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My 25 Stimulating Years with DBS in Parkinson's Disease

Hariz, M; (2017) My 25 Stimulating Years with DBS in Parkinson's Disease. Journal of Parkinson't Disease , 7 (s1) S35-S43. 10.3233/JPD-179007. Green open access

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Abstract

The year 2017 marks the 30th anniversary of the birth of modern deep brain stimulation (DBS), which was introduced by Benabid, Pollak et al. in 1987, initially targeting the motor thalamus to treat tremor, and subsequently targeting the subthalamic nucleus (STN) for treatment of symptoms of advanced Parkinson’s disease (PD). STN DBS is undoubtedly “the most important discovery since levodopa”, as stated by David Marsden in 1994. In 2014, The Lasker– DeBakey Clinical Medical Research Award to “honor two scientists who developed deep brain stimulation of the subthalamic nucleus”, was bestowed upon Benabid and DeLong. STN DBS remains today the main surgical procedure for PD, due to its effectiveness in ameliorating PD symptoms and because it is the only surgical procedure for PD that allows a radical decrease in medication. Future improvements of DBS include the possibility to deliver a “closed-loop”, “on demand” stimulation, as highly preliminary studies suggest that it may improve both axial and appendicular symptoms and reduce side effects such as dysarthria. Even though DBS of the subthalamic nucleus is the main surgical procedure used today for patients with PD, all patients are not suitable for STN DBS; as a functional neurosurgeon performing since more than 25 years various surgical procedures the aim of which is not to save life but to improve the patient’s quality of life, I consider that the surgery should be tailored to the patient’s individual symptoms and needs, and that its safety is paramount. “I used to wonder years ago when the anxiety, tension, and pain of the decision ...  would disappear. I now know the answer to that question. When? Never – that’s when.” Irving S. Cooper: The Vital Probe. My life as a brain surgeon (1981).

Type: Article
Title: My 25 Stimulating Years with DBS in Parkinson's Disease
Open access status: An open access version is available from UCL Discovery
DOI: 10.3233/JPD-179007
Publisher version: http://doi.org/10.3233/JPD-179007
Language: English
Additional information: This article is published online with Open Access and distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC 4.0).
Keywords: Parkinson’s disease, deep brain stimulation, subthalamic nucleus, globus pallidus, thalamus, quality of life, pallidotomy, stereotactic neurosurgery, safety
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases
URI: https://discovery.ucl.ac.uk/id/eprint/1551127
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