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Abnormal involuntary movements induced by subthalamic nucleus stimulation in parkinsonian patients
Author(s) -
Limousin Patricia,
Pollak Pierre,
Hoffmann Dominique,
Benazzouz Abdelhamid,
Perret Jean Edmond,
Benabid AlimLouis
Publication year - 1996
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.870110303
Subject(s) - subthalamic nucleus , levodopa , stimulation , deep brain stimulation , concomitant , dystonia , medicine , latency (audio) , movement disorders , anesthesia , neuroscience , psychology , parkinson's disease , disease , electrical engineering , engineering
Chronic electrical subthalamic nucleus (STN) stimulation is under investigation for alleviating parkinsonian symptoms. STN alterations may carry the risk of provoking abnormal involuntary movements (AIMs). We took advantage of the reversibility of the stimulation technique to assess the possibility of inducing AIMs, using different electrical variables with or without concomitant levodopa intake. Above a given threshold voltage, stimulation could induce contralateral distal mobile AIMs or hemiballism in the off‐drug condition in two patients. AIMs occurred after a latency that varied from a few minutes up to several hours after switching on the stinulator. Hemiballism immediately disappeared upon switching off the stimulator. In these patients, levodopa had never provoked that type of AIMs before surgery. Levodopa‐induced AIMs were not modified by electrical stimulation, but off‐phase dystonia disappeared in one patient. Stimulation of the STN induced AIMs that resembled both those observed following spontaneous lesions of the STN and levodopa‐induced diphasic AIMs in parkinsonian patients. As electrical stimulation provoked AIMs and antiparkinsonian benefit occurred with different electical variables and different timing, the mechanisms responsible for these two effects could be distinct.