Lesioning the subthalamic nucleus in the treatment of Parkinson's disease.

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...

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Main Authors: Parkin, S, Nandi, D, Giladi, N, Joint, C, Gregory, R, Bain, P, Scott, R, Aziz, T
Format: Journal article
Language:English
Published: 2001
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author Parkin, S
Nandi, D
Giladi, N
Joint, C
Gregory, R
Bain, P
Scott, R
Aziz, T
author_facet Parkin, S
Nandi, D
Giladi, N
Joint, C
Gregory, R
Bain, P
Scott, R
Aziz, T
author_sort Parkin, S
collection OXFORD
description 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.
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spelling oxford-uuid:ba40c436-07eb-4cca-9a2c-aa700d9708a92022-03-27T05:08:32ZLesioning the subthalamic nucleus in the treatment of Parkinson's disease.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ba40c436-07eb-4cca-9a2c-aa700d9708a9EnglishSymplectic Elements at Oxford2001Parkin, SNandi, DGiladi, NJoint, CGregory, RBain, PScott, RAziz, TEver 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.
spellingShingle Parkin, S
Nandi, D
Giladi, N
Joint, C
Gregory, R
Bain, P
Scott, R
Aziz, T
Lesioning the subthalamic nucleus in the treatment of Parkinson's disease.
title Lesioning the subthalamic nucleus in the treatment of Parkinson's disease.
title_full Lesioning the subthalamic nucleus in the treatment of Parkinson's disease.
title_fullStr Lesioning the subthalamic nucleus in the treatment of Parkinson's disease.
title_full_unstemmed Lesioning the subthalamic nucleus in the treatment of Parkinson's disease.
title_short Lesioning the subthalamic nucleus in the treatment of Parkinson's disease.
title_sort lesioning the subthalamic nucleus in the treatment of parkinson s disease
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