Comparative effects of unilateral and bilateral subthalamic nucleus deep brain stimulation

Neurology
R KumarAnthony E Lang

Abstract

To compare the effects of unilateral subthalamic nucleus (STN) deep brain stimulation (DBS) with bilateral STN DBS in advanced PD. Our initial 10 consecutive patients with medication-refractory motor fluctuations and levodopa-induced dyskinesias undergoing chronic bilateral STN DBS underwent a standardized evaluation of unilateral and bilateral STN DBS in the medication-off state 6 to 18 months after electrode implantation. Bilateral STN DBS improved the mean total Unified Parkinson's Disease Rating Scale motor score by 54%, whereas unilateral stimulation improved motor scores only 23%. Unilateral STN DBS improved postural stability and gait 14%, other axial motor features 19%, and overall parkinsonism in limbs contralateral to stimulation by 46%, including an 86% improvement in contralateral tremor. However, bilateral STN DBS resulted in greater improvement in each of these domains, including limb function, i.e., the reduction in scores from the limbs on one side was greater with bilateral than with unilateral stimulation of the contralateral STN. Bilateral STN DBS improves parkinsonism considerably more than unilateral STN DBS; bilateral simultaneous electrode implantation may be the most appropriate surgical option for patie...Continue Reading

Citations

Jul 12, 2002·Movement Disorders : Official Journal of the Movement Disorder Society·Philip Su, Ham-Min Tseng
Apr 12, 2002·Movement Disorders : Official Journal of the Movement Disorder Society·Dipankar NandiJohn F Stein
Apr 12, 2002·Movement Disorders : Official Journal of the Movement Disorder Society·Pierre PollakAlim-Louis Benabid
Dec 19, 2001·Movement Disorders : Official Journal of the Movement Disorder Society·W OndoR K Simpson
Oct 27, 2004·Experimental Brain Research·Maurizio FerrarinLeonardo Lopiano
Mar 24, 2006·Experimental Brain Research·Paolo CrennaMaurizio Ferrarin
Jun 20, 2008·Journal of Neurology·Noritoshi AraiYoshikazu Ugawa
Sep 18, 2001·Current Psychiatry Reports·R M RothD W Roberts
Dec 4, 2003·Parkinsonism & Related Disorders·John D PutzkeRyan J Uitti
Sep 5, 2001·Neurologic Clinics·J E Ahlskog
Oct 1, 2011·Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology·Yoland SmithMahlon R DeLong
Apr 12, 2003·Brain : a Journal of Neurology·Nikunj K PatelSteven S Gill
Jun 26, 2009·Brain : a Journal of Neurology·Yasin TemelTrevor Sharp
Jan 10, 2002·Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society·T LoddenkemperH O Lüders
Jan 20, 2007·Journal of Neurologic Physical Therapy : JNPT·Valerie E KellyAnne Shumway-Cook
Sep 13, 2007·The Neurologist·Drew S Kern, Rajeev Kumar
Jan 1, 2008·Neuromodulation : Journal of the International Neuromodulation Society·Yasin TemelVeerle Visser-Vandewalle
Apr 26, 2013·Journal of Neurology, Neurosurgery, and Psychiatry·Aparna Wagle ShuklaRobert Chen
Apr 19, 2005·Journal of Neurology, Neurosurgery, and Psychiatry·John D PutzkeRobert E Wharen
Apr 12, 2011·Journal of Neurology, Neurosurgery, and Psychiatry·M E McNeelyG M Earhart
Jul 19, 2001·Journal of Neurology, Neurosurgery, and Psychiatry·Mario Giorgio RizzoneLeonardo Lopiano
Jan 11, 2002·Journal of Neurology, Neurosurgery, and Psychiatry·Michele Maria LanotteLeonardo Lopiano
Sep 18, 2002·Journal of Neurology, Neurosurgery, and Psychiatry·T J LoherJ K Krauss
Jan 18, 2003·Journal of Neurology, Neurosurgery, and Psychiatry·A DanieleM Scerrati
Jun 17, 2006·Annual Review of Neuroscience·Joel S Perlmutter, Jonathan W Mink
Feb 23, 2011·Therapeutic Advances in Neurological Disorders·Amy W AmaraHarrison C Walker
Oct 11, 2005·Neurosurgical Focus·Dipankar NandiTipu Z Aziz
Aug 21, 2002·Journal of Neurosurgery·Dipankar NandiTipu Z Aziz
Sep 26, 2002·Journal of Neurosurgery·Philip SuHorng-Huei Liou
Oct 22, 2003·Journal of Neurosurgery·Veerle Visser-VandewalleE A M Beuls
Apr 17, 2007·Journal of Neurosurgery·Jerzy L SlowinskiRobert E Wharen
Dec 18, 2001·Movement Disorders : Official Journal of the Movement Disorder Society·Paul KrackPierre Pollak
Nov 8, 2005·Experimental Brain Research·Yasin TemelVeerle Visser-Vandewalle
Jun 15, 2005·Archives of Physical Medicine and Rehabilitation·Victor W MarkAdam J Woods
May 19, 2006·Expert Opinion on Therapeutic Targets·Yasin Temel, Veerle Visser-Vandewalle
Nov 17, 2015·Neuromodulation : Journal of the International Neuromodulation Society·Frank W PetragliaShivanand P Lad
Jul 31, 2003·Movement Disorders : Official Journal of the Movement Disorder Society·Sylvie RaoulPhilippe Damier
Sep 20, 2011·Parkinsonism & Related Disorders·Amy W AmaraHarrison C Walker
Dec 1, 2015·Clinical Neurology and Neurosurgery·Roy E StrowdMustafa S Siddiqui
Sep 22, 2009·Journal of the Neurological Sciences·Michele K YorkJoseph Jankovic
Jun 30, 2009·Progress in Neurobiology·Paolo GubelliniChristelle Baunez
Mar 28, 2009·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Shearwood McClellandRobert R Goodman
Aug 8, 2008·Journal of the Neurological Sciences·Giorgio TommasiLeonardo Lopiano
Jun 15, 2007·Parkinsonism & Related Disorders·Patric BlomstedtYves Agid
Jun 15, 2007·Journal of the Neurological Sciences·Alan DiamondJoseph Jankovic
Apr 21, 2007·Journal of the Neurological Sciences·Giorgio TommasiMichele Maria Lanotte
Dec 5, 2006·Parkinsonism & Related Disorders·Casey HalpernGordon Baltuch
Aug 10, 2004·Movement Disorders : Official Journal of the Movement Disorder Society·Bastiaan R BloemNir Giladi
Sep 17, 2004·Movement Disorders : Official Journal of the Movement Disorder Society·Maaike BakkerBastiaan R Bloem
Sep 23, 2003·Movement Disorders : Official Journal of the Movement Disorder Society·Amy J BastianJonathan W Mink
Jun 5, 2003·Movement Disorders : Official Journal of the Movement Disorder Society·Gurutz LinazasoroAsier Lasa
May 2, 2003·Movement Disorders : Official Journal of the Movement Disorder Society·Philip SuHorng-Huei Liou
Jul 1, 2006·Movement Disorders : Official Journal of the Movement Disorder Society·Valerie VoonAlexander I Tröster
May 25, 2007·Movement Disorders : Official Journal of the Movement Disorder Society·Ali SamiiRobert Goodkin
Nov 14, 2008·Movement Disorders : Official Journal of the Movement Disorder Society·Han-Joon KimBeom S Jeon
Jul 29, 2008·Movement Disorders : Official Journal of the Movement Disorder Society·Rocco AgostinoAlfredo Berardelli
Jan 19, 2007·Movement Disorders : Official Journal of the Movement Disorder Society·Ken NakamuraW J Marks
Mar 16, 2016·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Christopher R HoneyMichel Panisset
Feb 8, 2013·Movement Disorders : Official Journal of the Movement Disorder Society·Omesh KulkarniLudy C Shih
Sep 4, 2015·Neural Regeneration Research·Alexia-Sabine MoldovanL Wojtecki
Sep 10, 2014·The European Journal of Neuroscience·F U HohlefeldV V Nikulin
Jul 3, 2007·IEEE Transactions on Neural Systems and Rehabilitation Engineering : a Publication of the IEEE Engineering in Medicine and Biology Society·Maurizio FerrarinPaolo Crenna
Jul 3, 2007·IEEE Transactions on Neural Systems and Rehabilitation Engineering : a Publication of the IEEE Engineering in Medicine and Biology Society·Janey ProdoehlDavid E Vaillancourt
Oct 7, 2004·Clinical Neurophysiology : Official Journal of the International Federation of Clinical Neurophysiology·Jean-Pascal LefaucheurJean-Paul Nguyen
Sep 27, 2000·AORN Journal·D L ByrdP A Starr
Apr 20, 2006·Parkinsonism & Related Disorders·Yasin TemelVeerle Visser-Vandewalle
Oct 27, 2005·Progress in Neurobiology·Yasin TemelVeerle Visser-Vandewalle
Feb 24, 2004·Neurological Research·Joshua M RosenowAli Rezai
Apr 2, 2002·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Dipankar NandiJohn F Stein
Jun 20, 2015·Case Reports in Neurological Medicine·Daniel B Simmons, Khashayar Dashtipour
Jun 20, 2012·Parkinsonism & Related Disorders·Patric BlomstedtMarwan I Hariz
Mar 1, 2012·Experimental Neurology·Matteo BolognaAlfredo Berardelli
Aug 16, 2013·The Korean Journal of Physiology & Pharmacology : Official Journal of the Korean Physiological Society and the Korean Society of Pharmacology·Sang Baek RyuKyung Hwan Kim
Dec 25, 2010·Therapeutic Advances in Neurological Disorders·S J GroissA Schnitzler
Dec 1, 2017·Surgical Neurology International·Karlo J LizarragaAlfonso Fasano
Sep 4, 2001·Hospital Medicine·K BhatiaParkinson's Disease Consensus Working Group
Feb 6, 2018·Scientific Reports·K-Alexander EngelhardtLiana Melo-Thomas
Mar 8, 2019·Neuromodulation : Journal of the International Neuromodulation Society·Andrew RomeoHarrison C Walker
Aug 5, 2017·Journal of Cognitive Neuroscience·Jari PeräkyläKaisa M Hartikainen
Oct 23, 2002·Brain : a Journal of Neurology·Elena MoroPierre Pollak
Apr 15, 2003·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Aviva Abosch, Andres Lozano
Aug 2, 2003·CNS Spectrums·Benjamin D Greenberg, Ali Rezai
Mar 18, 2006·Neurosurgery·Ramin AmirnovinEmad N Eskandar
Jul 30, 2019·Annals of Clinical and Translational Neurology·Vibhor KrishnaAli Rezai
Nov 10, 2017·Movement Disorders : Official Journal of the Movement Disorder Society·Rick C Helmich
Apr 12, 2002·Movement Disorders : Official Journal of the Movement Disorder Society·Günther Deuschl, Peter Bain
May 1, 2000·Movement Disorders : Official Journal of the Movement Disorder Society·Mark Hallet, Irene Litvan
Mar 26, 2021·Gait & Posture·Mitesh PatelPer-Anders Fransson

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