Targeting the brain: considerations in 332 consecutive patients treated by deep brain stimulation (DBS) for severe neurological diseases

Neurol Sci. 2012 Dec;33(6):1285-303. doi: 10.1007/s10072-012-0937-9. Epub 2012 Jan 24.


Deep brain stimulation (DBS) extends the treatment of some severe neurological diseases beyond pharmacological and conservative therapy. Our experience extends the field of DBS beyond the treatment of Parkinson disease and dystonia, including several other diseases such as cluster headache and disruptive behavior. Since 1993, at the Istituto Nazionale Neurologico "Carlo Besta" in Milan, 580 deep brain electrodes were implanted in 332 patients. The DBS targets include Stn, GPi, Voa, Vop, Vim, CM-pf, pHyp, cZi, Nacc, IC, PPN, and Brodmann areas 24 and 25. Three hundred patients are still available for follow-up and therapeutic considerations. DBS gave a new therapeutic chance to these patients affected by severe neurological diseases and in some cases controlled life-threatening pathological conditions, which would otherwise result in the death of the patient such as in status dystonicus, status epilepticus and post-stroke hemiballismus. The balance of DBS in severe neurological disease is strongly positive even if further investigations and studies are needed to search for new applications and refine the selection criteria for the actual indications.

MeSH terms

  • Aged
  • Brain / physiology*
  • Deep Brain Stimulation / instrumentation
  • Deep Brain Stimulation / methods*
  • Dorsomedial Hypothalamic Nucleus / physiology
  • Female
  • Follow-Up Studies
  • Globus Pallidus / physiology
  • Humans
  • Male
  • Middle Aged
  • Nervous System Diseases / physiopathology
  • Nervous System Diseases / psychology
  • Nervous System Diseases / therapy*
  • Parkinson Disease / physiopathology
  • Parkinson Disease / psychology
  • Parkinson Disease / therapy
  • Quality of Life* / psychology
  • Severity of Illness Index*
  • Stereotaxic Techniques / instrumentation
  • Subthalamic Nucleus / physiology
  • Treatment Outcome
  • Ventral Thalamic Nuclei / physiology