Sažetak sa skupa
https://doi.org/10.21857/ypn4oc4189
Deep Brain Stimulation – Clinical Experience, Indications, and Future Perspectives
Darko Chudy
; Department of Neurosurgery, University Hospital Dubrava, 10 000, Zagreb, Croatia. School of Medicine, University of Zagreb, 10 000, Zagreb, Croatia.
Vladimira Vuletić
; Department of Neurology, Faculty of Medicine, University of Rijeka, 51000 Rijeka, Croatia. Department of Neurology, Clinical Hospital Center Rijeka, 51000 Rijeka, Croatia.
Marina Raguž
; Department of Neurosurgery, University Hospital Dubrava, 10 000, Zagreb, Croatia, School of Medicine, Catholic University of Croatia, 10 000, Zagreb, Croatia
Sažetak
Deep brain stimulation (DBS) represents one of the most significant advancements in functional
neurosurgery. Since its stereotactic origins in the mid-20th century, DBS has evolved into a standard
neurosurgical procedure for various movement disorders, most notably Parkinson’s disease, dystonia,
and essential tremor. With over 210,000 devices implanted globally and more than 12,000 new procedures
annually, the scope of DBS continues to expand.
At University Hospital Dubrava, more than 400 DBS procedures have been successfully performed to
date. Depending on the indication, surgical targets include the subthalamic nucleus (STN), internal
globus pallidus (GPi), ventral intermediate nucleus (VIM), posterior subthalamic area/caudal zona
incerta (PSA/cZI), and the centromedian-parafascicular complex (CM-pf ), as well as various thalamic
nuclei in the treatment of chronic pain. In addition to movement disorders, DBS has demonstrated efficacy
in treating Gilles de la Tourette syndrome and is emerging as a promising option in the management
of disorders of consciousness (DOC).
Our multidisciplinary team has recently focused on the application of DBS in patients with DOC,
including those in vegetative and minimally conscious states. Preliminary findings indicate that structural
preservation of the thalamus, basal ganglia, and brainstem, along with a favorable gray matter
proportion, may serve as predictive markers of clinical responsiveness to CM-pf stimulation. Although
early results are encouraging, this indication remains under active investigation, requiring further studies
to determine optimal patient selection and therapeutic mechanisms.
Despite its generally favorable safety profile, DBS is not without risks. Potential complications include
intracerebral hemorrhage, infection, hardware malfunction, and neuropsychiatric side effects. Therefore,
careful patient selection, thorough preoperative imaging, and multidisciplinary evaluation are
essential to achieving optimal outcomes.
This abstract provides an overview of the historical evolution, current indications, and institutional
experience with DBS, with particular emphasis on its expanding role in neuromodulation for patients
with disorders of consciousness. The future of DBS lies in broadening its clinical applications, refining
targeting strategies, and identifying reliable predictors of treatment response.
Ključne riječi
Hrčak ID:
333475
URI
Datum izdavanja:
25.6.2025.
Posjeta: 486 *