Effects of unilateral subthalamic and pallidal deep brain stimulation on fine motor functions in Parkinson's disease

Authors

  • Ken Nakamura MD, PhD,

    Corresponding author
    1. Department of Neurology, University of California, San Francisco, California, USA
    2. Parkinson's Disease Research, Education Clinical Center, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
    • Center for Parkinson's Disease and Movement Disorders, San Francisco VA Medical Center (127P), 4150 Clement Street, San Francisco, CA 94121
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  • Chadwick W. Christine MD,

    1. Department of Neurology, University of California, San Francisco, California, USA
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  • Philip A. Starr MD, PhD,

    1. Parkinson's Disease Research, Education Clinical Center, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
    2. Department of Neurological Surgery, University of California, San Francisco, California, USA
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  • William J. Marks Jr. MD

    1. Department of Neurology, University of California, San Francisco, California, USA
    2. Parkinson's Disease Research, Education Clinical Center, San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
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Abstract

Deep brain stimulation (DBS) is an effective treatment for selected patients with disabling Parkinson's disease (PD). The two main targets are the subthalamic nucleus (STN) and the globus pallidus internus (GPi), although it has not been established whether stimulation at one target is superior to the other. This prospective randomized study assessed the effects of unilateral DBS of the STN versus GPi on fine motor skills in 33 patients with advanced PD. Stimulation of either the STN (18 subjects) or GPi (15 subjects) in the off medication state significantly improved movement time and dexterity, but had little or no effect on reaction time. Overall, the extent of improvement did not differ between the two targets. The degree of improvement in movement time, but not dexterity, was correlated with the extent of preoperative medication responsiveness. Our findings suggest that DBS of the STN or GPi results in a similar improvement in hand movements at short-term follow-up. Preoperative medication responsiveness predicts improvement in some but not other motor tasks. © 2006 Movement Disorder Society

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