Personalized deep brain stimulation for Parkinson’s disease

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Oulu University Hospital, auditorium 8

Topic of the dissertation

Personalized deep brain stimulation for Parkinson’s disease

Doctoral candidate

Licentiate of Medicine Johannes Kähkölä

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, University of Oulu Graduate School, Faculty of Medicine, Medical Research Center (MRC)

Subject of study

Medicine

Opponent

Docent Riku Kivisaari, HUS Helsinki University Hospital

Custos

Docent Jani Katisko, Oulu University Hospital

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Personalized deep brain stimulation for Parkinson’s disease

Deep brain stimulation alleviates motor symptoms of advanced Parkinson’s disease and improves quality of life considerably, towards that of the general population. The required dose of antiparkinsonian medication also decreases significantly, and over 20% of patients were without levodopa medication 12 months after surgery.

The aim of the study was to determine factors affecting deep brain stimulation outcomes from Oulu University Hospital database, which included patients from 1997 to 2022. The exact location of the stimulation field appeared to influence treatment outcomes. Stimulating the part of subthalamic nucleus that was connected to cortical areas responsible for motor planning and coordination, was associated with more consistent treatment outcomes. Equally, patient selection appears to have an important role, as shorter disease duration was correlated with better motor outcomes. The results also show that although surgical infections are rare, preventative measures should be implemented to avoid revision surgery.

Most people know someone with Parkinson’s disease. It is the most common neurodegenerative movement disorder with characteristic and often visually prominent symptoms such as slowness of movement, tremor, and rigidity. Although less visible, non-motor symptoms such as depression and sleep disorders are also often present.

Deep brain stimulation may be considered in advanced Parkinson’s disease, if sufficient symptomatic control is not achieved with medical therapy. Stimulation is applied to specific brain regions using electrodes placed during surgery and connected to an implantable pulse generator. Stimulation can be adjusted in postoperative visits based on the clinical response, and the patient is also given a remote controller for adjustments. Besides Parkinson’s disease, deep brain stimulation has been used for tremor, epilepsy, and obsessive-compulsive disorder, and it is currently being studied for other neurologic and psychiatric conditions.
Last updated: 18.9.2024