Abnormal involuntary movements induced by subthalamic nucleus stimulation in parkinsonian patients

Patricia Limousin, Pierre Pollak, Dominique Hoffmann, Abdelhamid Benazzouz, Jean Edmond Perret, Alim-Louis Benabid
Mov Disord.. 1996-05-01; 11(3): 231-235
DOI: 10.1002/mds.870110303

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1. Mov Disord. 1996 May;11(3):231-5. doi: 10.1002/mds.870110303.

Abnormal involuntary movements induced by subthalamic nucleus stimulation in
parkinsonian patients.

Limousin P(1), Pollak P, Hoffmann D, Benazzouz A, Perret JE, Benabid AL.

Author information:
(1)Department of Clinical and Biological Neurosciences, Joseph Fourier
University of Grenoble, France.

Chronic electrical subthalamic nucleus (STN) stimulation is under investigation
for alleviating parkinsonian symptoms. STN alterations may carry the risk of
provoking abnormal involuntary movements (AIMs). We took advantage of the
reversibility of the stimulation technique to assess the possibility of inducing
AIMs, using different electrical variables with or without concomitant levodopa
intake. Above a given threshold voltage, stimulation could induce contralateral
distal mobile AIMs or hemiballism in the off-drug condition in two patients.
AIMs occurred after a latency that varied from a few minutes up to several hours
after switching on the stimulator. Hemiballism immediately disappeared upon
switching off the stimulator. In these patients, levodopa had never provoked
that type of AIMs before surgery. Levodopa-induced AIMs were not modified by
electrical stimulation, but off-phase dystonia disappeared in one patient.
Stimulation of the STN induced AIMs that resembled both those observed following
spontaneous lesions of the STN and levodopa-induced diphasic AIMs in
parkinsonian patients. As electrical stimulation provoked AIMs and
antiparkinsonian benefit occurred with different electrical variables and
different timing, the mechanisms responsible for these two effects could be

DOI: 10.1002/mds.870110303
PMID: 8723137 [Indexed for MEDLINE]

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