Brain Stimulation and Neurodegenerative Diseases

Dear Colleagues,

Neurodegenerative diseases are growing rapidly. In the last 25 years, the number of people with Parkinson's disease (PD), the second most common neurodegenerative disease after Alzheimer's disease, has doubled, and there is currently no end in sight to this growth. Since no cure is yet possible, the aim is to achieve the best possible symptom control in order to increase the quality of life of those affected in the long term.

In selected PD patients, deep brain stimulation (DBS) is one of the most effective therapy options. Electrodes are implanted bilaterally in deep brain areas through small drill holes and connected to an extracranial pulse generator on the chest wall. In PD, the most common target area is the subthalamic nucleus (STN), followed by the internal segment of the globus pallidus (GPI). Implantation is performed either under general anesthesia or, more commonly, as awake surgery so that immediate symptom control and side effects can be recorded.

During awake surgery, it is essential to avoid medications that could suppress micro leads recording or clinical symptoms. Accordingly, Parkinson's patients must remain OFF medication during surgery, which can be extremely uncomfortable and can sometimes lead to patients refusing DBS therapy.

Prof. Heidemarie Zach

Guest Editor

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