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Deep brain stimulation for P arkinson disease in A ustralia: current scientific and clinical status
Author(s) -
Poortvliet P. C.,
Silburn P. A.,
Coyne T. J.,
Chenery H. J.
Publication year - 2015
Publication title -
internal medicine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 1444-0903
DOI - 10.1111/imj.12656
Subject(s) - medicine , deep brain stimulation , disease , quality of life (healthcare) , intervention (counseling) , pedunculopontine nucleus , motor symptoms , physical medicine and rehabilitation , intensive care medicine , referral , physical therapy , parkinson's disease , psychiatry , family medicine , nursing
There is currently no cure for P arkinson disease ( PD ). Disease management is directed primarily at motor symptom relief, but the impact of non‐motor symptoms associated with PD should not be underestimated. Medical and surgical treatment options aim to increase functional independence and quality of life. Deep brain stimulation ( DBS ) has proven to be a safe, effective and cost‐efficient surgical treatment option. In 2009, the A ustralian referral guidelines, developed to provide a synopsis of DBS therapy for PD , were introduced, and since then novel findings have been reported regarding the timing of intervention, target selection and symptom management. Our aim is to provide an update of DBS for PD in A ustralia. Intervention at earlier stages of the disease can potentially improve quality of life over a longer period with greater possibilities for meaningful social and professional contributions. For less responsive motor symptoms (e.g. freezing of gait, postural instability), the pedunculopontine nucleus has emerged as a promising new surgical target. Traditional PD treatment is focused on improvement of motor symptoms, but the disorder is also characterised by non‐motor symptoms, often undiagnosed or undisclosed, that have the potential to impact quality of life to a greater extent than motor symptoms. It is essential to identify and routinely monitor for non‐motor symptoms as they can emerge at all stages of the disease or can result from treatment. Many of these current advances require long‐term monitoring of treatment outcomes to improve future clinical practice, refine patient selection and ensure best patient outcomes.