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Parkinson’s Disease
Volume 2017, Article ID 3410820, 15 pages
https://doi.org/10.1155/2017/3410820
Review Article

Comparison of Globus Pallidus Interna and Subthalamic Nucleus in Deep Brain Stimulation for Parkinson Disease: An Institutional Experience and Review

1Department of Neurology and Neurotherapeutics, UT Southwestern, Dallas, TX, USA
2Department of Neurology and Neurotherapeutics, Section of Movement Disorders, UT Southwestern, Dallas, TX, USA
3UT Southwestern Medical School, Dallas, TX, USA
4Henry Ford Hospital, Detroit, MI, USA
5Emory University, Atlanta, GA, USA

Correspondence should be addressed to Shilpa Chitnis; ude.nretsewhtuostu@sintihc.aplihs

Received 2 March 2017; Accepted 7 May 2017; Published 19 June 2017

Academic Editor: Aparna Wagle Shukla

Copyright © 2017 Shazia Mirza et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Deep Brain Stimulation (DBS) has revolutionized the lives of patients of Parkinson disease, offering therapeutic options to those not benefiting entirely from medications alone. With its proven track record of outperforming the best medical management, the goal is to unlock the full potential of this therapy. Currently, the Globus Pallidus Interna (GPi) and Subthalamic Nucleus (STN) are both viable targets for DBS, and the choice of site should focus on the constellation of symptoms, both motor and nonmotor, which are key determinants to quality of life. Our article sheds light on the specific advantages and drawbacks of the two sites, highlighting the need for matching the inherent properties of a target with specific desired effects in patients. UT Southwestern Medical Center has a robust and constantly evolving DBS program and the narrative from our center provides invaluable insight into the practical realities of DBS. The ultimate decision in selecting a DBS target is complex, ideally made by a multidisciplinary team, tailored towards each patient’s profile and their expectations, by drawing upon scientific evidence coupled with experience. Ongoing research is expanding our knowledge base, which should be dynamically incorporated into an institute’s DBS paradigm to ensure that patients receive the optimal therapy.