Effect on parkinsonian signs and symptoms of bilateral subthalamic nucleus stimulation
The Lancet. 1995-01-01; 345(8942): 91-95
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1. Lancet. 1995 Jan 14;345(8942):91-5. doi: 10.1016/s0140-6736(95)90062-4.
Effect of parkinsonian signs and symptoms of bilateral subthalamic nucleus
Limousin P(1), Pollak P, Benazzouz A, Hoffmann D, Le Bas JF, Broussolle E,
Perret JE, Benabid AL.
(1)Department of Clinical and Biological Neurosciences, Joseph Fourier
University of Grenoble, France.
In monkeys rendered parkinsonian, lesions and electrical stimulation of the
subthalamic nucleus reduce all major motor disturbances. The effect of
electrical stimulation of the subthalamic nucleus was assessed in three patients
with disabling akinetic-rigid Parkinson’s disease and severe motor fluctuations.
Quadripolar electrodes connected to a pulse generator were implanted in the
subthalamic nuclei on both sides. Patients were evaluated with the unified
Parkinson’s disease rating scale and timed motor tests. 3 months after surgery,
activities of daily living scores had improved by 58-88% and motor scores by
42-84%. This improvement was maintained for up to 8 months in the first patient
operated upon. One patient was confused for 2 weeks after surgery, and another
developed neuropsychological impairment related to a thalamic infarction which
improved over 3 months. In one patient, stimulation could induce ballism that
was stopped by reduction of stimulation. This is the first demonstration in
human beings of the part played by the subthalamic nuclei in the pathophysiology
of Parkinson’s disease.
PMID: 7815888 [Indexed for MEDLINE]