Deep-Brain Stimulation of the Subthalamic Nucleus or the Pars Interna of the Globus Pallidus in Parkinson's Disease

• Published in: The New England journal of medicine Vol. 345; no. 13; pp. 956 - 963
• Main Authors: Obeso, J A, Olanow, C W, Rodriguez-Oroz, M C, Krack, P, Kumar, R, Lang, A E
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 27.09.2001
• Subjects: Activities of Daily Living; Analysis of Variance; Biological and medical sciences; Cross-Over Studies; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Double-Blind Method; Electric Stimulation Therapy - adverse effects; Globus Pallidus; Health care; Humans; Medical sciences; Medical treatment; Motor Skills; Neurology; Parkinson Disease - classification; Parkinson Disease - physiopathology; Parkinson Disease - therapy; Parkinson's disease; Prospective Studies; Statistics, Nonparametric; Subthalamic Nucleus; Treatment Outcome; Human; Nervous system diseases; Pars intercerebralis; Parkinson disease; Stimulation; Electroencephalography; Crossover study; Pallidum; Cerebral disorder; Prospective; Electrodiagnosis; Central nervous system disease; Double blind study; Degenerative disease; Subthalamic nucleus; Extrapyramidal syndrome; Brain (vertebrata)
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa000827

In this double-blind, prospective study, bilateral stimulation was associated with significant improvement. Levodopa is the mainstay of treatment for Parkinson's disease. 1 However, long-term levodopa treatment is complicated by involuntary movements known as dyskinesia and motor fluctuations in which patients cycle between periods of good mobility (“on” periods) and impaired mobility (“off” periods). 2 These complications result in disability that cannot be satisfactorily controlled by medical therapy in the majority of patients. Advances in understanding of the pathophysiology of the basal ganglia have provided opportunities for new therapeutic strategies to manage these problems. 3 – 5 In animal models of Parkinson's disease, neuronal activity is increased in the subthalamic nucleus and pars interna of the globus . . .