American Board of Internal Medicine (ABIM) Certification Practice Exam

What condition is deep brain stimulation primarily used to treat?

1. Amyotrophic lateral sclerosis

2. Advanced Parkinson disease

3. Idiopathic intracranial hypertension

4. Multiple sclerosis

The correct answer is: Advanced Parkinson disease

Deep brain stimulation (DBS) is primarily utilized to treat advanced Parkinson disease, a neurodegenerative disorder characterized by motor symptoms such as tremors, stiffness, and bradykinesia. The procedure involves implanting electrodes in specific areas of the brain, which are then connected to a pulse generator that sends electrical impulses to modulate the abnormal activity of neurons associated with Parkinson's disease. The effectiveness of DBS in managing Parkinson disease is well-established, particularly in patients with severe symptoms that are not adequately controlled by medication. It can lead to significant improvements in motor function, reducing the frequency and severity of 'off' periods, where patients experience worsening of their symptoms between doses of medication. In contrast, while conditions like amyotrophic lateral sclerosis, idiopathic intracranial hypertension, and multiple sclerosis may involve neurological symptoms, they are not typically treated with deep brain stimulation. ALS is primarily managed with supportive care, intracranial hypertension is treated through medical or surgical methods aimed at reducing pressure, and multiple sclerosis is managed with a variety of disease-modifying therapies rather than DBS. Therefore, the use of deep brain stimulation in the context of advanced Parkinson disease highlights its role as a well-recognized intervention for improving quality of life in these patients.