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Chronic bilateral subthalamic deep brain stimulation in a patient with homozygous deletion in the Parkin gene
Author(s) -
Capecci Marianna,
Passamonti Luca,
Annesi Ferdinanda,
Annesi Grazia,
Bellesi Michele,
Candiano Innocenza Claudia Cirò,
Ricciuti Riccardo,
Iacoangeli Maurizio,
Scerrati Massimo,
Zappia Mario,
Tarantino Patrizia,
De Marco Elvira Valeria,
Civitelli Donatella,
Carrideo Sara,
Provinciali Leandro,
Ceravolo Maria Gabriella,
Quattrone Aldo
Publication year - 2004
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.20250
Subject(s) - levodopa , deep brain stimulation , parkin , parkinsonism , subthalamic nucleus , medicine , parkinson's disease , psychology , central nervous system disease , anesthesia , disease
Chronic subthalamic nucleus deep brain stimulation (STN‐DBS) is an efficacious treatment for idiopathic Parkinson's disease (PD) that cannot be further improved by medical therapy. We present a case of an individual with juvenile parkinsonism caused by homozygous deletion of exon 3 in the parkin gene with disabling long‐term side‐effects from levodopa who underwent bilateral STN neuromodulation. Parkin‐linked parkinsonism may show clinical features different from sporadic PD, yet it shares levodopa responsiveness. Because levodopa responsiveness is a predictor of STN‐DBS efficacy, we argued that this kind of surgical approach might be efficacious in hereditary parkin‐linked juvenile parkinsonism. We evaluated clinical and functional assessment before and 12 months after surgery. The results showed that the Unified Parkinson Disease Rating Scales Motor score improved by 84% in our patient, the levodopa equivalent daily dose medication (LEDD) was reduced by 66%, and, finally, disabling and severe dyskinesias disappeared. © 2004 Movement Disorder Society