Subthalamic nucleus deep brain stimulation for parkinson's disease after successful pallidotomy: clinical and electrophysiological observations

Movement Disorders : Official Journal of the Movement Disorder Society
Galit Kleiner-FismanAnthony E Lang

Abstract

Unilateral pallidotomy is an effective treatment for contralateral parkinsonism and dyskinesia, yet symptoms progress in many patients. Little is known about whether such patients obtain a useful response to subsequent bilateral subthalamic nucleus deep brain stimulation (STN DBS). Changes in Unified Parkinson's Disease Rating Scale (UPDRS) Motor and Activities of Daily Living (ADL) scores, medication requirements, and dyskinesias were measured. Clinical outcomes were compared to patients with de novo STN DBS. Neuronal recordings were performed. STN DBS resulted in a significant reduction in UPDRS Motor scores (42.1%; 95% confidence interval [CI], 26.9-57.4; P = 0.03), comparable with de novo STN DBS surgery (41%; 95% CI, 26-46%; P < 0.001). There was also less change in dyskinesia duration and disability scores (P = 0.017, 0.005). There were no side-to-side differences clinically or in the STN neuronal firing rates and patterns. Bilateral STN DBS is safe and efficacious in improving motor symptoms in patients with prior pallidotomy.

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Citations

Mar 17, 2007·The Clinical Neuropsychologist·Michael S OkunDawn Bowers
Sep 13, 2007·The Neurologist·Drew S Kern, Rajeev Kumar
Jul 1, 2007·Neuromodulation : Journal of the International Neuromodulation Society·Jeffrey E ArleJay L Shils
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Dec 6, 2006·Expert Review of Neurotherapeutics·Elena Moro, Anthony E Lang
Jun 23, 2010·Movement Disorders : Official Journal of the Movement Disorder Society·Galit Kleiner-FismanAnthony E Lang
Apr 3, 2008·Biochemical and Biophysical Research Communications·Tao XinZhiming Zhang
Jun 26, 2007·Disease-a-month : DM·Jeffrey W Cozzens
Jul 1, 2006·Movement Disorders : Official Journal of the Movement Disorder Society·Anthony E LangValerie Voon
May 5, 2006·Movement Disorders : Official Journal of the Movement Disorder Society·William G OndoJoseph Jankovic
Sep 13, 2008·Movement Disorders : Official Journal of the Movement Disorder Society·Elina TripolitiPatricia Limousin
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