Postoperative rehabilitation after deep brain stimulation surgery for movement disorders

Allert, Niels; Cheeran, Binith; Deuschl, Günther; Barbe, Michael T.; Csóti, Ilona; Ebke, Markus; Gläser, Martin; Kang, Jun-Suk; Kelm, Stefan; Krack, Paul; Kroth, Julia; Jobst, U.; Leisse, Markus; Oliviero, Antonio; Nolte, P.; Quick-Weller, Johanna; Strothjohann, M.H.; Tamás, Gertrúd; Werner, Michael; Volkmann, Jens; Fasano, Alfonso; Groppa, Sergiu

doi:10.1016/j.clinph.2017.12.035

Cited by 21 publications

(19 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In addition, patients need specialized neuro-rehabilitation after DBS implantation (5). Before selecting a proper setting of post-surgical rehabilitation, the individual needs and goals for rehabilitation have to be defined for each DBS patient individually.…”

Section: Clinical Aspects Of Dbs Surgerymentioning

confidence: 99%

“…Before selecting a proper setting of post-surgical rehabilitation, the individual needs and goals for rehabilitation have to be defined for each DBS patient individually. The goal-specific therapy could be physiotherapy, Lee Silverman Voice Treatment (LSVT-BIG) therapy, speech therapy, occupational therapy, talk therapy, cognitive therapy or behavioral therapy depending upon the patient's need for best long-term clinical outcome (5). …”

Section: Clinical Aspects Of Dbs Surgerymentioning

confidence: 99%

“…Five decades after its introduction, L-DOPA is still the most effective and widely used drug to alleviate the symptoms of PD (4). In recent years, deep brain stimulation (DBS) has become a standard evidence-based therapy for severe movement disorders such as PD (5), tremor (6) and dystonia (7). Since the first DBS surgery in Grenoble nearly 30 years ago (8), over 100,000 patients have undergone DBS implantations for neurologic and neuropsychiatric conditions (9).…”

Section: Introductionmentioning

confidence: 99%

“…Medically intractable motor fluctuations and tremor are independent indications for DBS in PD, in which the electrodes are most commonly implanted in the subthalamic nucleus (STN) or globus pallidus internus (GPi) (5). Bilateral STN-DBS effectively improves the motor fluctuations, bradykinesia and tremor (18).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Deep Brain Stimulation and L-DOPA Therapy: Concepts of Action and Clinical Applications in Parkinson's Disease

et al. 2018

Self Cite

View full text Add to dashboard Cite

L-DOPA is still the most effective pharmacological therapy for the treatment of motor symptoms in Parkinson's disease (PD) almost four decades after it was first used. Deep brain stimulation (DBS) is a safe and highly effective treatment option in patients with PD. Even though a clear understanding of the mechanisms of both treatment methods is yet to be obtained, the combination of both treatments is the most effective standard evidenced-based therapy to date. Recent studies have demonstrated that DBS is a therapy option even in the early course of the disease, when first complications arise despite a rigorous adjustment of the pharmacological treatment. The unique feature of this therapeutic approach is the ability to preferentially modulate specific brain networks through the choice of stimulation site. The clinical effects have been unequivocally confirmed in recent studies; however, the impact of DBS and the supplementary effect of L-DOPA on the neuronal network are not yet fully understood. In this review, we present emerging data on the presumable mechanisms of DBS in patients with PD and discuss the pathophysiological similarities and differences in the effects of DBS in comparison to dopaminergic medication. Targeted, selective modulation of brain networks by DBS and pharmacodynamic effects of L-DOPA therapy on the central nervous system are presented. Moreover, we outline the perioperative algorithms for PD patients before and directly after the implantation of DBS electrodes and strategies for the reduction of side effects and optimization of motor and non-motor symptoms.

show abstract

Section: Clinical Aspects Of Dbs Surgerymentioning

confidence: 99%

Section: Clinical Aspects Of Dbs Surgerymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Deep Brain Stimulation and L-DOPA Therapy: Concepts of Action and Clinical Applications in Parkinson's Disease

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…Allert et al 55 suggest that patients need specialized neuro-rehabilitation after DBS implantation. Before selecting a proper setting of post-surgical rehabilitation, the individual needs and goals for rehabilitation have to be defined for each DBS patient individually.…”

Section: Post-operative Long-term Care Managementmentioning

confidence: 99%

The advances of Deep Brain Stimulation (DBS) for treatment of Parkinson s disease (PD)

2018

View full text Add to dashboard Cite

Advanced Parkinson's disease (PD) is characterized by the presence of motor fluctuations, various degrees of dyskinesia, and disability with functional impact on daily living and independence. Therapeutic management aims to extend levodopa (L-DOPA) benefit while minimizing motor complications and includes, in selected cases, the implementation of drug infusion and surgical techniques. The concept of deep brain stimulation (DBS) for PD was introduced over 20 years ago, but our understanding of the nuances of this procedure continues to improve. This review aims to demonstrate the advances of DBS in the treatment of PD patients.

show abstract

Effect of thalamic deep brain stimulation on swallowing in patients with essential tremor

Lapa

Claus

Reitz

et al. 2020

Ann Clin Transl Neurol

View full text Add to dashboard Cite

Objective: Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) is a mainstay treatment for severe and drug-refractory essential tremor (ET). Although stimulation-induced dysarthria has been extensively described, possible impairment of swallowing has not been systematically investigated yet. Methods: Twelve patients with ET and bilateral VIM-DBS with self-reported dysphagia after VIM-DBS were included. Swallowing function was assessed clinically and using by flexible endoscopic evaluation of swallowing in the stim-ON and in the stim-OFF condition. Presence, severity, and improvement of dysphagia were recorded. Results: During stim-ON, the presence of dysphagia could be objectified in all patients, 42% showing mild, 42% moderate, and 16 % severe dysphagia. During stim-OFF, all patients experienced a statistically significant improvement of swallowing function. Interpretation: VIM-DBS may have an impact on swallowing physiology in ET-patients. Further studies to elucidate the prevalence and underlying pathophysiological mechanisms are warranted.

show abstract

Postoperative rehabilitation after deep brain stimulation surgery for movement disorders

Cited by 21 publications

References 54 publications

Deep Brain Stimulation and L-DOPA Therapy: Concepts of Action and Clinical Applications in Parkinson's Disease

Deep Brain Stimulation and L-DOPA Therapy: Concepts of Action and Clinical Applications in Parkinson's Disease

The advances of Deep Brain Stimulation (DBS) for treatment of Parkinson s disease (PD)

Effect of thalamic deep brain stimulation on swallowing in patients with essential tremor

Contact Info

Product

Resources

About