Estimulação cerebral profunda das bordas dorsal e ventral do núcleo subtalâmico em pacientes com doença de Parkinson: uma revisão sistemática

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Mariane de Oliveira Gomes
Juliane de Oliveira Gomes
Ana Paula Espindula
Márcio Luis Alves Moura
Marcus Paulo Ribeiro Machado
Luciano Gonçalves
Roberto Alexandre Dezena
Leonardo Augusto Lombardi

Resumo

Pacientes com doença de Parkinson frequentemente experimentam sinais motores e sintomas não motores ocasionados pela doença. A estimulação cerebral profunda do Núcleo Subtalâmico (NST) ou de suas bordas ventral ou dorsal é uma das opções de tratamento indicada para tratar sintomas refratários dessa doença. No entanto, ainda não se sabe qual a borda que, ao ser estimulada, gera mais efeitos benéficos a esses pacientes, sendo esse o objetivo dessa revisão sistemática. Para responder essa questão foram realizadas buscas eletrônicas e manuais em cinco bancos de dados e na literatura cinzenta para identificar estudos que abordassem essa temática. Foram executados a seleção dos estudos, extração de dados e análise do risco de viés dos estudos incluídos. No total, sete artigos foram selecionados para comporem o estudo. A maioria dos estudos apresentou baixo risco de viés, sendo que a principal limitação metodológica deles se relacionou com os critérios de inclusão da amostra. A estimulação da borda dorsal ou ventral do NST resultou na melhora dos sinais motores da doença de Parkinson, com alguns dos estudos inclusos com tendência para a escolha da estimulação da borda dorsal para melhores efeitos motores, enquanto a melhora dos sintomas não motores e do controle inibitório foi devido à estimulação da borda ventral. Os achados sugerem que a melhora dos sinais motores da doença de Parkinson pode ser ocasionada ao estimular a borda dorsal ou ventral do Núcleo subtalâmico, enquanto os sintomas não motores, como a ansiedade, melhoram com a estimulação da borda ventral.

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Gomes , M. de O., Gomes, J. de O., Espindula, A. P., Moura, M. L. A., Machado, M. P. R., Gonçalves, L., Dezena, R. A., & Lombardi, L. A. (2024). Estimulação cerebral profunda das bordas dorsal e ventral do núcleo subtalâmico em pacientes com doença de Parkinson: uma revisão sistemática. ABCS Health Sciences, 49, e024304. https://doi.org/10.7322/abcshs.2022059.2113
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Artigos de Revisão

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