Subthalamic Deep Brain Stimulation for Parkinson’s Disease

J Korean Neurol Assoc > Volume 24(3); 2006 > Article

Journal of the Korean Neurological Association 2006;24(3): 191-203.

파킨슨병에 대한 시상하핵 심부뇌자극술

류철형, 장진우a 이명식

연세대학교 의과대학 신경과학교실, 신경외과학교실a

Subthalamic Deep Brain Stimulation for Parkinson’s Disease

Chul Hyoung Lyoo

Departments of Neurology, Neurosurgerya, Yonsei University College of Medicine, Seoul, Korea

Abstract

The recent progress in the basic knowledge of basal ganglia pathways and advances in the techniques of the neuroimaging studies enabled subthalamic deep brain stimulation (STN DBS). In Korea, more than three hundreds and fifty patients with PD have been treated with STN DBS since the first trial at March 2000. STN DBS effectively improves all parkinsonian deficits occurring especially during levodopa ‘off’ period and decreases the daily ‘off’ time. The daily requirement of levodopa dosage can be reduced to about half of the preoperative one. The favorable responses to the STN DBS can be maintained even after five years. However, parkinsonian deficits during levodopa ‘on’ period can not be controlled as effectively as those during the levodopa ‘off’ period. The axial symptoms including gait disturbance and postural instability during the levodopa ‘on’ period cannot be improved or even are worsen by STN DBS. Patients aged over 70 frequently show less remarkable improvement of parkinsonian deficits than the younger ones. Therefore, selection of appropriate candidate for STN DBS is the most important factor deciding the outcome of the STN DBS.KeyWords:Parkinson Disease, Deep brain stimulation, Subthalamic nucleus