New targets for deep brain stimulation treatment of Parkinson's disease. (December 2013)

• Record Type: Journal Article
• Authors: Castrioto, Anna; Moro, Elena
• Is Part Of: Expert review of neurotherapeutics. Volume 13:Number 12(2013)
• Page Start: 1319
• Page End: 1328
• Publication Date: 2013-12
• Subjects: basal ganglia -- centromedian-parafascicular complex -- closed-loop stimulation -- deep brain stimulation -- mesencephalic locomotor region -- Parkinson's disease -- pedunculopontine nucleus -- substantia nigra -- zona incerta; Neuropharmacology -- Periodicals; 615.7805
• DOI: 10.1586/14737175.2013.859987
• Languages: English
• ISSNs: 1473-7175

Abstract

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) and the globus pallidus pars interna (GPi) has been shown to be an effective treatment for patients with Parkinson's disease. Strong clinical evidence supports the improvement of motor and non-motor complications and quality of life, with some data suggesting that GPi DBS might be less effective than STN DBS. However, neither STN nor GPi stimulation provides a satisfactory control of non-dopaminergic symptoms, such as gait and balance impairment and cognitive decline, which are frequent and disabling symptoms in advanced Parkinson's disease patients. Therefore, several efforts have been made to discover alternative and new targets to overcome these current DBS limitations. Among these new targets, the stimulation of the pedunculopontine nucleus has initially appeared encouraging. However, findings from different double-blind trials have mitigated the enthusiasm. A multi-target strategy aimed at improving symptoms with different pathogenetic mechanisms might be a promising approach in the next years.