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One-Sided Brain Stimulation Improves Parkinson's

Wed Nov 3, 2004 05:04 PM ET

NEW YORK (Reuters Health) - For people with advanced Parkinson's
disease, electrical stimulation through an electrode implanted in one
side of the brain produces long-lasting improvements in movement
difficulties on both sides of the body, a new study shows.

"If you can get nice benefit with unilateral deep brain stimulation,
why not do that and minimize the risk" associated with more extensive
surgery, Dr. Jay L. Alberts said in an interview with Reuters Health.


Then if the disease should progress, he said, the opposite side will
still be available for implantation of a second deep brain
stimulation device.

Currently, most surgeons perform bilateral procedures, Alberts
explained.

Alberts, with the Atlanta VA Rehabilitation and Research Center, and
his associates tested the manual dexterity of both hands of patients
with advanced Parkinson's disease who were given unilateral deep
brain stimulation devices. The devices were implanted on the opposite
side to the dominant hand, and were in place for 11 to 55 months.

The subjects all exhibited improvements in scores on a Parkinson's
disease rating scale when the electrodes were turned on, team reports
in the journal Motor Control. The patients also displayed better
reaching consistency and grip force, as well as decreased movement
times.

The devices were also tested in two different regions of the brain --
known as the subthalamic nucleus and the globus pallidus. The
procedure normally involves subthalamic stimulation, but the
researchers found no evidence that one site was better than the
other.

This is important, Alberts said, because "data suggest that
stimulating the subthalamic nucleus may increase certain
neuropsychological problems, such as depression and working memory
deficits." Hence, implantation in this area should be avoided in
patients with depression or mild cognitive impairment.

"We hope this study opens up the possibility of deep brain
stimulation in the globus pallidus for other patients who might not
ordinarily qualify for stimulation of the subthalamic nucleus," he
said.

SOURCE: Motor Control, October 2004.

SOURCE: Reuters Health / Reuters, NY
http://tinyurl.com/6z8yp

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