Parkinson's disease, subthalamic stimulation, and selection of candidates: A pathological study

Authors

  • Bechir Jarraya MD,

    1. Fédération de Neurologie, Centre d'Investigation Clinique and Institut National de la Santé et de la Recherche Médicale (INSERM) U289, Hôpital de la Salpêtrière, Paris, France
    Search for more papers by this author
  • Anne-Marie Bonnet MD,

    1. Fédération de Neurologie, Centre d'Investigation Clinique and Institut National de la Santé et de la Recherche Médicale (INSERM) U289, Hôpital de la Salpêtrière, Paris, France
    Search for more papers by this author
  • Charles Duyckaerts MD,

    1. Laboratoire de Neuropathologie Escourolle and INSERM U106 and U360, Hôpital de la Salpêtrière, Paris, France
    Search for more papers by this author
  • Jean-Luc Houeto MD,

    1. Fédération de Neurologie, Centre d'Investigation Clinique and Institut National de la Santé et de la Recherche Médicale (INSERM) U289, Hôpital de la Salpêtrière, Paris, France
    Search for more papers by this author
  • Philippe Cornu MD,

    1. Service de Neurochirurgie, Hôpital de la Salpêtrière, Paris, France
    Search for more papers by this author
  • Jean-Jacques Hauw MD,

    1. Laboratoire de Neuropathologie Escourolle and INSERM U106 and U360, Hôpital de la Salpêtrière, Paris, France
    Search for more papers by this author
  • Yves Agid MD, PhD

    Corresponding author
    1. Fédération de Neurologie, Centre d'Investigation Clinique and Institut National de la Santé et de la Recherche Médicale (INSERM) U289, Hôpital de la Salpêtrière, Paris, France
    • Centre d'Investigation Clinique, Hôpital de la Salpêtrière, 47 boulevard de l'Hôpital, 75013 Paris, France
    Search for more papers by this author

Abstract

We report on a patient with Parkinson's disease (PD) who was moderately improved by stimulation of the subthalamic nucleus (STN) and died 2 years after electrode implantation. After neurosurgery, symptoms that had responded to levodopa treatment preoperatively continued to improve. Postural instability, dysarthria, and cognitive impairment continued to worsen, despite STN stimulation and levodopa treatment. Postmortem examination of the brain confirmed the diagnosis of PD and showed that the electrodes had been correctly positioned within the STN. The failure of STN stimulation in this patient confirms the importance of screening and excluding patients from surgery with evolving parkinsonian axial symptoms or cognitive impairment. © 2003 Movement Disorder Society

Ancillary