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Neuroscience fundamentals relevant to neuromodulation: Neurobiology of deep brain stimulation in Parkinson's disease.
Neurotherapeutics
April 2024
Division of Neurosurgery, Department of Surgery, University of Toronto, Canada; KITE, Toronto, Canada; CRANIA, Toronto, Canada; Krembil Research Institute, University Health Network Toronto, Canada.
Deep Brain Stimulation (DBS) has become a pivotal therapeutic approach for Parkinson's Disease (PD) and various neuropsychiatric conditions, impacting over 200,000 patients. Despite its widespread application, the intricate mechanisms behind DBS remain a subject of ongoing investigation. This article provides an overview of the current knowledge surrounding the local, circuit, and neurobiochemical effects of DBS, focusing on the subthalamic nucleus (STN) as a key target in PD management.
View Article and Find Full Text PDFMyths and facts about the EARLYSTIM study.
Mov Disord
December 2014
Assistance-Publique Hôpitaux de Paris; Centre d'Investigation Clinique 9503, Institut du Cerveau et de la Moelle épinière; Département de Neurologie, Université Pierre et Marie Curie-Paris 6 et INSERM, CHU Pitié-Salpêtrière, Paris, France, and Movement Disorders Center, Department of Neurology, Bern University Hospital and University of Bern, Switzerland.
DBS of the STN improves quality of life (QoL) and motor function not only in advanced Parkinson's disease (PD), but also in PD with early motor complications, as shown in the recent EARLYSTIM study. In spite of the evidence in favor of STN-DBS, the findings of the EARLYSTIM study have recently been controversially debated. Here, we argue that a placebo or lessebo effect is unlikely to have relevantly contributed to the favorable outcome of STN-DBS in the EARLYSTIM study.
View Article and Find Full Text PDFSubthalamic nucleus-deep brain stimulation for early motor complications in Parkinson's disease-the EARLYSTIM trial: early is not always better.
Mov Disord
December 2014
Morton and Gloria Shulman Movement Disorders Clinic and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, University Health Network, Division of Neurology, University of Toronto, Toronto, Ontario, Canada; Parkinson's Disease and Movement Disorders Clinic, Division of Neurology, University of Ottawa, The Ottawa Hospital, Ottawa, Ontario, Canada.
Subthalamic nucleus deep brain stimulation (STN-DBS) has revolutionized the management of disabling motor complications in Parkinson's disease. The EARLYSTIM trial applied this treatment to patients who had been experiencing motor complications for less than three years. STN-DBS significantly improved all primary and secondary outcome measures while best medical therapy failed to provide any improvement at the two-year follow-up time point.
View Article and Find Full Text PDFRelevance of EARLYSTIM in a tertiary movement disorders center.
Mov Disord
August 2014
Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
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