Deep brain stimulation in the treatment of Parkinson’s disease

Abstract

Introduction: Parkinson’s disease (PD) is neurodegenerative and has bradykinesia, rest tremor, stiffnes and postural instability. These changes come from the degeneration of dopaminergic neurons. The treatment, carried out based on levodopa, provides improvements in the condition of the patients, however, they provide side effects. Based on this, the Deep Brain Stimulation (DBS) technique - stimulation of subcortical structures with electrodes - is a good treatment option. Methods: A narrative review of the literature was carried out, using the PubMed database with the keywords “Deep brain stimulation”, “Therapeutic use” and “Parkinson’s disease”. Included articles of meta-analysis, systematic review and review published in the last year. Results: The DBS offers a significant improvement in motor symptoms, gait, postural instability, reduction in tremors and in their progression. However, DBS can offer risks to the patient. Comparing the effectiveness of DBS with other therapies for Parkinson’s, such as levodopa/ carbidopa intestinal infusion gel (LCIG) and best medical therapy (BMT), it was found that BMT is botton. The cost-effectiveness comparison of these techniques, showed that DBS is the most costly procedure. It stands out comparisons can have intrinsic biases, such as the conflict of interest with pharmaceutical companies. Conclusion: DBS is a beneficial intervention for patients with PD who have important motor symptoms. Performed only in cases with indication, due to the possibility of complications.