title: Motor cortex stimulation for movement disorders.
abstract: BACKGROUND
  Motor cortex stimulation (MCS) was introduced by Tsubokawa in 1991 1 for the treatment of thalamic pain, after coming to the conclusion that the hyperactivity of thalamic neurons after spino-thalamic tractotomy was inhibited by stimulation of the motor cortex. MCS has been reported not only to be effective on pain, but also to improve movement disorders such as Parkinson's disease, tremor, dystonia, poststroke movement disorders and hemiparesis. Most of these publications are case reports or small series, and the real impact of MCS on movement disorders remains to be determined.
  
  
  METHODS
  In order to clarify this point, we conducted a PubMed search from 1991 to 2016 using established MeSH words. A total of 40 papers were selected and examined. Furthermore, personal experience with MCS for Parkinson's disease and akinesia, is reported.
  
  
  RESULTS
  Only four studies were randomized controlled clinical trials: three out of four failed to demonstrate the efficacy of MCS at short term.
  
  
  CONCLUSIONS
  At long term, MCS seems to show a clinical positive effect in the studies prolonged in an open observational trial.
authors.affiliation: Department of Neurosurgery, Catholic University, Policlinico Gemelli Foundation, Rome, Italy - bcioni@rm.unicatt.it.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Cioni
authors.forename: Tommaso
authors.initials: T
authors.lastname: Tufo
authors.forename: Annarita
authors.initials: A
authors.lastname: Bentivoglio
authors.forename: Gianluca
authors.initials: G
authors.lastname: Trevisi
authors.forename: Carla
authors.initials: C
authors.lastname: Piano
mesh_terms: D001921:Brain / Q000503:physiopathology / Q000601:surgery*; D046690:Deep Brain Stimulation / Q000379:methods; D004599:Electric Stimulation Therapy / Q000379:methods; D006801:Humans; D009044:Motor Cortex / Q000601:surgery*; D009069:Movement Disorders / Q000628:therapy*; D016896:Treatment Outcome