California, Los Angeles (UCLA) professor of neurology and director of the UCLA Movement Disorder Program, said in a university news release.
Bronstein and his colleagues published the consensus outline in
the Oct. 11 online edition of
Archives of Neurology.
The authors explained that DBS is a treatment provided by
neurosurgeons, who use MRI scans to target the area of the brain
where abnormal electrical signals set in motion the disease's
telltale tremors. Once the area is identified, a neurostimulator is
surgically implanted in order to provide electrical stimulation and
restore proper signaling.
Among the new indications, experts say the ideal candidates for
DBS are those otherwise healthy patients who suffer from tremors
and motor problems but for whom medication options are
The procedure should be performed by an experienced neurosurgeon
and team with an expertise in deep microsurgery involving high-tech
neuroimaging equipment, the experts advise.
As for how it should be applied, the authors noted that while
the two brain regions most commonly treated with DBS are suitable
targets for Parkinson's intervention, physicians should be aware
that applying DBS to one of them -- the so-called "subthalamic
nuclei" -- can trigger depression and other side effects in some
Lastly, the new consensus acknowledges that surgery still has a
role to play in Parkinson's treatment, with removal of the affected
portion of the brain an alternative treatment that should be
considered for most patients.
For more on Parkinson's disease, visit the
U.S. National Institute of Neurological Disorders and
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