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dc.contributor.author
Rossi, Malco Damián
dc.contributor.author
Bruno, Veronica Andrea
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Arena, Julieta
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Cammarota, Ángel
dc.contributor.author
Merello, Marcelo Jorge
dc.date.available
2020-01-15T18:00:57Z
dc.date.issued
2018-05
dc.identifier.citation
Rossi, Malco Damián; Bruno, Veronica Andrea; Arena, Julieta; Cammarota, Ángel; Merello, Marcelo Jorge; Challenges in PD Patient Management After DBS: A Pragmatic Review; Wiley Blackwell Publishing, Inc; Movement Disorders Clinical Practice; 5; 3; 5-2018; 246-254
dc.identifier.issn
2330-1619
dc.identifier.uri
http://hdl.handle.net/11336/94758
dc.description.abstract
Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) or internal globus pallidus (GPi) represents an effective and universally applied therapy for Parkinson's disease (PD) motor complications. However, certain procedure-related problems and unrealistic patient expectations may detract specialists from indicating DBS more widely despite significant clinical effects. Methods: This review provides a pragmatic educational summary of the most conflicting postoperative management issues in patients undergoing DBS for PD. Results: DBS in PD has been associated with certain complications and post-procedural management issues, which can complicate surgical outcome interpretation. Many PD patients consider DBS outcomes negative due to unfulfilled expectations, even when significant motor symptom improvement is achieved. Speech, gait, postural stability, and cognition may worsen after DBS and body weight may increase. Although DBS may induce impulse control disorders in some cases, in others, it may actually improve them when dopamine agonist dosage is reduced after surgery. However, apathy may also arise, especially when dopaminergic medication tapering is rapid. Gradual loss of response with time suggests disease progression, rather than the wearing off of DBS effects. Furthermore, implantable pulse generator expiration is considered a movement disorder emergency, as it may worsen parkinsonian symptoms or cause life-threatening akinetic crises due to malignant DBS withdrawal syndrome. Conclusion: Major unsolved issues occurring after DBS therapy preclude complete patient satisfaction. Multidisciplinary management at experienced centers, as well as careful and comprehensive delivery of information to patients, should contribute to make DBS outcome expectations more realistic and allow post procedural complications to be better accepted.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
Wiley Blackwell Publishing, Inc
dc.rights
info:eu-repo/semantics/openAccess
dc.rights.uri
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.subject
ADVERSE EFFECTS
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CLINICAL OUTCOME
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COMPLICATIONS
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DEEP BRAIN STIMULATION
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PARKINSON'S DISEASE
dc.subject.classification
Otras Ciencias de la Salud
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Ciencias de la Salud
dc.subject.classification
CIENCIAS MÉDICAS Y DE LA SALUD
dc.title
Challenges in PD Patient Management After DBS: A Pragmatic Review
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2019-12-20T22:53:54Z
dc.journal.volume
5
dc.journal.number
3
dc.journal.pagination
246-254
dc.journal.pais
Estados Unidos
dc.description.fil
Fil: Rossi, Malco Damián. Fundación para la Lucha Contra las Enfermedades Neurológicas de la Infancia. Instituto de Investigaciones Neurológicas "Raúl Carrea"; Argentina
dc.description.fil
Fil: Bruno, Veronica Andrea. Fundación para la Lucha Contra las Enfermedades Neurológicas de la Infancia. Instituto de Investigaciones Neurológicas "Raúl Carrea"; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
dc.description.fil
Fil: Arena, Julieta. Fundación para la Lucha Contra las Enfermedades Neurológicas de la Infancia. Instituto de Investigaciones Neurológicas "Raúl Carrea"; Argentina
dc.description.fil
Fil: Cammarota, Ángel. Fundación para la Lucha Contra las Enfermedades Neurológicas de la Infancia. Instituto de Investigaciones Neurológicas "Raúl Carrea"; Argentina
dc.description.fil
Fil: Merello, Marcelo Jorge. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Fundación para la Lucha Contra las Enfermedades Neurológicas de la Infancia. Instituto de Investigaciones Neurológicas "Raúl Carrea"; Argentina
dc.journal.title
Movement Disorders Clinical Practice
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://onlinelibrary.wiley.com/doi/full/10.1002/mdc3.12592
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1002/mdc3.12592
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