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Intraoperative dopamine release during globus pallidus internus stimulation in Parkinson's disease
Author(s) -
Martinez Raquel C.R.,
Hamani Clement,
Carvalho Milene Cristina,
Oliveira Amanda Ribeiro,
Alho Eduardo,
Navarro Jessie,
Santos Ghilardi Maria Gabriela,
BorSengShu Edson,
Heinsen Helmut,
Otoch José Pinhata,
Brandão Marcus Lira,
Barbosa Egberto Reis,
Teixeira Manoel Jacobsen,
Fonoff Erich Talamoni
Publication year - 2013
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.25691
Subject(s) - pallidotomy , deep brain stimulation , globus pallidus , parkinson's disease , stimulation , dopamine , medicine , microdialysis , basal ganglia , psychology , anesthesia , neuroscience , disease , central nervous system
Background 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). Methods We have used microdialysis to record pallidal DA in 5 patients with PD undergoing microelectrode‐guided pallidotomy. Results 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. Conclusions 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