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Subthalamic deep brain stimulation for the treatment of Parkinson disease
Authors:Mandat Tomasz  Tykocki Tomasz  Koziara Henryk  Koziorowski Dariusz  Brodacki Bogdan  Rola Rafał  Bonicki Wiesław  Nauman Paweł
Affiliation:1. Center of Oncology Maria Sklodowska-Curie Memorial Institute, Warsaw, Poland;2. Department of Neurosurgery, Institute of Psychiatry and Neurology, Warsaw, Poland;3. Department of Neurology, Health Sciences Division, Medical University of Warsaw, Warsaw, Poland;4. Department of Neurology, Military Medical Institute, Warsaw, Poland;6. Department of Physiology and Pathophysiology, Medical University of Warsaw, Warsaw, Poland;1. The Spine and Nerve Centers of the Virginias, Charleston, WV, USA;2. Hunter Pain Specialists, Newcastle, New South Wales, Australia;3. UKHealthCare Pain Services, Department of Anesthesiology, University of Kentucky College of Medicine, Lexington, KY, USA;4. Evolve Restorative Center, Santa Rosa, CA, USA;5. Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA;6. Napa Valley Orthopaedic Medical Group, Napa, CA, USA;7. Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA;8. Millennium Pain Center; College of Medicine, University of Illinois, Urbana-Champaign, IL, USA;9. Jupiter Medical Center, Jupiter, FL, USA;10. The Pain and Spine Institute of New York, New York, NY, USA;11. Pain Diagnostics and Interventional Care, Pittsburgh, PA, USA;12. Center for Interventional Pain and Spine, Bryn Mawr, PA, USA;13. IPM Medical Group, Inc, Walnut Creek, CA, USA;14. Pain Management, Cleveland Clinic, Cleveland, OH, USA;15. Department of Anesthesiology, Amsterdam University Medical Centers, Amsterdam, The Netherlands;16. Precision Brain, Spine and Pain Center, Melbourne, Victoria, Australia;17. Metro Pain Group, Monash Clinical Research, Melbourne, Victoria, Australia;18. MidWestern Medical School, Pain Doctor, LLC, Glendale, AZ, USA;19. Carolinas Pain Institute, Charlotte, NC, USA;20. Surgi-Care of New York, New York, NY, USA;21. Barolat Neurosciences, Presbyterian-St. Luke''s Medical Center, Denver, CO, USA;22. Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA;23. Valencia University Medical School, Department of Anesthesiology Critical Care and Pain Management, General University Hospital, Valencia, Spain;24. Department of Neurological Surgery, Oregon Health and Science University, Portland, OR, USA;25. Service of Neurosurgery and Pain Clinic, University Hospital “Puerta del Mar,” Cadiz, Spain;26. Stanford Pain Management Center, Redwood City, CA, USA;27. Ohmedica Joint and Spine Health Specialists, Tampa, FL, USA;28. Precision Brain, Spine and Pain Centre and The Royal Melbourne Hospital, Department of Surgery at Melbourne University, Melbourne, Victoria, Australia;29. Nuffield Department of Surgical Sciences, Oxford University, Oxford, England, UK;30. Neurosurgical Clinic Varese Regional Hospital, Varese, Italy;31. Fundacion CENIT, University of Buenos Aires, Buenos Aires, Argentina;32. Allegheny General Hospital, Allegheny Health Network, Pittsburgh, PA, USA;33. Nuffield Department of Clinical Neurosciences, Oxford, England, UK;34. Senior Consultant Neurosurgery, Sahlgrenska University Hospital, Göteborg, Sweden;35. Providence Healthcare, University of British Columbia, Vancouver, BC, Canada;36. Commonwealth Pain and Spine, Lexington and Bardstown, KY, USA;37. Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA;38. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA;39. Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA;40. Neurosurgical Services, Clinical Research, Anesthesia Pain Care Consultants, Tamarac, FL, USA;1. Minnesota Regional Sleep Disorders Center, Departments of Psychiatry, Hennepin County Medical Center and University of Minnesota Medical School, Minneapolis, United States;2. Mayo Clinic for Sleep Medicine, and Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States;3. Minnesota Regional Sleep Disorders Center, Department of Neurology, University of Minnesota Medical School, Minneapolis, United States
Abstract:Background and purposeThe role of subthalamic nucleus deep brain stimulation (STN DBS) in the treatment of Parkinson disease (PD) is well established. The authors present a group of patients diagnosed with PD who were treated with STN DBS.Material and methodsBetween 2008 and 2009, 32 female and 34 male patients with PD were treated with STN DBS. Mean age at implantation was 57 ± 12 years. PD lasted from 6 to 21 years (mean 10 years). Patients were qualified for the surgery according to the CAPSIT-PD criteria. The STN was identified with direct and indirect methods. Macrostimulation and microrecording for STN identification were used in all cases. A unilateral STN DBS system was implanted in two cases and bilateral implantation was performed among rest of the group. Outcome was assessed six months after implantation.ResultsThe mean reduction of UPDRS III score among 51 patients who underwent follow-up was 45% (5-89%). Reduction of levodopa consumption varied from 15 to 100%. Infection forced the authors to remove the DBS system in one case four months after implantation. Skin erosion above the internal pulse generator was noted in four cases.ConclusionsCardinal symptoms of Parkinson's disease can be safely and effectively treated with STN DBS in selected group of patients.
Keywords:Parkinson disease  deep brain stimulation  subthalamic nucleus  choroba Parkinsona  g??boka stymulacja mózgu  j?dro niskowzgórzowe
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