1.Target Selection Recommendations Based on Impact of Deep Brain Stimulation Surgeries on Nonmotor Symptoms of Parkinson's Disease.
Xiao-Hong WANG ; Lin ZHANG ; Laura SPERRY ; John OLICHNEY ; Sarah Tomaszewski FARIAS ; Kiarash SHAHLAIE ; Norika Malhado CHANG ; Ying LIU ; Su-Ping WANG ; Cui WANG
Chinese Medical Journal 2015;128(24):3371-3380
OBJECTIVEThis review examines the evidence that deep brain stimulation (DBS) has extensive impact on nonmotor symptoms (NMSs) of patients with Parkinson's disease (PD).
DATA SOURCESWe retrieved information from the PubMed database up to September, 2015, using various search terms and their combinations including PD, NMSs, DBS, globus pallidus internus (GPi), subthalamic nucleus (STN), and ventral intermediate thalamic nucleus.
STUDY SELECTIONWe included data from peer-reviewed journals on impacts of DBS on neuropsychological profiles, sensory function, autonomic symptoms, weight changes, and sleep disturbances. For psychological symptoms and cognitive impairment, we tried to use more reliable proofs: Random, control, multicenter, large sample sizes, and long period follow-up clinical studies. We categorized the NMSs into four groups: those that would improve definitively following DBS; those that are not significantly affected by DBS; those that remain controversial on their surgical benefit; and those that can be worsened by DBS.
RESULTSIn general, it seems to be an overall beneficial effect of DBS on NMSs, such as sensory, sleep, gastrointestinal, sweating, cardiovascular, odor, urological symptoms, and sexual dysfunction, GPi-DBS may produce similar results; Both STN and Gpi-DBS are safe with regard to cognition and psychology over long-term follow-up, though verbal fluency decline is related to DBS; The impact of DBS on behavioral addictions and dysphagia is still uncertain.
CONCLUSIONSAs the motor effects of STN-DBS and GPi-DBS are similar, NMSs may determine the target choice in surgery of future patients.
Deep Brain Stimulation ; Globus Pallidus ; surgery ; Humans ; Male ; Parkinson Disease ; surgery ; therapy ; Subthalamic Nucleus ; surgery