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Effects of unilateral subthalamic and pallidal deep brain stimulation on fine motor functions in Parkinson's disease
Author(s) -
Nakamura Ken,
Christine Chadwick W.,
Starr Philip A.,
Marks William J.
Publication year - 2007
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.21300
Subject(s) - deep brain stimulation , subthalamic nucleus , parkinson's disease , stimulation , physical medicine and rehabilitation , globus pallidus , psychology , central nervous system disease , neuroscience , movement disorders , motor symptoms , medicine , basal ganglia , disease , central nervous system
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