Deep brain stimulation for Parkinson's disease Indications
Deep brain stimulation is an established and evidence-based therapeutic option for the treatment of advanced Parkinson's disease. Main indication and inclusion criteria are the presence of idiopathic Parkinsonism with motor fluctuations and/or dyskinesias and/or with medication refractory tremor, a significant improvement of akinesia/rigidity in response to dopaminergic medication, the absence of relevant cognitive deficits and other significant comorbidities. DBS neurosurgery has a low risk of complications. The clinical programming should follow an established monopolar review algorithm. Regular follow-up visits are required for stimulation monitoring 1).
The results indicate that the patients' age, rather than disease duration (DD), has a negative effect on the levodopa response (LR). Therefore, patients with an advanced age and with a poor LR are not good candidates 2).
It is only beneficial to some elderly PD patients aged 70 years or older. Tremor, axial dysfunctions and drug-induced dyskinesia are the main indications for the elderly; however, their clinical benefits are inferior to those of younger patients 3).