Skip to main content

Advertisement

Log in

Deep Brain Stimulation in Parkinson’s Disease: Overview and Complications

  • Review Article
  • Published:
Activitas Nervosa Superior

Abstract

Deep brain stimulation (DBS) of basal ganglia has become a frequently performed surgery in patients with advanced Parkinson’s disease. Throughout the years, this technique has reached advances in imaging techniques, neurophysiological recording possibilities, and in hardware and software technology. Nevertheless, to reach optimal results of DBS therapy, a number of aspects must be carefully considered. In current paper, overview of DBS procedure is provided with special focus on complications of this, an even so ever more promising therapeutic approach.

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

Access this article

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

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Anderson, V. C., Burchiel, K. J., Hogarth, P., Favre, J., & Hammerstad, J. P. (2005). Pallidal vs. subthalamic nucleus deep brain stimulation in Parkinson disease. Archives of Neurology, 62, 554–560. doi:10.1001/archneur.62.4.554.

    Article  PubMed  Google Scholar 

  • Benabid, A. L., Pollak, P., Gross, C., Hoffmann, D., Benazzouz, A., Gao, D. M., Laurent, A., Gentil, M., & Perret, J. (1994). Acute and long-term effects of subthalamic nucleus stimulation of Parkinson’s disease. Stereotactic and Functional Neurosurgery, 62, 76–84. doi:10.1159/000098600.

    Article  PubMed  Google Scholar 

  • Benabid, A. L., Koudsie, A., Benazzouz, A., Piallat, B., Krack, P., Limousin-Dowsey, P., Lebas, J. F., & Pollak, P. (2001). Deep brain stimulation for Parkinson’s disease. Advances in Neurology, 86, 405–412.

    PubMed  Google Scholar 

  • Bergman, H., Wichmann, T., & DeLong, M. R. (1990). Reversal of experimental parkinsonism by lesions of the subthalamic nucleus. Science, 249, 1436–1438.

    Article  PubMed  Google Scholar 

  • Blahak, C., Wöhrle, J. C., Capelle, H. H., Bäzner, H., Grips, E., Weigel, R., Hennerici, M. G., & Krauss, J. K. (2007). Tremor reduction by subthalamic nucleus stimulation and medication in advanced Parkinson’s disease. Journal of Neurology, 254, 169–178. doi:10.1007/s00415-006-0305-x.

    Article  PubMed  Google Scholar 

  • Bolanowski Jr., S. J., & Zwislocki, J. J. (1984). Intensity and frequency characteristics of pacinian corpuscles. I. Action potentials. Journal of Neurophysiology, 51, 793–811.

    PubMed  Google Scholar 

  • Chan, D. T. M., Zhu, X. L., Yeung, J. H. M., Mok, V. C. T., Wong, E., Lau, C., & Poon, W. S. (2009). Complications of deep brain stimulation: a collective review. Asian Journal of Surgery, 32, 258–263. doi:10.1016/S1015-9584(09)60404-8.

    Article  PubMed  Google Scholar 

  • Chou, Y. C., Lin, S. Z., Hsieh, W. A., Lin, S. H., Lee, C. C., Hsin, Y. L., Yen, P.-S., Lee, C. W., Chiu, W.-T., & Chen, S. Y. (2007). Surgical and hardware complications in subthalamic nucleus deep brain stimulation. Journal of Clinical Neuroscience, 14(7), 643–649. doi:10.1016/j.jocn.2006.02.016.

    Article  PubMed  Google Scholar 

  • Chung, S. J., Jeon, S. R., Kim, S. R., Sung, Y. H., & Lee, M. C. (2006). Bilateral effects of unilateral subthalamic nucleus deep brain stimulation in advanced parkinson’s disease. European Neurology, 56, 127–132. doi:10.1159/000095704.

    Article  PubMed  Google Scholar 

  • Deuschl, G., Herzog, J., Kleiner-Fisman, G., Kubu, C., Lozano, A. M., Lyons, K. E., Rodriguez-Oroz, M. C., Tamma, F. G., Tröster, A. I., Vitek, J. L., Volkmann, J., & Voon, V. (2006). Deep brain stimulation: postoperative issues. Movement Disorders, 21, S219–S237. doi:10.1002/mds.20957.

    Article  PubMed  Google Scholar 

  • Durif, F., Lemaire, J. J., Debilly, B., & Dordain, G. (1999). Acute and chronic effects of anteromedial globus pallidus stimulation in Parkinson’s disease. Journal of Neurology Neurosurgery and Psychiatry, 67, 315–322.

    Article  Google Scholar 

  • Ghika, J., Villemure, J. G., Fankhauser, H., Favre, J., Assal, G., & Ghika-Schmid, F. (1998). Efficiency and safety of bilateral contemporaneous pallidal stimulation (deep brain stimulation) in levodopa-responsive patients with Parkinson’s disease with severe motor fluctuations: a 2-year follow-up review. Journal of Neurosurgery, 89, 713–718.

    Article  PubMed  Google Scholar 

  • Grosset, D. G., Grosset, K. A., Okun, M. S., & Fernandez, H. H. (Eds.). (2009). Parkinson’s disease. London: Manson Publishing.

    Google Scholar 

  • Guridi, J., Rodriguez-Oroz, M. C., Alegre, M., & Obeso, J. A. (2012). Hardware complications in deep brain stimulation: electrode impedance and loss of clinical benefit. Parkinsonism and Related Disorders, 18, 765–769. doi:10.1016/j.parkreldis.2012.03.014.

    Article  PubMed  Google Scholar 

  • Hariz, M. I. (2002). Complications of deep brain stimulation surgery. Movement Disorders, 17, S162–S166. doi:10.1002/mds.10159.

    Article  PubMed  Google Scholar 

  • Hariz, M. I., & Fodstad, H. (2000). Do microelectrode techniques increase accuracy or decrease risks in pallidotomy and deep brain stimulation? A critical review of the literature. Stereotactic and Functional Neurosurgery, 72, 157–169.

    Article  Google Scholar 

  • Hashimoto, T., Elder, C. M., Okun, M. S., Patrick, S. K., & Vitek, J. L. (2003). Stimulation of the subthalamic nucleus changes the firing pattern of pallidal neurons. Journal of Neuroscience, 23, 1916–1923.

    PubMed  Google Scholar 

  • Iacopino, D. G., Maugeri, R., Giugno, A., & Giller, C. A. (2015). A strange case of downward displacement of a deep brain stimulation electrode 10 years following implantation: the gliding movement of snakes theory. World Neurosurgery, 84, 591 e1–591 e5. doi:10.1016/j.wneu.2015.03.047.

    Article  Google Scholar 

  • Kocabicak, E., & Temel, Y. (2013). Deep brain stimulation of the subthalamic nucleus in Parkinson’s disease: surgical technique, tips, tricks and complications. Clinical Neurology and Neurosurgery, 115, 2318–2323. doi:10.1016/j.clineuro.2013.08.020.

    Article  PubMed  Google Scholar 

  • Lefaucheur, R., Derrey, S., Borden, A., Wallon, D., Ozkul, O., Gérardin, E., & Maltête, D. (2013). Post-operative edema surrounding the electrode: an unusual complication of deep brain stimulation. Brain Stimulation, 6, 459–460. doi:10.1016/j.brs.2012.05.012.

    Article  PubMed  Google Scholar 

  • Lintas, A., Silkis, I. G., Albéri, L., & Villa, A. E. P. (2012). Dopamine deficiency increases synchronized activity in the rat subthalamic nucleus. Brain Research, 1434, 142–151. doi:10.1016/j.brainres.2011.09.005.

    Article  PubMed  Google Scholar 

  • Lockshin, N. A., & Lockshin, B. N. (2011). Skin ulceration secondary to deep brain stimulation device leads. Journal of the American Academy of Dermatology, 65, e122–e123. doi:10.1016/j.jaad.2011.03.025.

    Article  PubMed  Google Scholar 

  • Lozano, A. M., & Mahant, N. (2004). Deep brain stimulation surgery for Parkinson’s disease: mechanisms and consequences. Parkinsonism and Related Disorders, 10, S49–S58. doi:10.1016/j.parkreldis.2003.12.006.

    Article  PubMed  Google Scholar 

  • Lozano, A. M., Dostrovsky, J., Chen, R., & Ashby, P. (2002). Deep brain stimulation for Parkinson’s disease: disrupting the disruption. Lancet Neurology, 1, 225–231. doi:10.1016/S1474-4422(02)00101-1.

    Article  PubMed  Google Scholar 

  • Mehanna, R. (2015). Deep brain stimulation for Parkinson’s disease. In R. Mehanna (Ed.), Deep brain stimulation. Huston: Nova Science Publishers, Inc..

    Google Scholar 

  • Mehanna, R., & Jankovic, J. (2010). Respiratory problems in neurologic movement disorders. Parkinsonism and Related Disorders, 16, 628–638. doi:10.1016/j.parkreldis.2010.07.004.

    Article  PubMed  Google Scholar 

  • Mohit, A. A., Samii, A., Slimp, J. C., Grady, M. S., & Goodkin, R. (2004). Mechanical failure of the electrode wire in deep brain stimulation. Parkinsonism and Related Disorders, 10, 153–156. doi:10.1016/j.parkreldis.2003.11.001.

    Article  Google Scholar 

  • Nakajima, T., Zrinzo, L., Foltynie, T., Olmos, I. A., Taylor, C., Hariz, M. I., & Limousin, P. (2011). MRI-guided subthalamic nucleus deep brain stimulation without microelectrode recording: can we dispense with surgery under local anaesthesia? Stereotactic and Functional Neurosurgery, 89, 318–325. doi:10.1159/000330379.

    Article  PubMed  Google Scholar 

  • Odekerken, V. J. J., van Laar, T., Staal, M. J., Mosch, A., Hoffmann, C. F. E., Nijssen, P. C. G., Beute, G. N., van Vugt, J. P. P., Lenders, M. W. P. M., Contarino, M. F., Mink, M. S. J., Bour, L. J., van den Munckhof, P., Schmand, B. A., de Haan, R. J., Schuurman, P. R., & de Bie, R. M. A. (2013). Subthalamic nucleus versus globus pallidus bilateral deep brain stimulation for advanced Parkinson’s disease (NSTAPS study): a randomised controlled trial. The Lancet Neurology, 12, 37–44. doi:10.1016/S1474-4422(12)70264-8.

    Article  PubMed  Google Scholar 

  • Pollak, P. (2013). Deep brain stimulation for Parkinson’s disease—patient selection. Handook of Clinical Neurology, 116, 97–105. doi:10.1016/B978-0-444-53497-2.00009-7.

    Article  Google Scholar 

  • Silberstein, P., Bittar, R. G., Boyle, R., Cook, R., Coyne, T., O'Sullivan, D., Pell, M., Peppard, R., Rodrigues, J., Silburn, P., Stell, R., & Watson, P. (2009). Deep brain stimulation for Parkinson’s disease: Australian referral guidelines. Journal of Clinical Neuroscience, 16, 1001–1008. doi:10.1016/j.jocn.2008.11.026.

    Article  PubMed  Google Scholar 

  • Slowinski, J. L., Putzke, J. D., Uitti, R. J., Lucas, J. A., Turk, M. F., Kall, B. A., & Wharen, R. E. (2007). Unilateral deep brain stimulation of the subthalamic nucleus for Parkinson disease. Journal of Neurosurgery, 106, 626–632. doi:10.3171/jns.2007.106.4.626.

    Article  PubMed  Google Scholar 

  • Starr, P. A., Christine, C. W., Theodosopoulos, P. V., Lindsey, N., Byrd, D., Mosley, A., & Marks Jr., W. J. (2002). Implantation of deep brain stimulators into the subthalamic nucleus: technical approach and magnetic resonance imaging-verified lead locations. Journal of Neurosurgery, 97, 370–387.

    Article  PubMed  Google Scholar 

  • Stemper, B., Berić, A., Welsch, G., Haendl, T., Sterio, D., & Hilz, M. J. (2006). Deep brain stimulation improves orthostatic regulation of patients with Parkinson disease. Neurology, 67, 1781–1785. doi:10.1212/01.wnl.0000244416.30605.f1.

    Article  PubMed  Google Scholar 

  • Strowd, R. E., Herco, M., Passmore-Griffin, L., Avery, B., Haq, I., Tatter, S. B., et al. (2016). Association between subthalamic nucleus deep brain stimulation and weight gain: results of a case-control study. Clinical Neurology and Neurosurgery, 140, 38–42. doi:10.1016/j.clineuro.2015.11.002.

    Article  PubMed  Google Scholar 

  • Tabbal, S. D., Ushe, M., Mink, J. W., Revilla, F. J., Wernle, A. R., Hong, M., Karimi, M., & Perlmutter, J. S. (2008). Unilateral subthalamic nucleus stimulation has a measurable ipsilateral effect on rigidity and bradykinesia in Parkinson disease. Experimental Neurology, 211(1), 234–242. doi:10.1016/j.expneurol.2008.01.024.

    Article  PubMed  PubMed Central  Google Scholar 

  • Vergani, F., Landi, A., Pirillo, D., Cilia, R., Antonini, A., & Sganzerla, E. P. (2010). Surgical, medical, and hardware adverse events in a series of 141 patients undergoing subthalamic deep brain stimulation for Parkinson disease. World Neurosurgery, 73, 338–344. doi:10.1016/j.wneu.2010.01.017.

    Article  PubMed  Google Scholar 

  • Volkmann, J. (2007). Deep brain stimulation for Parkinson’s disease. Parkinsonism and Related Disorders, 13, S462–S465. doi:10.1016/S1353-8020(08)70050-6.

    Article  PubMed  Google Scholar 

  • Xiaowu, H., Xiufeng, J., Xiaoping, Z., Bin, H., Laixing, W., Yiqun, C., Jinchuan, L., Aiguo, J., & Jianmin, L. (2010). Risks of intracranial hemorrhage in patients with Parkinson’s disease receiving deep brain stimulation and ablation. Parkinsonism and Related Disorders, 16, 96–100. doi:10.1016/j.parkreldis.2009.07.013.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by the project “CEITEC—Central European Institute of Technology” (CZ.1.05/1.1.00/02.0068) from the European Regional Development Fund and the grant project no.16-33798A from the Ministry of Health Research Program of the Ministry of Health of Czech Republic. The funders had no role in decision to publish, or in preparation of the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alena Damborská.

Ethics declarations

Conflict of interest

The authors declare that they have no potential conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ludovico, I., Damborská, A. Deep Brain Stimulation in Parkinson’s Disease: Overview and Complications. Act Nerv Super 59, 4–11 (2017). https://doi.org/10.1007/s41470-017-0003-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s41470-017-0003-2

Keywords

Navigation