During the last decade, it has become clear that
deep brain stimulation (DBS)
therapy provides a dramatic improvement in the symptoms of
movement disorders. We have experienced DBS in 110 patients with various types of
involuntary movements, and confirmed the benefits of stimulation of the thalamic nucleus ventralis intermedius (Vim), internal globus pallidus (GPi) and subthalamic nucleus (STN) in these patients. DBS
therapy affords the best effect on
tremor when the Vim is selected as the stimulation site. DBS
therapy is also useful for controlling rigidity when the GPi or STN is stimulated. Improvements of
bradykinesia and gait disturbance are often induced by DBS
therapy involving the GPi or STN.
Dopa-induced
dyskinesia can be attenuated effectively by the direct and/or indirect effects of DBS
therapy. DBS of the Vim also provides excellent control of post-
stroke involuntary movements, including
hemiballism and hemichoreoathetosis.
Dystonia in young patients is controlled effectively by DBS of GPi. Ablative procedures for control of
involuntary movement disorders, such as thalamotomy and
pallidotomy, always carry a risk associated with creating additional lesions in an already damaged brain. In contrast, there is not such a risk in DBS
therapy. This modality of
therapy is an important option in treating
involuntary movements.