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Stereotact Funct Neurosurg 1999 Apr;72(2-4):170-173

Subthalamic Stimulation in Parkinson's Disease. preliminary results.

Levesque MF, Taylor S, Rogers R, Le MT, Swope D

Cedars-Sinai Medical Center, Functional Neurosurgery Unit, Los Angeles,
Calif.,
USA.

Objectives:
We wanted to evaluate chronic subthalamic nucleus (STN) stimulation
as an alternative to pallidotomy for severe Parkinson's disease
symptomatology.

Methods:
Nine patients met clinical criteria for unilateral standard
pallidotomy. All had severe medically refractory drug-induced dyskinesia and
had
reached maximal daily levodopa therapy. Pre- and postoperative videos,
neuropsychometric testings and clinical stagings were administered. Three
patients were selected to undergo stereotactic implantation of a deep brain
stimulator (DBS) after Institutional Review Board approval and informed
consent.
These were performed using digitized microrecordings. The other group
received
unilateral pallidotomy.

Results:
At a mean follow-up of 6 months, our results
support recent findings of significant major improvement in motor scores,
activity of daily living and decrease in amount of daily levodopa intake by
close to 50% after 3 months of stimulation. Conclusions: Chronic stimulation
of
the STN appears to provide significant motor improvement in patients with
severe
Parkinson's disease and is more beneficial than pallidotomy.