Journal
PARKINSONISM & RELATED DISORDERS
Volume 13, Issue 5, Pages 261-265Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.parkreldis.2006.07.020
Keywords
neuromodulation; globus pallidus internus; pallidotomy; stereotactic surgery; basal ganglia
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Neuromodulation is the functional modification of neural structures through the use of electrical stimulation. Its most clinically applicable use is deep brain stimulation (DBS) of basal ganglia structures in Parkinson's disease (PD) and essential tremor (ET). More recently, it has been used as a means of treating dystonic movement disorders. The main target of DBS for dystonia is the posteroventral globus pallidus internus (GPi), although the thalamus has been used as an alternate target in a minority of cases. In comparison to the effects seen in PD, the improvement in dystonic postures appear to differ in several ways-delay of clinical benefit, higher voltage requirements, and varied stimulator settings. In this review, the authors discuss the clinical characteristics, pathophysiology, microelectrode recording (MER) signatures, optimal surgical targets, programming parameters and outcomes in dystonia. (c) 2006 Elsevier Ltd. All rights reserved.
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