Fast Five Quiz: Management of Parkinson's Disease

Rajesh Pahwa, MD


January 13, 2022

For patients with dopamine-resistant symptoms such as motor fluctuations and dyskinesias, DBS is an alternative therapy for dopamine-responsive signs of disease.

Past randomized controlled trials have demonstrated the superiority of subthalamic nucleus (STN)-DBS over pharmacologic treatment in reducing motor complications and improving quality of life in patients with advanced disease. However, motor signs, including freezing, falling, and axial signs, do not show a marked improvement with DBS.

The UK National Collaborating Centre for Chronic Conditions notes that eligible patients for STN and globus pallidus internus are those without significant mental health problems such as depression and dementia. Depression is one of the most frequent nonmotor symptoms in Parkinson's disease in both early and advanced disease; it may even precede diagnosis.

Central to choosing appropriate patients for DBS is that the patient's symptoms are still responding to levodopa (despite the response not being adequately maintained through the day or complicated by dyskinesia).

Learn more about DBS.

Editor's Recommendations


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.