Estimulação cerebral profunda no tratamento da doença de Parkinson: uma revisão bibliográfica
Arquivos
Data
2022-12-14
Autores
Lima, Karolina Vieira [UNIFESP]
Orientadores
Garcia, Raphael Caio [UNIFESP]
Tipo
Trabalho de conclusão de curso de graduação
Título da Revista
ISSN da Revista
Título de Volume
Resumo
A Doença de Parkinson (DP) é uma enfermidade neurodegenerativa idiopática que acomete progressivamente os neurônios dopaminérgicos e não dopaminérgicos, resultando em alterações neuronais que ocasionam sintomas motores e não motores. A dor é um dos sintomas não motores mais prevalentes e impacta diretamente a qualidade de vida dos pacientes. Até o presente momento a DP não possui cura, entretanto seu tratamento inicial focado na terapia sintomatológica visa a reposição da dopamina (DA) através de fármacos. A estimulação cerebral profunda (Deep Brain Stimulation ̶ DBS) do núcleo subtalâmico (NST), é um tratamento alternativo de padrão ouro para pacientes em estágio avançado da doença, em que o tratamento farmacológico já não é mais efetivo. A DBS tem mostrado resultados satisfatórios no tratamento da DP, trazendo benefícios tanto para sintomas motores, quanto não motores. O presente estudo tem o objetivo de realizar uma revisão bibliográfica a fim de levantar dados a respeito do tratamento da DP com a DBS. A metodologia utilizada foi incluiu a busca de artigos em bases de dados como a National Library of Medicine (Pubmed) e Journal of Neurology, Neurosurgery and Psychiatry. Foram selecionados artigos em português e inglês com inclusão de todos os trabalhos que abordavam tratamento da DP com DBS. As palavras-chave utilizadas foram doença de Parkinson, núcleo subtalâmico, levodopa e estimulação cerebral profunda. Trabalhos abordando a DBS para tratamento que não tivessem relação à DP foram excluídos. Os achados dessa pesquisa contribuem na ampliação da diversidade terapêutica da DP na busca de uma terapia mais efetiva para pacientes parkinsonianos que possuem a qualidade de vida comprometida pela doença. Desse modo, evidencia-se a necessidade de novos estudos no tratamento da DP, sobretudo no que se diz respeito aos sintomas não motores, visto que, a literatura ainda é relativamente escassa.
Parkinson's disease (PD) is an idiopathic neurodegenerative disease that progressively affects dopaminergic and non-dopaminergic neurons, resulting in neuronal dysfunctions causing motor and non-motor symptoms. Pain is one of the most prevalent non-motor symptoms and directly affects patients' life quality. Until today, PD has no cure; however, the initial treatment has focus on symptomatic therapy of the disease, directed at the replacement of dopamine through medicines. Deep Brain Stimulation (DBS) of the subthalamic nucleus (SN) is an alternative gold standard treatment for patients in advanced stages of the disease, in which pharmacological treatment is no longer effective. DBS has shown satisfactory results in the treatment of PD, bringing benefits to both motor and non-motor symptoms. The present study aims to carry out a literature review in order to gather data from recent research regarding the treatment of nociception with DBS. The methodology used included the search for articles in databases such as the National Library of Medicine (Pubmed) and Journal of Neurology, Neurosurgery and Psychiatry. Articles in Portuguese and English were selected, including all works from a reliable source regarding the treatment of PD with DBS. The keywords used were Parkinson's disease, subthalamic nucleus, levodopa and deep brain stimulation. Studies approaching DBS for treatment that were unrelated to PD were excluded. The findings of these studies contribute to the expansion of the therapeutic diversity of PD in the search for a more effective therapy for parkinsonian patients whose has quality of life is compromised by the disease. Thus, the need for further studies in the treatment of PD is evident, especially with regard to non-motor symptoms, since the literature is still relatively scarce.
Parkinson's disease (PD) is an idiopathic neurodegenerative disease that progressively affects dopaminergic and non-dopaminergic neurons, resulting in neuronal dysfunctions causing motor and non-motor symptoms. Pain is one of the most prevalent non-motor symptoms and directly affects patients' life quality. Until today, PD has no cure; however, the initial treatment has focus on symptomatic therapy of the disease, directed at the replacement of dopamine through medicines. Deep Brain Stimulation (DBS) of the subthalamic nucleus (SN) is an alternative gold standard treatment for patients in advanced stages of the disease, in which pharmacological treatment is no longer effective. DBS has shown satisfactory results in the treatment of PD, bringing benefits to both motor and non-motor symptoms. The present study aims to carry out a literature review in order to gather data from recent research regarding the treatment of nociception with DBS. The methodology used included the search for articles in databases such as the National Library of Medicine (Pubmed) and Journal of Neurology, Neurosurgery and Psychiatry. Articles in Portuguese and English were selected, including all works from a reliable source regarding the treatment of PD with DBS. The keywords used were Parkinson's disease, subthalamic nucleus, levodopa and deep brain stimulation. Studies approaching DBS for treatment that were unrelated to PD were excluded. The findings of these studies contribute to the expansion of the therapeutic diversity of PD in the search for a more effective therapy for parkinsonian patients whose has quality of life is compromised by the disease. Thus, the need for further studies in the treatment of PD is evident, especially with regard to non-motor symptoms, since the literature is still relatively scarce.