Which intervention is used as a surgical option for advanced Parkinson disease?

Which intervention is used as a surgical option for advanced Parkinson disease?

• A. Physical therapy
• B. Deep brain stimulation
• C. Levodopa therapy
• D. Occupational therapy

Answer: (B)

Deep brain stimulation is the surgical option used for advanced Parkinson disease. When Parkinson progresses, patients often experience motor fluctuations and dyskinesias despite optimized medical therapy, especially long-term levodopa use. DBS involves implanting electrodes into deep brain targets, typically the subthalamic nucleus or the globus pallidus internus, and delivering high-frequency electrical stimulation. This modulation of the abnormal basal ganglia circuitry smooths out motor symptoms—tremor, rigidity, and bradykinesia—and can reduce off-time and dyskinesias, often allowing a lower dose of levodopa and fewer medication-related side effects. DBS is reversible and adjustable, unlike older lesioning procedures, and is best suited for patients who have a good response to levodopa but persistent motor symptoms or fluctuations. It is, however, not a cure and requires careful patient selection and follow-up due to surgical risks and potential cognitive or psychiatric effects. Physical and occupational therapies are supportive, not surgical, and levodopa therapy remains pharmacologic rather than surgical.

Deep brain stimulation is the surgical option used for advanced Parkinson disease. When Parkinson progresses, patients often experience motor fluctuations and dyskinesias despite optimized medical therapy, especially long-term levodopa use. DBS involves implanting electrodes into deep brain targets, typically the subthalamic nucleus or the globus pallidus internus, and delivering high-frequency electrical stimulation. This modulation of the abnormal basal ganglia circuitry smooths out motor symptoms—tremor, rigidity, and bradykinesia—and can reduce off-time and dyskinesias, often allowing a lower dose of levodopa and fewer medication-related side effects. DBS is reversible and adjustable, unlike older lesioning procedures, and is best suited for patients who have a good response to levodopa but persistent motor symptoms or fluctuations. It is, however, not a cure and requires careful patient selection and follow-up due to surgical risks and potential cognitive or psychiatric effects. Physical and occupational therapies are supportive, not surgical, and levodopa therapy remains pharmacologic rather than surgical.