title: Motor cortex stimulation in Parkinson's disease.
abstract: Motor Cortex Stimulation (MCS) is less efficacious than Deep Brain Stimulation (DBS) in Parkinson's disease. However, it might be proposed to patients excluded from DBS or unresponsive to DBS. Ten patients with advanced PD underwent unilateral MCS contralaterally to the worst clinical side. A plate electrode was positioned over the motor cortex in the epidural space through single burr hole after identification of the area with neuronavigation and neurophysiological tests. Clinical assessment was performed by total UPDRS, UPDRS III total, UPDRS III-items 27-31, UPDRS IV, and UPDRS II before implantation in off-medication and on-medication states and after surgery at 1, 3, 6, 12, 18, 24, and 36 months in on-medication/on-stimulation and off-medication/on-stimulation states. We assessed changes of quality of life, throughout the Parkinson's disease quality of life scale (PDQoL-39), and the dose of anti-Parkinson's disease medications, throughout the Ldopa equivalent daily dose (LEDD). During off-medication state, we observed moderate and transitory reduction of total UPDRS and UPDRS total scores and significant and long-lasting improvement in UPDRS III items 27-31 score for axial symptoms. There was marked reduction of UPDRS IV score and LEDD. PDQL-39 improvement was also significant. No important complications and adverse events occurred.
authors.affiliation: Department of Neurosurgery, University Hospital of Germaneto, Campus "Salvatore Venuta", Viale Europa, 88100 Catanzaro, Italy.
authors.forename: Marisa
authors.initials: M
authors.lastname: De Rose
authors.forename: Giusy
authors.initials: G
authors.lastname: Guzzi
authors.forename: Domenico
authors.initials: D
authors.lastname: Bosco
authors.forename: Mary
authors.initials: M
authors.lastname: Romano
authors.forename: Serena Marianna
authors.initials: SM
authors.lastname: Lavano
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Plastino
authors.forename: Giorgio
authors.initials: G
authors.lastname: Volpentesta
authors.forename: Rosa
authors.initials: R
authors.lastname: Marotta
authors.forename: Angelo
authors.initials: A
authors.lastname: Lavano