Acute and long-term effects of subthalamic nucleus stimulation of Parkinson’s disease
Stereotact Funct Neurosurg. 1994-01-01; 62(1-4): 76-84
DOI: 10.1159/000098600
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1. Stereotact Funct Neurosurg. 1994;62(1-4):76-84. doi: 10.1159/000098600.
Acute and long-term effects of subthalamic nucleus stimulation in Parkinson’s
disease.
Benabid AL(1), Pollak P, Gross C, Hoffmann D, Benazzouz A, Gao DM, Laurent A,
Gentil M, Perret J.
Author information:
(1)Department of Neurosciences, University Hospital, Grenoble, France.
In animal models of Parkinson’s disease (PD), it is postulated that the
excessive output from the subthalamic nucleus (STN) plays a critical role.
Selective lesions or high frequency electrical stimulation of the STN can
alleviate parkinsonian symptoms in MPTP-treated monkeys. We decided to carry out
STN stimulation in patients suffering from severe akinetic forms of PD. After
approval of the institutional ethical committee, we operated on a parkinsonian
patient aged 51, suffering for 8 years from a strongly disabling akinetorigid
form of PD, complicated by an on-off effect (Hoehn and Yahr stage 5 in the
worst-off motor phase). Stereotactic surgery was done on one side under local
anesthesia. The theoretical target was chosen according to stereotactic atlases,
based on ventriculographic landmarks such as anterior and posterior commissures
(AC and PC). The final position of the chronic electrodes was optimized using
electrophysiological recording and stimulation along with clinical assessment
and surface EMG of agonist and antagonist muscles of the examined limbs. A
spontaneous increase in neuronal activity was recorded in an area located 2-4 mm
under the level of the intercommissural plane, 10 mm from the midline, at
mid-distance between AC and PC. Within the same place, a 130-Hz stimulation
induced acute and reversible akinesia alleviation mainly on the contralateral
limbs, comparable to that obtained with dopaminergic drugs. No dyskinesia, such
as hemiballism, was induced by introduction of electrodes or by stimulation.
Then a long-term quadripolar DBS Medtronic electrode was inserted in this area.
Studies of the effects of chronic stimulation were extensively performed to
determine the best spatiotemporal and electrical stimulation variables.(ABSTRACT
TRUNCATED AT 250 WORDS)
DOI: 10.1159/000098600
PMID: 7631092 [Indexed for MEDLINE]