Evidence map›Paper›PMID 38216697›Full record

ReviewNeurosurgical review2024

Directional deep brain stimulation in the management of Parkinson's disease: efficacy and constraints-an analytical appraisal.

Mayara Tszesnioski Maçaneiro, Ana Clara Azevedo, Bruna Maurício Poerner, Milena Dangui da Silva, Andrei Koerbel

Abstract readReview
PubMed Publisher
In one paragraph

Review in Neurosurgical review, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Mayara Tszesnioski MaçaneiroMedical Department at Universidade da Região de Joinville - UNIVILLE, Joinville, Santa Catarina, Brazil. mayara.macaneiro@univille.br.ORCID https://orcid.org/0000-0002-2041-0408
Ana Clara AzevedoMedical Department at Universidade da Região de Joinville - UNIVILLE, Joinville, Santa Catarina, Brazil.
Bruna Maurício PoernerMedical Department at Universidade da Região de Joinville - UNIVILLE, Joinville, Santa Catarina, Brazil.
Milena Dangui da SilvaMedical Department at Universidade da Região de Joinville - UNIVILLE, Joinville, Santa Catarina, Brazil.
Andrei KoerbelUniversidade da Região de Joinville - UNIVILLE, Joinville, Santa Catarina, Brazil.ORCID https://orcid.org/0000-0003-2658-8087

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Deep brain stimulation (DBS) is a widely employed treatment for Parkinson's disease. However, conventional DBS utilizing ring-shaped leads can often result in undesirable side effects by stimulating nearby brain structures, thus limiting its effectiveness. To address this issue, a novel DBS electrode was developed to allow for directional stimulation, avoiding neighboring structures. This literature review aims to analyze the disparities between conventional and directional DBS and discuss the benefits and limitations associated with this innovative electrode design, focusing on the stimulation-induced side effects it can or cannot mitigate. A comprehensive search was conducted in MEDLINE/PubMed, ScienceDirect, and EBSCO databases using the Boolean search criteria: "Deep brain stimulation" AND "Parkinson" AND "Directional." Following the application of inclusion and exclusion criteria, the selected articles were downloaded for full-text reading. Subsequently, the results were organized and analyzed to compose this article. Numerous studies have demonstrated that directional DBS effectively reduces side effects associated with brain stimulation, prevents the stimulation of non-targeted structures, and expands the therapeutic window, among other advantages. However, it has been observed that directional DBS may be more challenging to program and requires higher energy consumption. Furthermore, there is a lack of standardization among different manufacturers of directional DBS electrodes. Various stimulation-induced side effects, including dysarthria, dyskinesia, paresthesias, and symptoms of pyramidal tract activation, have been shown to be mitigated with the use of directional DBS. Moreover, directional electrodes offer a wider therapeutic window and a reduced incidence of undesired effects, requiring the same or lower minimum current for symptom relief compared to conventional DBS. The utilization of directional leads in DBS offers numerous advantages over conventional electrodes without significant drawbacks for patients undergoing directional DBS therapy.

Indexed as

Deep Brain StimulationParkinson DiseaseElectrodesHumansConventional DBSDirectional DBSDirectional electrodesParkinson’s diseaseParkinson treatmentRing stimulation leads

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.