Subthalamic stimulation in Parkinson's disease. Preliminary results.
OBJECTIVE
We wanted to evaluate chronic subthalamic nucleus (STN) stimulation as an alternative to pallidotomy for severe Parkinson's disease symptomatology.


METHODS
Nine patients met clinical criteria for unilateral standard pallidotomy. All had severe medically refractory drug-induced dyskinesia and had reached maximal daily levodopa therapy. Pre- and postoperative videos, neuropsychometric testings and clinical stagings were administered. Three patients were selected to undergo stereotactic implantation of a deep brain stimulator (DBS) after Institutional Review Board approval and informed consent. These were performed using digitized microrecordings. The other group received unilateral pallidotomy.


RESULTS
At a mean follow-up of 6 months, our results support recent findings of significant major improvement in motor scores, activity of daily living and decrease in amount of daily levodopa intake by close to 50% after 3 months of stimulation.


CONCLUSIONS
Chronic stimulation of the STN appears to provide significant motor improvement in patients with severe Parkinson's disease and is more beneficial than pallidotomy.
Lévesque
M F
MF
Cedars-Sinai Medical Center, Functional Neurosurgery Unit, Los Angeles, California 90048, USA. levesque@cshs.org
Taylor
S
S
Rogers
R
R
Le
M T
MT
Swope
D
D
D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001931:Brain Mapping; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D004598:Electrosurgery; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D005917:Globus Pallidus / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage / Q000627:therapeutic use; D016343:Monitoring, Intraoperative / Q000379:methods*; D010300:Parkinson Disease / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D011446:Prospective Studies; D013238:Stereotaxic Techniques; D020531:Subthalamic Nucleus / Q000503:physiopathology*; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D007980:Levodopa