Chronic high frequency (130 Hz) stimulation (HFS) of the thalamic target @entity2277 , first used in our group in 1987 as a treatment of @entity400 of various origins, has been used over the last ten years in 137 @entity1 . Since 1993, this method has been extended to two other targets (subthalamic nucleus (STN): 137 @entity1 and the medial pallidum ( @entity14243 ): 12 @entity1 ), based on recent experimental data in @entity35 and monkeys. STN appears to be a target of major interest, able to control the three cardinal symptoms and to allow the decrease or suppression of levodopa treatment, which then also suppresses levodopa induced @entity910 . The stereotactic technique is based on the determination of the target using ventriculography, MRI and electrophysiology, with both microrecording of single neuron activity and microstimulation inducing therapeutic symptom suppression and side effects. Chronic electrodes are then placed bilaterally at the best physiologically defined location and then connected to implantable stimulators (either 2 Itrel II or the new double channel Kinetra), operated at 130-185 Hz, 60 ms pulse width, 2.5 to 3.5 volts. There was no operative mortality and permanent morbidity was observed in 3 @entity1 . The mechanisms of action of HFS are not fully understood, but are definitely related to high frequency and are probably different depending on the target. Inhibition of cellular activity or of neural network functions could be induced, by jamming of a retroactive loop for @entity400 , or by shutdown of neurotransmitter release in STN. Mechanisms within an individual target are also probably different for @entity400 or for other symptom alleviation. All cardinal symptoms are alleviated from @entity400 to @entity910 and @entity2003 . This strong improvement allows the decrease of the drug dosage to approximately 30% of the preoperative level, which suppresses the levodopa-induced @entity910 . The off period @entity3519 are also suppressed as well as freezings and falls. The effects remain stable over more than 5 years and in the same period, the off stimulation-off medication UPDRS remains stable and does not increase at the usual rate The low rate of permanent complications, the minor side effects and their immediate reversibility, the possibility of bilateral implantation in one session and the long-term persistence of symptom relief are strong arguments which support chronic HFS of STN as the method of choice when a surgical procedure is indicated for the treatment of @entity191 and even more when a bilateral procedure is necessary. Recent data show that STN stimulation could be useful in the treatment of @entity3519 as well as some forms of @entity302 . It is therefore possible that DBS in STN as well as in other targets could become a potent therapeutic tool in the near future for @entity16 .

Deep brain stimulation of the corpus luysi (subthalamic nucleus) and other targets in XXXX . Extension to new indications such as @entity3519 and @entity302 .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity2003 :: ('MESH:D009127', 'Disease') :: ['rigidity'] @entity14243 :: ('2821', 'Gene') :: ['GPi'] @entity16 :: ('MESH:D009422', 'Disease') :: ['neurological disorders'] @entity910 :: ('MESH:D004409', 'Disease') :: ['dyskinesias', 'akinesia'] @entity191 :: ('MESH:D010300', 'Disease') :: ["Parkinson's disease"] @entity400 :: ('MESH:D014202', 'Disease') :: ['tremor'] @entity2277 :: ('7431', 'Gene') :: ['Vim'] @entity302 :: ('MESH:D004827', 'Disease') :: ['epilepsy'] @entity35 :: ('10116', 'Species') :: ['rats'] @entity3519 :: ('MESH:D004421', 'Disease') :: ['dystonias', 'dystonia']
@entity191 :: (MESH:D010300,Disease) :: ['Parkinson's disease']
