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PMID: 9322838: Pallidal stimulation 7/2 France 1997

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High-frequency stimulation of the globus pallidus internalis
in Parkinson's disease: a study of seven cases.
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The effectiveness of ventroposterolateral pallidotomy in the treatment of
akinesia and rigidity is not a new discovery, and agrees with recent
investigations into the pathogenesis of Parkinson's disease, which
highlight the role played by the unbridled activity of the subthalamic
nucleus (STN) and the consequent overactivity of the globus pallidus
internalis (GPi).

Because high-frequency stimulation can reversibly incapacitate a nerve
structure, we applied stimulation to the same target.

Seven patients suffering from severe Parkinson's disease (Stages III-V on
the Hoehn and Yahr scale) and, particularly, bradykinesia, rigidity, and
levodopa-induced dyskinesias underwent unilateral electrode implantation in
the posteroventral GPi.

Follow-up evaluation using the regular Unified Parkinson's Disease Rating
Scale has been conducted for 1 year in all seven patients, 2 years in five
of them, and 3 years in one.
In all cases high-frequency stimulation has alleviated akinesia and
rigidity and has generally improved gait and speech disturbances.

In some cases tremor was attenuated.

In a similar manner, the authors observed a marked diminution in
levodopa-induced dyskinesias.

This could be an excellent primary therapy for younger patients exhibiting
severe bradykinesia, rigidity, and levodopa-induced dyskinesias, which
would allow therapists to keep ventroposterolateral pallidotomy in reserve
as a second weapon.


J Neurosurg 1997 Oct;87(4):491-498
Gross C, Rougier A, Guehl D, Boraud T, Julien J, Bioulac B
Universite Victor Segalen Bordeaux II, France.
PMID: 9322838, MUID: 97462611
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janet paterson/50/9/sinemet/selegiline/prozac/paterson@xxxxxx/bermuda


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