Funding agencies: Support was provided by the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP; grant nos. 11/08575-7, 12/06825-9, 11/00041-3 and 10/50669-6), Conselho Nacional de Desenvolvimento. (CNPq 471325/2011-2) and CAPES (project Grant 23038.027765/2009-10; Aux-PE-PNPD 2193/2009).
Intraoperative dopamine release during globus pallidus internus stimulation in Parkinson's disease
Article first published online: 21 OCT 2013
© 2013 Movement Disorder Society
Volume 28, Issue 14, pages 2027–2032, December 2013
How to Cite
Martinez, R. C.R., Hamani, C., de Carvalho, M. C., de Oliveira, A. R., Alho, E., Navarro, J., dos Santos Ghilardi, M. G., Bor-Seng-Shu, E., Heinsen, H., Otoch, J. P., Brandão, M. L., Barbosa, E. R., Teixeira, M. J. and Fonoff, E. T. (2013), Intraoperative dopamine release during globus pallidus internus stimulation in Parkinson's disease. Mov. Disord., 28: 2027–2032. doi: 10.1002/mds.25691
Relevant conflicts of interest/financial disclosures: C.H. is a consultant for St Jude Medical.
Full financial disclosure and author roles may be found in the online version of this article
- Issue published online: 9 DEC 2013
- Article first published online: 21 OCT 2013
- Manuscript Accepted: 22 AUG 2013
- Manuscript Revised: 15 AUG 2013
- Manuscript Received: 18 APR 2013
- deep brain stimulation;
- Parkinson's disease;
- motor symptoms
It is still unclear whether dopamine (DA) levels correlate with Parkinson's disease (PD) severity or play a role in the mechanisms of high-frequency stimulation (HFS).
We have used microdialysis to record pallidal DA in 5 patients with PD undergoing microelectrode-guided pallidotomy.
We found that patients with more severe disease and, consequently, lower pallidal DA did poorly after pallidal lesions. In the operating room, 4 of 5 patients had a significant increase in DA levels during HFS (600%, on average). To test the hypothesis that DA was important for the effects of stimulation, we correlated the amelioration in rigidity observed in the operating room with pallidal DA release. Though rigidity was 56% better during stimulation, no correlation was found between such an improvement and DA release.
These findings suggest that additional mechanisms not directly dependent on pallidal DA release may be involved in the clinical effects of HFS of the globus pallidus internus. © 2013 International Parkinson and Movement Disorder Society