Document Detail


Lesioning the subthalamic nucleus in the treatment of Parkinson's disease.
MedLine Citation:
PMID:  12378059     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ever since it was demonstrated about twenty years ago by two independent groups (Aziz et al. and Bergman et al.) that the cardinal clinical features of MPTP-induced Parkinson's disease (PD) in non-human primate models can be alleviated by lesions of the subthalamic nucleus (STN), this structure has been the focus of interest for functional neurosurgeons involved in the treatment of PD. Initially lesioning and later chronic high frequency stimulation of the STN has become the standard surgical target of akinetic PD. In this brief report we present our experience with 14 STN lesions (8 unilateral and 3 bilateral) confirmed by post-operative imaging. We found significant improvement in OFF rigidity and in ON tremor following unilateral lesions. The major complications were speech disturbance and L-Dopa resistant limb dystonia. Functional disability scores showed inconsistent reduction. There was insufficient data to comment on the significance of bilateral lesions; however, there was a similar pattern of improvement in tremor and speech disturbance. In addition, there was worsening of gait. We comment on the lower degree of improvement in motor scores in our series compared to the few others in recent literature and stress that even in these studies the UPDRS benefits did not translate directly into functional benefit for the patients.
Authors:
S Parkin; D Nandi; N Giladi; C Joint; R Gregory; P Bain; R Scott; T Z Aziz
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Stereotactic and functional neurosurgery     Volume:  77     ISSN:  1011-6125     ISO Abbreviation:  Stereotact Funct Neurosurg     Publication Date:  2001  
Date Detail:
Created Date:  2002-10-14     Completed Date:  2002-12-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8902881     Medline TA:  Stereotact Funct Neurosurg     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  68-72     Citation Subset:  IM    
Copyright Information:
Copyright 2002 S. Karger AG, Basel
Affiliation:
Neurology, Radcliffe Infirmary, Oxford, UK.
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MeSH Terms
Descriptor/Qualifier:
Electrodes, Implanted
Humans
Parkinson Disease / physiopathology,  surgery*
Severity of Illness Index
Stereotaxic Techniques
Subthalamic Nucleus / physiopathology,  surgery*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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