Skip to main content

Advertisement

SpringerLink
Log in

High frequency deep brain stimulation of the subthalamic nucleus versus continuous subcutaneous apomorphine infusion therapy: a review

  • Movement Disorders - CONy Pro/Con debate
  • Published:
Journal of Neural Transmission Aims and scope Submit manuscript

Abstract

In advanced Parkinson’s disease, several therapeutical option including not only lesional surgery (VIM, GPi) and deep brain stimulation (STN, GPi, VIM) but also continuous subcutaneous apomorphine infusion therapy can be proposed to the patient. The choice depends on the hope of the patient, patient’s general health condition and the experience and choice of the neurosurgical and neurologist team. Here we report our experience based on 400 STN-DBS cases and we discuss, on the basis of our experience and on the literature, the advantage and disadvantage of DBS strategy as compared with non-surgical option such as continuous subcutaneous apomorphine infusion therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  • Ahlskog JE, Muenter MD (2001) Frequency of levodopa-related dyskinesias and motor fluctuations as estimated from the cumulative literature. Mov Disord 16:448–458

    Article  PubMed  CAS  Google Scholar 

  • Alegret M, Valldeoriola F, Marti M, Pilleri M, Junque C, Rumia J et al (2004) Comparative cognitive effects of bilateral subthalamic stimulation and subcutaneous continuous infusion of apomorphine in Parkinson’s disease. Mov Disord 19:1463–1469

    Article  PubMed  Google Scholar 

  • Alesch F (2005) Sudden failure of dual channel pulse generators. Mov Disord 20:64–66 discussion 66

    Article  PubMed  Google Scholar 

  • Antonini A, Isaias IU, Canesi M, Zibetti M, Mancini F, Manfredi L et al (2007) Duodenal levodopa infusion for advanced Parkinson’s disease: 12-month treatment outcome. Mov Disord 22:1145–1149

    Article  PubMed  Google Scholar 

  • Antonini A, Mancini F, Canesi M, Zangaglia R, Isaias IU, Manfredi L et al (2008) Duodenal levodopa infusion improves quality of life in advanced Parkinson’s disease. Neurodegener Dis 5:244–246

    Article  PubMed  CAS  Google Scholar 

  • Ardouin C, Pillon B, Peiffer E, Bejjani P, Limousin P, Damier P et al (1999) Bilateral subthalamic or pallidal stimulation for Parkinson’s disease affects neither memory nor executive functions: a consecutive series of 62 patients. Ann Neurol 46:217–223

    Article  PubMed  CAS  Google Scholar 

  • Benabid AL, Pollak P, Seigneuret E, Hoffmann D, Gay E, Perret J (1993) Chronic VIM thalamic stimulation in Parkinson’s disease, essential tremor and extra-pyramidal dyskinesias. Acta Neurochir Suppl (Wien) 58:39–44

    CAS  Google Scholar 

  • Benabid AL, Chabardes S, Mitrofanis J, Pollak P (2009) Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease. Lancet Neurol 8:67–81

    Article  PubMed  Google Scholar 

  • Binder DK, Rau GM, Starr PA (2005) Risk factors for hemorrhage during microelectrode-guided deep brain stimulator implantation for movement disorders. Neurosurgery 56:722–732 discussion 722–732

    Article  PubMed  Google Scholar 

  • Burchiel KJ (1995) Thalamotomy for movement disorders. Neurosurg Clin N Am 6:55–71

    PubMed  CAS  Google Scholar 

  • Burkhard PR, Vingerhoets FJ, Berney A, Bogousslavsky J, Villemure JG, Ghika J (2004) Suicide after successful deep brain stimulation for movement disorders. Neurology 63:2170–2172

    PubMed  CAS  Google Scholar 

  • Charles PD, Van Blercom N, Krack P, Lee SL, Xie J, Besson G et al (2002) Predictors of effective bilateral subthalamic nucleus stimulation for PD. Neurology 59:932–934

    PubMed  CAS  Google Scholar 

  • Czernecki V, Pillon B, Houeto JL, Welter ML, Mesnage V, Agid Y et al (2005) Does bilateral stimulation of the subthalamic nucleus aggravate apathy in Parkinson’s disease? J Neurol Neurosurg Psychiatry 76:775–779

    Article  PubMed  CAS  Google Scholar 

  • Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schafer H, Botzel K et al (2006) A randomized trial of deep-brain stimulation for Parkinson’s disease. N Engl J Med 355:896–908

    Article  PubMed  CAS  Google Scholar 

  • Diamond A, Jankovic J (2005) The effect of deep brain stimulation on quality of life in movement disorders. J Neurol Neurosurg Psychiatry 76:1188–1193

    Article  PubMed  CAS  Google Scholar 

  • Dujardin K, Defebvre L, Krystkowiak P, Blond S, Destee A (2001) Influence of chronic bilateral stimulation of the subthalamic nucleus on cognitive function in Parkinson’s disease. J Neurol 248:603–611

    Article  PubMed  CAS  Google Scholar 

  • Esselink RA, de Bie RM, de Haan RJ, Lenders MW, Nijssen PC, van Laar T et al (2009) Long-term superiority of subthalamic nucleus stimulation over pallidotomy in Parkinson disease. Neurology 73:151–153

    Article  PubMed  CAS  Google Scholar 

  • Ferraye MU, Debu B, Fraix V, Goetz L, Ardouin C, Yelnik J et al (2010) Effects of pedunculopontine nucleus area stimulation on gait disorders in Parkinson’s disease. Brain 133:205–214

    Article  PubMed  CAS  Google Scholar 

  • Fraix V, Pollak P, Van Blercom N, Xie J, Krack P, Koudsie A et al (2001) Effect of subthalamic nucleus stimulation on levodopa-induced dyskinesia in Parkinson’s disease. 2000. Neurology 57:S60–S62

    PubMed  CAS  Google Scholar 

  • Fraix V, Houeto JL, Lagrange C, Le Pen C, Krystkowiak P, Guehl D et al (2006) Clinical and economic results of bilateral subthalamic nucleus stimulation in Parkinson’s disease. J Neurol Neurosurg Psychiatry 77:443–449

    Article  PubMed  CAS  Google Scholar 

  • Fraix V, Chabardes S, Krainik A, Seigneuret E, Grand S, Le Bas JF, Krack P, Benabid AL, Pollak P (2010) Effects of magnetic resonance imaging in patients with implanted deep brain stimulation systems. J Neurosurg 113(6):1242–1245

    Google Scholar 

  • Frank MJ, Samanta J, Moustafa AA, Sherman SJ (2007) Hold your horses: impulsivity, deep brain stimulation, and medication in Parkinsonism. Science 318:1309–1312

    Article  PubMed  CAS  Google Scholar 

  • Funkiewiez A, Ardouin C, Caputo E, Krack P, Fraix V, Klinger H et al (2004) Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s disease. J Neurol Neurosurg Psychiatry 75:834–839

    Article  PubMed  CAS  Google Scholar 

  • Goodman RR, Kim B, McClelland S 3rd, Senatus PB, Winfield LM, Pullman SL et al (2006) Operative techniques and morbidity with subthalamic nucleus deep brain stimulation in 100 consecutive patients with advanced Parkinson’s disease. J Neurol Neurosurg Psychiatry 77:12–17

    Article  PubMed  CAS  Google Scholar 

  • Hamani C, Richter E, Schwalb JM, Lozano AM (2005) Bilateral subthalamic nucleus stimulation for Parkinson’s disease: a systematic review of the clinical literature. Neurosurgery 56:1313–1321 discussion 1321–1324

    Article  PubMed  Google Scholar 

  • Hariz MI (2002) Complications of deep brain stimulation surgery. Mov Disord 17(Suppl 3):S162–S166

    Article  PubMed  Google Scholar 

  • Hariz MI, Bergenheim AT (2001) A 10-year follow-up review of patients who underwent Leksell’s posteroventral pallidotomy for Parkinson disease. J Neurosurg 94:552–558

    Article  PubMed  CAS  Google Scholar 

  • Hariz MI, Rehncrona S, Quinn NP, Speelman JD, Wensing C (2008) Multicenter study on deep brain stimulation in Parkinson’s disease: an independent assessment of reported adverse events at 4 years. Mov Disord 23:416–421

    Article  PubMed  Google Scholar 

  • Herzog J, Volkmann J, Krack P, Kopper F, Potter M, Lorenz D et al (2003) Two-year follow-up of subthalamic deep brain stimulation in Parkinson’s disease. Mov Disord 18:1332–1337

    Article  PubMed  Google Scholar 

  • Honig H, Antonini A, Martinez-Martin P, Forgacs I, Faye GC, Fox T et al (2009) Intrajejunal levodopa infusion in Parkinson’s disease: a pilot multicenter study of effects on nonmotor symptoms and quality of life. Mov Disord 24:1468–1474

    Article  PubMed  Google Scholar 

  • Houeto JL, Mesnage V, Mallet L, Pillon B, Gargiulo M, du Moncel ST et al (2002) Behavioural disorders, Parkinson’s disease and subthalamic stimulation. J Neurol Neurosurg Psychiatry 72:701–707

    Article  PubMed  CAS  Google Scholar 

  • Hutchison WD, Allan RJ, Opitz H, Levy R, Dostrovsky JO, Lang AE et al (1998) Neurophysiological identification of the subthalamic nucleus in surgery for Parkinson’s disease. Ann Neurol 44:622–628

    Article  PubMed  CAS  Google Scholar 

  • Joint C, Nandi D, Parkin S, Gregory R, Aziz T (2002) Hardware-related problems of deep brain stimulation. Mov Disord 17(Suppl 3):S175–S180

    Article  PubMed  Google Scholar 

  • Kleiner-Fisman G, Herzog J, Fisman DN, Tamma F, Lyons KE, Pahwa R et al (2006) Subthalamic nucleus deep brain stimulation: summary and meta-analysis of outcomes. Mov Disord 21(Suppl 14):S290–S304

    Article  PubMed  Google Scholar 

  • Krack P, Pollak P, Limousin P, Hoffmann D, Xie J, Benazzouz A et al (1998) Subthalamic nucleus or internal pallidal stimulation in young onset Parkinson’s disease. Brain 121(Pt 3):451–457

    Article  PubMed  Google Scholar 

  • Krack P, Kumar R, Ardouin C, Dowsey PL, McVicker JM, Benabid AL et al (2001) Mirthful laughter induced by subthalamic nucleus stimulation. Mov Disord 16:867–875

    Article  PubMed  CAS  Google Scholar 

  • Krack P, Fraix V, Mendes A, Benabid AL, Pollak P (2002) Postoperative management of subthalamic nucleus stimulation for Parkinson’s disease. Mov Disord 17(Suppl 3):S188–S197

    Article  PubMed  Google Scholar 

  • Krack P, Batir A, Van Blercom N, Chabardes S, Fraix V, Ardouin C et al (2003) Five-year follow-up of bilateral stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med 349:1925–1934

    Article  PubMed  CAS  Google Scholar 

  • Lagrange E, Krack P, Moro E, Ardouin C, Van Blercom N, Chabardes S et al (2002) Bilateral subthalamic nucleus stimulation improves health-related quality of life in PD. Neurology 59:1976–1978

    PubMed  CAS  Google Scholar 

  • Lang AE, Lozano AM (1998) Parkinson’s disease. Second of two parts. N Engl J Med 339:1130–1143

    Article  PubMed  CAS  Google Scholar 

  • Limousin P, Pollak P, Benazzouz A, Hoffmann D, Le Bas JF, Broussolle E et al (1995) Effect of parkinsonian signs and symptoms of bilateral subthalamic nucleus stimulation. Lancet 345:91–95

    Article  PubMed  CAS  Google Scholar 

  • Limousin P, Krack P, Pollak P, Benazzouz A, Ardouin C, Hoffmann D et al (1998) Electrical stimulation of the subthalamic nucleus in advanced Parkinson’s disease. N Engl J Med 339:1105–1111

    Article  PubMed  CAS  Google Scholar 

  • Lozano AM, Lang AE (2001) Pallidotomy for Parkinson’s disease. Adv Neurol 86:413–420

    PubMed  CAS  Google Scholar 

  • Lozano AM, Snyder BJ (2008) Deep brain stimulation for parkinsonian gait disorders. J Neurol 255(Suppl 4):30–31

    Article  PubMed  Google Scholar 

  • Lyons KE, Wilkinson SB, Overman J, Pahwa R (2004) Surgical and hardware complications of subthalamic stimulation: a series of 160 procedures. Neurology 63:612–616

    PubMed  Google Scholar 

  • Macia F, Perlemoine C, Coman I, Guehl D, Burbaud P, Cuny E et al (2004) Parkinson’s disease patients with bilateral subthalamic deep brain stimulation gain weight. Mov Disord 19:206–212

    Article  PubMed  Google Scholar 

  • Mallet L, Polosan M, Jaafari N, Baup N, Welter ML, Fontaine D et al (2008) Subthalamic nucleus stimulation in severe obsessive-compulsive disorder. N Engl J Med 359:2121–2134

    Article  PubMed  CAS  Google Scholar 

  • Meissner W, Trottenberg T, Klaffke S, Paul G, Kuhn AA, Arnold G et al (2001) Apomorphine therapy versus deep rain stimulation. Clinical and economic aspects in patients with advanced Parkinson disease. Nervenarzt 72:924–927

    Article  PubMed  CAS  Google Scholar 

  • Moreau C, Defebvre L, Destee A, Bleuse S, Clement F, Blatt JL et al (2008) STN-DBS frequency effects on freezing of gait in advanced Parkinson disease. Neurology 71:80–84

    Article  PubMed  CAS  Google Scholar 

  • Moro E, Lozano AM, Pollak P, Agid Y, Rehncrona S, Volkmann J, Kulisevsky J, Obeso JA, Albanese A, Hariz MI, Quinn NP, Speelman JD, Benabid AL, Fraix V, Mendes A, Welter ML, Houeto JL, Cornu P, Dormont D, Tornqvist AL, Ekberg R, Schnitzler A, Timmermann L, Wojtecki L, Gironell A, Rodriguez-Oroz MC, Guridi J, Bentivoglio AR, Contarino MF, Romito L, Scerrati M, Janssens M, Lang AE (2010) Long-term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson’s disease. Mov Disord 25(5):578–586

    Google Scholar 

  • Ohye C, Shibazaki T, Sato S (2005) Gamma knife thalamotomy for movement disorders: evaluation of the thalamic lesion and clinical results. J Neurosurg 102(Suppl):234–240

    Article  PubMed  Google Scholar 

  • Ostergaard K, Sunde N, Dupont E (2002) Effects of bilateral stimulation of the subthalamic nucleus in patients with severe Parkinson’s disease and motor fluctuations. Mov Disord 17:693–700

    Article  PubMed  Google Scholar 

  • Pahwa R, Wilkinson SB, Overman J, Lyons KE (2003) Bilateral subthalamic stimulation in patients with Parkinson disease: long-term follow up. J Neurosurg 99:71–77

    Article  PubMed  Google Scholar 

  • Parsons TD, Rogers SA, Braaten AJ, Woods SP, Troster AI (2006) Cognitive sequelae of subthalamic nucleus deep brain stimulation in Parkinson’s disease: a meta-analysis. Lancet Neurol 5:578–588

    Article  PubMed  Google Scholar 

  • Piallat B, Chabardes S, Torres N, Fraix V, Goetz L, Seigneuret E et al (2009) Gait is associated with an increase in tonic firing of the sub-cuneiform nucleus neurons. Neuroscience 158:1201–1205

    Article  PubMed  CAS  Google Scholar 

  • Pietz K, Hagell P, Odin P (1998) Subcutaneous apomorphine in late stage Parkinson’s disease: a long term follow up. J Neurol Neurosurg Psychiatry 65:709–716

    Article  PubMed  CAS  Google Scholar 

  • Pillon B, Ardouin C, Damier P, Krack P, Houeto JL, Klinger H et al (2000) Neuropsychological changes between “off” and “on” STN or GPi stimulation in Parkinson’s disease. Neurology 55:411–418

    PubMed  CAS  Google Scholar 

  • Poewe W, Wenning GK (2000) Apomorphine: an underutilized therapy for Parkinson’s disease. Mov Disord 15:789–794

    Article  PubMed  CAS  Google Scholar 

  • Pollak P (2007) Deep brain stimulation for movement disorders. In: Jankovic J (ed) Parkinson’s disease and movements disorders. Lippincott Williams & Wilkins, Philadelphia, pp 653–691

    Google Scholar 

  • Rodriguez-Oroz MC, Obeso JA, Lang AE, Houeto JL, Pollak P, Rehncrona S et al (2005) Bilateral deep brain stimulation in Parkinson’s disease: a multicentre study with 4 years follow-up. Brain 128:2240–2249

    Article  PubMed  CAS  Google Scholar 

  • Samanta J, Hauser RA (2007) Duodenal levodopa infusion for the treatment of Parkinson’s disease. Expert Opin Pharmacother 8:657–664

    Article  PubMed  CAS  Google Scholar 

  • Schoenen J, Di Clemente L, Vandenheede M, Fumal A, De Pasqua V, Mouchamps M et al (2005) Hypothalamic stimulation in chronic cluster headache: a pilot study of efficacy and mode of action. Brain 128:940–947

    Article  PubMed  CAS  Google Scholar 

  • Seijo FJ, Alvarez-Vega MA, Gutierrez JC, Fdez-Glez F, Lozano B (2007) Complications in subthalamic nucleus stimulation surgery for treatment of Parkinson’s disease. Review of 272 procedures. Acta Neurochir (Wien) 149:867–875 discussion 876

    Article  CAS  Google Scholar 

  • Sillay KA, Larson PS, Starr PA (2008) Deep brain stimulator hardware-related infections: incidence and management in a large series. Neurosurgery 62:360–366 discussion 366–367

    Article  PubMed  Google Scholar 

  • Stefani A, Lozano AM, Peppe A, Stanzione P, Galati S, Tropepi D et al (2007) Bilateral deep brain stimulation of the pedunculopontine and subthalamic nuclei in severe Parkinson’s disease. Brain 130:1596–1607

    Article  PubMed  Google Scholar 

  • Stibe C, Lees A, Stern G (1987) Subcutaneous infusion of apomorphine and lisuride in the treatment of parkinsonian on-off fluctuations. Lancet 1:871

    Article  PubMed  CAS  Google Scholar 

  • Stibe CM, Lees AJ, Kempster PA, Stern GM (1988) Subcutaneous apomorphine in parkinsonian on-off oscillations. Lancet 1:403–406

    Article  PubMed  CAS  Google Scholar 

  • Strowd RE, Cartwright MS, Passmore LV, Ellis TL, Tatter SB, Siddiqui MS (2010) Weight change following deep brain stimulation for movement disorders. J Neurol 257(8):1293–1297

    Google Scholar 

  • Tasker RR (1990) Thalamotomy. Neurosurg Clin N Am 1:841–864

    PubMed  CAS  Google Scholar 

  • Thobois S, Ardouin C, Lhommee E, Klinger H, Lagrange C, Xie J et al (2010) Non-motor dopamine withdrawal syndrome after surgery for Parkinson’s disease: predictors and underlying mesolimbic denervation. Brain 133:1111–1127

    Article  PubMed  Google Scholar 

  • Tseng HM, Su PC, Liu HM, Liou HH, Yen RF (2007) Bilateral subthalamotomy for advanced Parkinson disease. Surg Neurol 68(Suppl 1):S43–S50 discussion S50–S51

    Article  PubMed  Google Scholar 

  • Varma TR, Fox SH, Eldridge PR, Littlechild P, Byrne P, Forster A et al (2003) Deep brain stimulation of the subthalamic nucleus: effectiveness in advanced Parkinson’s disease patients previously reliant on apomorphine. J Neurol Neurosurg Psychiatry 74:170–174

    Article  PubMed  CAS  Google Scholar 

  • Vingerhoets FJ, Villemure JG, Temperli P, Pollo C, Pralong E, Ghika J (2002) Subthalamic DBS replaces levodopa in Parkinson’s disease: two-year follow-up. Neurology 58:396–401

    PubMed  Google Scholar 

  • Visser-Vandewalle V, van der Linden C, Temel Y, Celik H, Ackermans L, Spincemaille G et al (2005) Long-term effects of bilateral subthalamic nucleus stimulation in advanced Parkinson disease: a four year follow-up study. Parkinsonism Relat Disord 11:157–165

    Article  PubMed  Google Scholar 

  • Voon V, Moro E, Saint-Cyr JA, Lozano AM, Lang AE (2005) Psychiatric symptoms following surgery for Parkinson’s disease with an emphasis on subthalamic stimulation. Adv Neurol 96:130–147

    PubMed  Google Scholar 

  • Voon V, Potenza MN, Thomsen T (2007) Medication-related impulse control and repetitive behaviors in Parkinson’s disease. Curr Opin Neurol 20:484–492

    Article  PubMed  Google Scholar 

  • Voon V, Fernagut PO, Wickens J, Baunez C, Rodriguez M, Pavon N et al (2009) Chronic dopaminergic stimulation in Parkinson’s disease: from dyskinesias to impulse control disorders. Lancet Neurol 8:1140–1149

    Article  PubMed  CAS  Google Scholar 

  • Witjas T, Kaphan E, Azulay JP, Blin O, Ceccaldi M, Pouget J et al (2002) Nonmotor fluctuations in Parkinson’s disease: frequent and disabling. Neurology 59:408–413

    PubMed  Google Scholar 

  • Witjas T, Kaphan E, Regis J, Jouve E, Cherif AA, Peragut JC et al (2007) Effects of chronic subthalamic stimulation on nonmotor fluctuations in Parkinson’s disease. Mov Disord 22:1729–1734

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, University Hospital, Grenoble, France

    R. Carron, C. Maineri, E. Seigneuret & Stéphan Chabardès

  2. Department of Neurology, University Hospital, Grenoble, France

    V. Fraix, P. Krack & P. Pollak

  3. Grenoble Institute of Neuroscience, INSERM U836, Grenoble, France

    V. Fraix, B. Piallat, P. Krack, P. Pollak & Stéphan Chabardès

  4. CEA LETI Clinatec, Grenoble, France

    A. L. Benabid

  5. Joseph Fourier University, Grenoble, France

    R. Carron, B. Piallat, P. Krack, P. Pollak & Stéphan Chabardès

  6. Clinique de Neurochirurgie, CHU Michallon, 38043, Grenoble Cédex, France

    Stéphan Chabardès

Authors
  1. R. Carron
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. Fraix
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Maineri
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. E. Seigneuret
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. Piallat
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. P. Krack
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. P. Pollak
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. L. Benabid
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Stéphan Chabardès
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stéphan Chabardès.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Carron, R., Fraix, V., Maineri, C. et al. High frequency deep brain stimulation of the subthalamic nucleus versus continuous subcutaneous apomorphine infusion therapy: a review. J Neural Transm 118, 915–924 (2011). https://doi.org/10.1007/s00702-010-0556-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00702-010-0556-7

Keywords

Search

Navigation