Deep brain stimulation improves upper limb akinesia
associated with Parkinson's
WESTPORT, Apr 29, 1999 (Reuters Health) - Continuing electrical
stimulation of the internal pallidum or subthalamic nucleus
significantly improves some motor symptoms in patients with
Parkinson's disease, according to a multicenter group.
In the April issue of the Annals of Neurology, Dr. R. G. Brown, of
the Institute of Psychiatry in London, and colleagues report study
findings on 12 patients with Parkinson's disease. In half of the
subjects, chronically stimulating electrodes were implanted
bilaterally in the internal pallidum, and in the other half the
electrodes were implanted in the subthalamic nucleus.
An average of 8.3 months later, the researchers obtained detailed
measurements of upper limb akinesia. "Stimulation improved a
number of aspects of motor function, and particularly movement
time, and force production," they report. "Time to initiate
movements, and to perform repetitive movements also improved
but less dramatically."
The observed effects of deep brain stimulation in these patients
"...closely parallel previous reports of the effects of dopaminergic
medication," the investigators add.
For the most part, Dr. Brown's team found few significant
differences between the two treatment groups. All patients
experienced a similar degree of upper limb akinesia improvement,
but rigidity improved more in the patients who received
subthalamic nucleus stimulation.
Based on the similarity of the findings between the two groups, Dr.
Brown and associates suggest that disruption of pallidal output
may be the key determinant of upper limb akinesia in patients with
Parkinson's disease.
Ann Neurol 1999;45:473-488.
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Judith Richards, London, Ontario, Canada
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