title: CT-guided unilateral thalamotomy with macroelectrode mapping for the treatment of Parkinson's disease.
abstract: OBJECTIVE
  To evaluate the effect of unilateral thalamotomy in patients with Parkinson's disease.
  
  
  METHODS
  The junction of the ventralis oralis posterior and ventralis intermedius nuclei targeted under CT-guidance, and confirmed by impedance recording and macrostimulation.
  
  
  RESULTS
  At the 6-month assessment the tremor has been completely abolished in 37 patients (82.2%), and reduced in 6 patients (13.3%). The Unified Parkinson's Disease Rating Scale tremor score decreased by 92.5%, rigidity improved by 65.9%. Axial symptoms and bradykinesia showed smaller improvement. The levodopa and anti-cholinergic medication significantly reduced. An improvement in the quality of life measured by the Parkinson's Disease Questionnaire (PDQ-39) has been observed. The dimensions of mobility, activities of daily living, emotional well being, and stigma were significantly (P<0.05) better, other changes were not significant. The single index improved from 47.8+/-7.8 to 28.9+/-6.3. Transient complications noted in 9 patients (20%), mild persistent morbidity observed in 3 patients (6.7%). At the 1, 2 and 3-year follow-up neither contralateral tremor, rigidity, nor bradykinesia progression was statistically significant.
  
  
  CONCLUSIONS
  CT-guided thalamotomy with macro-electrode mapping provides a safe, effective and long lasting control of tremor and rigidity, reduces the need for medication, and improves the quality of life.
authors.affiliation: Department of Neurosurgery, St. John's Hospital, Budapest, Hungary.
authors.forename: I
authors.initials: I
authors.lastname: Valálik
authors.forename: S
authors.initials: S
authors.lastname: Sági
authors.forename: D
authors.initials: D
authors.lastname: Solymosi
authors.forename: J
authors.initials: J
authors.lastname: Julow
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D004566:Electrodes; D004594:Electrophysiology; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009017:Morbidity; D010300:Parkinson Disease / Q000601:surgery*; D011788:Quality of Life; D015641:Radiography, Interventional / Q000379:methods*; D012720:Severity of Illness Index; D013238:Stereotaxic Techniques; D013788:Thalamus / Q000601:surgery*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014202:Tremor / Q000473:pathology
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa