ABSTRACT
High frequency deep brain stimulation (DBS) procedures have become more
common to treat medically refractory Parkinson’s disease (PD) in those who
are experiencing “tolerance” to dopaminergic agents as manifested by dyskine-
sias and rapid motor fluctuations. Their efficacy has been optimal for suppressing
the isolated clinical signs that usually are responsive to dopaminergic agents
(tremor, rigidity, and bradykinesia), but not necessarily efficacious when
considering gait and postural disturbances, speech impairments, motor blocks,
cognitive/behavioral difficulties, dysautonomia, and other motoric and nonmotoric signs that are either usually not responsive to dopaminergic agents or are
manifestations of later stage disease. Functional status and quality of life have
been generally reported as improved after DBS procedures (1-5).
