Deep brain stimulation of the subthalamic nucleus in Parkinson’s disease: From history to the interaction with the monoaminergic systems

Faggiani E(1), Benazzouz A(2).

Author information:
(1)Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33076
Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293,
33076 Bordeaux, France.
(2)Univ. de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293, 33076
Bordeaux, France; CNRS, Institut des Maladies Neurodégénératives, UMR 5293,
33076 Bordeaux, France. Electronic address: .

Parkinson’s disease is the second most common neurodegenerative disorder,
characterized by the manifestation of motor symptoms, which are mainly
attributed to the degeneration of dopamine neurons in the pars compacta of
substantia nigra. Based on advancements in the understanding of the
pathophysiology of the disease, especially in animal models, the subthalamic
nucleus has been pointed as a major target for deep brain stimulation in the
treatment of motor symptoms, first developed in non-human primate and then
successfully transfered to parkinsonian patients. Nevertheless, despite the
focus on motor deficits, Parkinson’s disease is also characterized by the
manifestation of non-motor symptoms, which can be due to the additional
degeneration of norepinephrine, serotonin and cholinergic systems. The
pathophysiology of the non-motor symptoms is under studied and consequently not
well treated. Furthermore, data from the literature about the impact of
subthalamic deep brain stimulation on non-motor disorders are controversial and
still under debate. Similarly, the risk of mood disorders post-deep brain
stimulation surgery remains also controversial. Here, we review the clinical and
experimental data of this neurosurgical approach on motor and non-motor
behaviors and provide evidence for its interaction with the monoaminergic
systems.

Copyright © 2016 Elsevier Ltd. All rights reserved.

 

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