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Controversies in Deep Brain Stimulation Surgery: Micro-Electrode Recordings

  • Jeroen HabetsEmail author
  • Bethany Isaacs
  • Saman Vinke
  • Pieter Kubben
Chapter

Abstract

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) was first applied as a neurosurgical intervention technique for Parkinson’s disease (PD) in the 1990s and has since become a widely accepted practice. Bilateral STN-DBS has been proven to be significantly improve levodopa-responsive parkinsonian symptoms and quality of life compared to best medical treatment alone [1, 2]. DBS is generally considered in patients only when pharmacological treatment does not respond in sufficient effect any longer or leads to unacceptable adverse effects. Stimulation of the subthalamic nucleus (STN) is the most common practice since it results in more time in well-treated ‘ON-condition’, though the internal segment of the globus pallidus (GPi) is also a possibility [3, 4]. While DBS of the STN specifically is effective for a majority of patients in relieving the motor related symptoms of PD, a fraction of patients will fail to witness such beneficial effects. Moreover, DBS patients may develop a number of side effects spanning a range of domains, from speech and gait impairments to cognitive decline and impulse control disorders, as well as psychiatric and emotional disturbances.

Keywords

Parkinson’s disease Deep brain stimulation MER guided MRI guided 

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Jeroen Habets
    • 1
    • 2
    Email author
  • Bethany Isaacs
    • 1
    • 2
    • 3
  • Saman Vinke
    • 4
  • Pieter Kubben
    • 1
    • 2
  1. 1.Department of NeurosurgeryMaastricht University Medical CenterMaastrichtThe Netherlands
  2. 2.Translational Neuroscience LabSchool for Mental Health and Neuroscience, Maastricht UniversityMaastrichtThe Netherlands
  3. 3.Integrative Model-based Cognitive Neuroscience Research UnitUniversity of AmsterdamAmsterdamThe Netherlands
  4. 4.Department of NeurosurgeryRadboud University Medical CenterNijmegenThe Netherlands

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