期刊
PROGRESS IN NEUROBIOLOGY
卷 110, 期 -, 页码 74-88出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.pneurobio.2013.04.002
关键词
Children; Deep brain stimulation; Dystonia; Ethics; Movement disorders; Parkinson's disease
资金
- German Research Foundation (DFG) [219]
- Federal Ministry of Education and Research in Germany
- Health Canada
- Kluh Stiftung
- Hoffnungsbaum e.V.
- NBIA Disorders Association USA
- Deutsche Parkinson Vereinigung
Deep brain stimulation (DBS) has proven to be a successful therapeutic approach in several patients with movement disorders such as Parkinson's disease and dystonia. Hitherto its application was mainly restricted to advanced disease patients resistant to medication or with severe treatment side effects. However, there is now growing interest in earlier application of DBS, aimed at improving clinical outcomes, quality of life, and avoiding psychosocial consequences of chronic disease-related impairments. We address the clinical and ethical aspects of two early uses of DBS, (1) DBS early in the course of the disease, and (2) DBS early in life (i.e. in children). Possible benefits, risks and burdens are discussed and thoroughly considered. Further research is needed to obtain a careful balance between exposing vulnerable patients to potential severe surgical risks and excluding them from a potentially good outcome. (C) 2013 Elsevier Ltd. All rights reserved.
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