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DOI: 10.1055/s-0038-1627324
Tiefe Hirnstimulation bei der Parkinsonschen Krankheit
Deep brain stimulation in patients with Parkinson‘s diseasePublikationsverlauf
Eingegangen am:
21. September 2008
angenommen am:
05. Januar 2008
Publikationsdatum:
20. Januar 2018 (online)
Zusammenfassung
Die tiefe Hirnstimulation des Nucleus subthalamicus (STNStimulation) ist eine hocheffektive Therapieoption zur Behandlung von Patienten mit Morbus Parkinson. Die STNStimulation führt zu einer deutlichen Verbesserung der OFF-Phasen-Symptome um etwa 50% und der hypokinetischen Fluktuationen und Dyskinesien um ca. 70%. Darüber hinaus kann unter der STN-Stimulation die dopaminerge Medikation um etwa 50% reduziert werden. In kontrollierten Studien konnte gezeigt werden, dass durch diese symptomatischen Effekte bei operierten Patienten die Lebensqualität signifikant besser ist als bei vergleichbaren Patienten unter optimierter medikamentöser Therapie. Derzeit wird die STN-Stimulation meist in fortgeschrittenen Krankheitsstadien angewendet, wenn durch eine orale Medikation keine Verbesserung mehr erzielt werden kann. Zukünftige Studien werden zeigen, ob die STN-Stimulation auch früher eingesetzt werden sollte, um sekundären Komplikationen der Erkrankung vorzubeugen und die bereits früh einsetzende psychosoziale Behinderung bei Parkinsonpatienten abzumildern.
Summary
Subthalamic deep brain stimulation (STN-DBS) has been established as a highly effective therapeutic approach for amelioration of motor symptoms in Parkinson’s disease (PD). STN-DBS results in a mean reduction of off-motor symptoms by about 50% and hypo- and hyperkinetic fluctuations by 70%. Simultaneously, the dopaminergic medication can be reduced by about 50%. It has been shown that no other therapy is as effective as STN-DBS in improving life quality of PD patients. Nowadays, STN-DBS is recommended for patients in progressive stages of PD who will not improve by adjustment of medication. Future studies will show whether STN-DBS might also be an option earlier in the course of the disease to prevent motor complications as well as social maladaption of PD patients.
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