Estimulação cerebral profunda na qualidade de vida dos pacientes com Doença de Parkinson
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Jun 13, 2025
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Resumo
Objetivo: Avaliar impactos da terapia de estimulação cerebral profunda no tratamento e qualidade de vida dos pacientes portadores de Doença de Parkinson. Métodos: Trata-se de uma Revisão integrativa da literatura, com busca no Medical Publisher, Literatura Latino-Americana e do Caribe em Ciências da Saúde, EBSCOhost, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior e The Search portal for Life Science com os Descritores em Ciências da Saúde (DeCS) em inglês: "Parkinson Disease", "Deep Brain Stimulation" e “Quality of life”, utilizando operador booleano “AND”, Com aplicação dos critérios de inclusão e exclusão, resultou em amostra final de 26 artigos. Resultados: Achados evidenciaram que a DBS no Núcleo Subtalâmico (STN) está associada à melhora nos sintomas psiquiátricos, motores e na qualidade de vida. A intervenção também proporciona uma redução na dose de levodopa diminuindo os efeitos colaterais do seu uso prolongado, levando a um bom desfecho clínico desses casos. Considerações finais: Constatou-se que, quando bem indicada, a DBS é eficaz e apresenta benefícios, principalmente relacionados à melhora da função motora, depressão, ansiedade e cognição. Entretanto existem lacunas a serem exploradas para melhor prognóstico e resolução dos impactos negativos ainda presentes nesse contexto clínico, fazendo-se necessário ampliação das pesquisas acerca desse tema.
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Como Citar
SilvaM. de F. T. da, SousaM. N. A. de, & QueirozA. P. de. (2025). Estimulação cerebral profunda na qualidade de vida dos pacientes com Doença de Parkinson. Revista Eletrônica Acervo Saúde, 25(6), e20796. https://doi.org/10.25248/reas.e20796.2025
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A revista detém os direitos autorais exclusivos de publicação deste artigo nos termos da lei 9610/98.
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Referências
1. ALVES GS, et al. Impacto da estimulação cerebral profunda na qualidade de vida e humor em pacientes com doença de Parkinson. Revista Brasileira de Neurologia, 2018; 54: 5-12.
2. BARGIOTAS P, et al. Sleep-wake functions and quality of life in patients with subthalamic deep brain stimulation for Parkinson’s disease. PloS one, 2017; 12(12): e0190027.
3. BIRCHALL EL, et al. The effect of unilateral subthalamic nucleus deep brain stimulation on depression in Parkinson’s disease. Brain stimulation, 2017; 10(3): 651–656.
4. BUONO V, et al. The effect on deep brain stimulation of subthalamic nucleus and dopaminergic treatment in Parkinson disease. Medicine, 2020; 99 (32):e21578.
5. CAI YZ, et al. Long-term outcomes of subthalamic nucleus deep brain stimulation for Parkinson’s disease in Singapore. Annals of the Academy of Medicine, 2024; Singapore, 53(8): 481–489.
6. CURY RG, et al. Effects of deep brain stimulation on pain and other nonmotor symptoms in Parkinson disease. Neurology, 2014; 83(16): 1403–1409.
7. DA SILVA AG, et al. Difficulties in activities of daily living are associated with stigma in patients with Parkinson’s disease who are candidates for deep brain stimulation. Revista brasileira de psiquiatria, 2020; 42(2): 190–194.
8. DE SOUSA MNA, et al. Trilhando o caminho do conhecimento: o método de revisão integrativa para análise e síntese da literatura científica. OLEL, 2023; 21(10): 18448–18483.
9. DULSKI J, et al. The impact of subthalamic deep brain stimulation on sleep and other non-motor symptoms in Parkinson’s disease. Parkinsonism & related disorders, 2019; 64: 138–144.
10. DULSKI J, et al. The impact of subthalamic deep brain stimulation on polysomnographic sleep pattern in patients with Parkinson’s disease – Preliminary report. Neurologia i neurochirurgia polska, 2018; 52(4): 514–518.
11. FLODEN D, et al. Predicting quality of life outcomes after subthalamic nucleus deep brain stimulation. Neurology, 2014; 83(18): 1627–1633.
12. FRIZON LA, et al. Quality of life improvement following deep brain stimulation for Parkinson disease: Development of a prognostic model. Neurosurgery, 2019; 85(3): 343–349.
13. GHILARDI MGS, et al. Efficacy of deep brain stimulation of the subthalamic nucleus versus globus pallidus internus on sensory complaints. NPJ Parkinson’s disease, 2024; 10(1): 73.
14. GITTIS AH, et al. Circuit-specific deep brain stimulation provides insights into movement control. Annual review of neuroscience, 2024; 47(1): 63–83.
15. GRUBER D, et al. Longterm outcome of cognition, affective state, and quality of life following subthalamic deep brain stimulation in Parkinson’s disease. Journal of neural transmission (Vienna, Austria), 2019; 126(3): 309–318.
16. HACKER ML, et al. Long-term neuropsychological outcomes of deep brain stimulation in early-stage Parkinson’s disease. Parkinsonism & related disorders, 2023; 113(105479).
17. HIGUCHI MA, et al. Interdisciplinary Parkinson’s disease deep brain stimulation screening and the relationship to unintended hospitalizations and quality of life. PloS one, 2016; 11(5): e0153785.
18. JOST ST, et al. Neurostimulation for advanced Parkinson disease and quality of life at 5 years: A nonrandomized controlled trial. JAMA network open, 2024; 7(1): e2352177.
19. JOST ST, et al. Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease. NPJ Parkinson’s disease, 2021; 7(1):48.
20. KÄHKÖLÄ J, et al. Deep brain stimulation of subthalamic nucleus improves quality of life in general and Mental Health domains in Parkinson’s disease to the level of the general population. Neuromodulation: journal of the International Neuromodulation Society, 2024; 27(3): 520–527.
21. KALAMPOKINI S, et al. Effects of subthalamic nucleus deep brain stimulation on facial emotion recognition in Parkinson’s disease: A critical literature review. Behavioural neurology, 2020; 2020: 4329297.
22. KRACK P, et al. Deep brain stimulation in movement disorders: From experimental surgery to evidence-based therapy. Movement disorders: official journal of the Movement Disorder Society, 2019; 34(12): 1795–1810.
23. LI H, et al. Effect of Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) on balance performance in Parkinson’s disease. PloS one, 2020; 15(9): e0238936.
24. NGOGA D, et al. Deep brain stimulation improves survival in severe Parkinson’s disease. Journal of neurology, neurosurgery, and psychiatry, 2014; 85(1): 17–22.
25. OLCHIK M, et al. The impact of Deep brain stimulation on the quality of life and swallowing in individuals with Parkinson’s disease. International archives of otorhinolaryngology, 2018; 22(02): 125–129.
26. OLSON MC, et al. Deep brain stimulation in PD: risk of complications, morbidity, and hospitalizations: a systematic review. Frontiers in aging neuroscience, v. 15, p. 1258190, 2023.
27. PUSSWALD G, et al. Depression, quality of life, activities of daily living, and subjective memory after deep brain stimulation in Parkinson disease-A reliable change index analysis. International journal of geriatric psychiatry, 2019; 34(11): 1698–1705.
28. SABA RA, et al. Guidelines for Parkinson’s disease treatment: consensus from the Movement Disorders Scientific Department of the Brazilian Academy of Neurology - motor symptoms. Arquivos de neuro-psiquiatria, 2022; 80(3): 316–329.
29. SCHNITZLER A, et al. Directional deep brain stimulation for Parkinson’s disease: Results of an international crossover study with randomized, double-blind primary endpoint. Neuromodulation: journal of the International Neuromodulation Society, 2022; 25(6): 817–828.
30. SCHUEPBACH WMM, et al. Neurostimulation for Parkinson’s disease with early motor complications. The New England journal of medicine, 2013; 368(7): 610–622.
31. SCHUEPBACH WMM, et al. Quality of life predicts outcome of deep brain stimulation in early Parkinson disease. Neurology, 2019; 92(10): e1109–e1120.
32. SKVARC DR, et al. Cognitive change after subthalamic deep brain stimulation for Parkinson’s disease – a systematic meta-regressive analysis. medRxiv (Cold Spring Harbor Laboratory), 2023.
33. SOBSTYL M, et al. The influence of unilateral subthalamic deep brain stimulation on the quality of life of patients with parkinson’s disease. Turkish neurosurgery, 2018.
34. VOON V, et al. A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson’s disease. Brain: a journal of neurology, 2008;131(10): 2720–2728.
35. WEAVER FM, Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson diseaseA randomized controlled trial. JAMA: the journal of the American Medical Association, 2009; 301(1): 63.
36. ZAZO E, et al. Deep brain stimulation in patients with Parkinson’s disease: Effect on psychiatric symptoms and quality of life. Journal of neurological surgery. Part A, Central European neurosurgery, 2018; 79(02): 130–138.
37. ZHANG F, et al. Subthalamic nucleus-deep brain stimulation improves autonomic dysfunctions in Parkinson’s disease. BMC neurology, 2022; 22(1):124.
38. ZOON TJC, et al. A multicenter double-blind randomized crossover study comparing the impact of dorsal subthalamic nucleus deep brain stimulation versus standard care on apathy in Parkinson’s disease: a study protocol. Trials, 2024; 25(1): 104.
39. ZORRO-GUÍO ÓF, et al. Estimulación cerebral profunda para enfermedad de Parkinson: experiencia, beneficios y limitaciones en un centro en Latinoamérica. Cirugia y cirujanos, 2023
2. BARGIOTAS P, et al. Sleep-wake functions and quality of life in patients with subthalamic deep brain stimulation for Parkinson’s disease. PloS one, 2017; 12(12): e0190027.
3. BIRCHALL EL, et al. The effect of unilateral subthalamic nucleus deep brain stimulation on depression in Parkinson’s disease. Brain stimulation, 2017; 10(3): 651–656.
4. BUONO V, et al. The effect on deep brain stimulation of subthalamic nucleus and dopaminergic treatment in Parkinson disease. Medicine, 2020; 99 (32):e21578.
5. CAI YZ, et al. Long-term outcomes of subthalamic nucleus deep brain stimulation for Parkinson’s disease in Singapore. Annals of the Academy of Medicine, 2024; Singapore, 53(8): 481–489.
6. CURY RG, et al. Effects of deep brain stimulation on pain and other nonmotor symptoms in Parkinson disease. Neurology, 2014; 83(16): 1403–1409.
7. DA SILVA AG, et al. Difficulties in activities of daily living are associated with stigma in patients with Parkinson’s disease who are candidates for deep brain stimulation. Revista brasileira de psiquiatria, 2020; 42(2): 190–194.
8. DE SOUSA MNA, et al. Trilhando o caminho do conhecimento: o método de revisão integrativa para análise e síntese da literatura científica. OLEL, 2023; 21(10): 18448–18483.
9. DULSKI J, et al. The impact of subthalamic deep brain stimulation on sleep and other non-motor symptoms in Parkinson’s disease. Parkinsonism & related disorders, 2019; 64: 138–144.
10. DULSKI J, et al. The impact of subthalamic deep brain stimulation on polysomnographic sleep pattern in patients with Parkinson’s disease – Preliminary report. Neurologia i neurochirurgia polska, 2018; 52(4): 514–518.
11. FLODEN D, et al. Predicting quality of life outcomes after subthalamic nucleus deep brain stimulation. Neurology, 2014; 83(18): 1627–1633.
12. FRIZON LA, et al. Quality of life improvement following deep brain stimulation for Parkinson disease: Development of a prognostic model. Neurosurgery, 2019; 85(3): 343–349.
13. GHILARDI MGS, et al. Efficacy of deep brain stimulation of the subthalamic nucleus versus globus pallidus internus on sensory complaints. NPJ Parkinson’s disease, 2024; 10(1): 73.
14. GITTIS AH, et al. Circuit-specific deep brain stimulation provides insights into movement control. Annual review of neuroscience, 2024; 47(1): 63–83.
15. GRUBER D, et al. Longterm outcome of cognition, affective state, and quality of life following subthalamic deep brain stimulation in Parkinson’s disease. Journal of neural transmission (Vienna, Austria), 2019; 126(3): 309–318.
16. HACKER ML, et al. Long-term neuropsychological outcomes of deep brain stimulation in early-stage Parkinson’s disease. Parkinsonism & related disorders, 2023; 113(105479).
17. HIGUCHI MA, et al. Interdisciplinary Parkinson’s disease deep brain stimulation screening and the relationship to unintended hospitalizations and quality of life. PloS one, 2016; 11(5): e0153785.
18. JOST ST, et al. Neurostimulation for advanced Parkinson disease and quality of life at 5 years: A nonrandomized controlled trial. JAMA network open, 2024; 7(1): e2352177.
19. JOST ST, et al. Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease. NPJ Parkinson’s disease, 2021; 7(1):48.
20. KÄHKÖLÄ J, et al. Deep brain stimulation of subthalamic nucleus improves quality of life in general and Mental Health domains in Parkinson’s disease to the level of the general population. Neuromodulation: journal of the International Neuromodulation Society, 2024; 27(3): 520–527.
21. KALAMPOKINI S, et al. Effects of subthalamic nucleus deep brain stimulation on facial emotion recognition in Parkinson’s disease: A critical literature review. Behavioural neurology, 2020; 2020: 4329297.
22. KRACK P, et al. Deep brain stimulation in movement disorders: From experimental surgery to evidence-based therapy. Movement disorders: official journal of the Movement Disorder Society, 2019; 34(12): 1795–1810.
23. LI H, et al. Effect of Subthalamic Nucleus Deep Brain Stimulation (STN-DBS) on balance performance in Parkinson’s disease. PloS one, 2020; 15(9): e0238936.
24. NGOGA D, et al. Deep brain stimulation improves survival in severe Parkinson’s disease. Journal of neurology, neurosurgery, and psychiatry, 2014; 85(1): 17–22.
25. OLCHIK M, et al. The impact of Deep brain stimulation on the quality of life and swallowing in individuals with Parkinson’s disease. International archives of otorhinolaryngology, 2018; 22(02): 125–129.
26. OLSON MC, et al. Deep brain stimulation in PD: risk of complications, morbidity, and hospitalizations: a systematic review. Frontiers in aging neuroscience, v. 15, p. 1258190, 2023.
27. PUSSWALD G, et al. Depression, quality of life, activities of daily living, and subjective memory after deep brain stimulation in Parkinson disease-A reliable change index analysis. International journal of geriatric psychiatry, 2019; 34(11): 1698–1705.
28. SABA RA, et al. Guidelines for Parkinson’s disease treatment: consensus from the Movement Disorders Scientific Department of the Brazilian Academy of Neurology - motor symptoms. Arquivos de neuro-psiquiatria, 2022; 80(3): 316–329.
29. SCHNITZLER A, et al. Directional deep brain stimulation for Parkinson’s disease: Results of an international crossover study with randomized, double-blind primary endpoint. Neuromodulation: journal of the International Neuromodulation Society, 2022; 25(6): 817–828.
30. SCHUEPBACH WMM, et al. Neurostimulation for Parkinson’s disease with early motor complications. The New England journal of medicine, 2013; 368(7): 610–622.
31. SCHUEPBACH WMM, et al. Quality of life predicts outcome of deep brain stimulation in early Parkinson disease. Neurology, 2019; 92(10): e1109–e1120.
32. SKVARC DR, et al. Cognitive change after subthalamic deep brain stimulation for Parkinson’s disease – a systematic meta-regressive analysis. medRxiv (Cold Spring Harbor Laboratory), 2023.
33. SOBSTYL M, et al. The influence of unilateral subthalamic deep brain stimulation on the quality of life of patients with parkinson’s disease. Turkish neurosurgery, 2018.
34. VOON V, et al. A multicentre study on suicide outcomes following subthalamic stimulation for Parkinson’s disease. Brain: a journal of neurology, 2008;131(10): 2720–2728.
35. WEAVER FM, Bilateral deep brain stimulation vs best medical therapy for patients with advanced Parkinson diseaseA randomized controlled trial. JAMA: the journal of the American Medical Association, 2009; 301(1): 63.
36. ZAZO E, et al. Deep brain stimulation in patients with Parkinson’s disease: Effect on psychiatric symptoms and quality of life. Journal of neurological surgery. Part A, Central European neurosurgery, 2018; 79(02): 130–138.
37. ZHANG F, et al. Subthalamic nucleus-deep brain stimulation improves autonomic dysfunctions in Parkinson’s disease. BMC neurology, 2022; 22(1):124.
38. ZOON TJC, et al. A multicenter double-blind randomized crossover study comparing the impact of dorsal subthalamic nucleus deep brain stimulation versus standard care on apathy in Parkinson’s disease: a study protocol. Trials, 2024; 25(1): 104.
39. ZORRO-GUÍO ÓF, et al. Estimulación cerebral profunda para enfermedad de Parkinson: experiencia, beneficios y limitaciones en un centro en Latinoamérica. Cirugia y cirujanos, 2023