By William J. Marks Jr
A realistic advisor to using this particularly new therapy for the motor signs of varied flow disorders.
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Additional resources for Deep Brain Stimulation Management
Mov Disord 2002;17:1084–5. 20. Sheikhi J, Yesavage J. Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. In Brink TL, ed. Clinical Gerontology: A Guide to Assessment and Intervention. New York: Haworth Press; 1986:165–73. 21. Miyasaki JM, Shannon K, Voon V, et al. Practice parameter: evaluation and treatment of depression, psychosis, and dementia in Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology.
In Parkinson’s disease (PD), the results of dopamine deficiency include increased neuronal activity in the subthalamic nucleus (STN) and globus pallidus internus (GPi), with irregular and bursting neuronal firing patterns. Increased synchrony is found among sensorimotor networks, which may contribute to PD motor signs. Movement disorders may be thought of as “brain arrhythmias”: DBS as a brain pacemaker Loss of dopaminergic input to the striatum results in the appearance of the classical motor signs of Parkinson’s disease (PD).
Secondary dystonia 10–20% improvement in BFMDRS movement score Notes: BFMDRS, Burke–Fahn–Marsden Dystonia Rating Scale; TWSTRS, Toronto Western Spasmodic Torticollis Rating Scale. Counseling patients on expected DBS surgical outcome Once a dystonia patient has been properly evaluated and screened for DBS, it is important to counsel the patient on the degree of expected improvement in symptoms with DBS treatment. Patients with childhood/juvenile-onset primary generalized dystonia generally have the best outcome, with improvements of 50–70% as measured by the BFMDRS movement score commonly achieved.
Deep Brain Stimulation Management by William J. Marks Jr