Inhibition of levodopa effects by internal pallidal stimulation

Paul Krack, Pierre Pollak, Patricia Limousin, Dominique Hoffmann, Abdelhamid Benazzouz, Alim-Louis Benabid
Mov Disord.. 1998-07-01; 13(4): 648-652
DOI: 10.1002/mds.870130407

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1. Mov Disord. 1998 Jul;13(4):648-52. doi: 10.1002/mds.870130407.

Inhibition of levodopa effects by internal pallidal stimulation.

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

Author information:
(1)Department of Clinical and Biological Neurosciences and INSERM U318, Joseph
Fourier University of Grenoble, France.

Comment in
Mov Disord. 1999 May;14(3):536-40.

We report three patients with bilateral GPi stimulation for stage 4 Parkinson’s
disease (PD) with severe levodopa-induced dyskinesias (LID). In all three it was
possible to completely inhibit LID using high-stimulation parameters. Parallel
to complete inhibition of LID, an inhibition of the anti-akinetic effect of
levodopa was observed, whereas, at the same time, rigidity was markedly
improved. GPi stimulation is adaptable over time, and stimulation parameters
have to be programmed according to off- and on-period motor symptoms. The main
interest of stimulation is the possibility of finding a compromise between LID
alleviation in on-phase without loss of the beneficial motor effects and
improvement in parkinsonism in off-phase. In some patients, residual dyskinesias
have to be accepted so as not to aggravate on-period motor symptoms by a
presumed overinhibition of basal ganglia outflow.

DOI: 10.1002/mds.870130407
PMID: 9686769 [Indexed for MEDLINE]

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