Table B9.

Therapeutic Breakout 9 Deep brain stimulation procedures

Advantages
Do not necessitate making a destructive brain lesion
Bilateral procedures can be performed with relatively minimal risk
Potential to stimulate brain targets one might be hesitant to lesion (e.g., bilateral targets, STN, supplementary motor area)
Stimulation settings can be adjusted at any time to maximize benefit and minimize adverse effects
Stimulation of STN and GPi benefit all cardinal features of PD
Do not preclude future therapies that depend on the integrity of the basal ganglia
Disadvantages
Necessitate needle passage(s) through the brain, with risk for side effects
Mechanical and infectious side effects associated with an implanted device
Need to periodically replace battery
Optimal target site not known
Mechanism of action not known
High costs