| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Centre d'Investigation Clinique-Fédération de Neurologie (Drs. Bejjani, Damier, Arnulf, Bonnet, Vidailhet, and Agid), Service de neuroradiologie (Drs. Dormont and Marsault), Service d'exploration fonctionnelle neurologique (Dr. Pidoux), Service de neurochirurgie (Dr. Cornu), Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Address correspondence and reprint requests to Dr. Yves Agid, Centre d'Investigation Clinique-Fédération de Neurologie, Boulevard de l'hôpital, 75651 Paris Cedex 13, France.
There has been renewed interest in functional surgery as treatment for Parkinson's disease (PD). Although pallidotomy and chronic pallidal stimulation are highly effective in suppressing levodopa-induced dyskinesia(LID), both methods also seem to be effective in reducing parkinsonian disability. However, the simultaneous improvement of LID and motor signs is hard to explain with the classic model of basal ganglia circuitry. Taking advantage of the fact that deep brain stimulation is reversible and that implanted electrodes contain four discrete stimulation sites, we investigated the effect of stimulation on different sites of the globus pallidus (GP) in five PD patients. Stimulation in the dorsal GP (upper contact) significantly improved gait, akinesia, and rigidity and could induce dyskinesia when patients were in the "off" state. In contrast, stimulation in the posteroventral GP (lower contact) significantly worsened gait and akinesia, although the reduction in rigidity remained. For patients in the "on" state, stimulation in the posteroventral GP dramatically reduced LID but, as in the"off" state, worsened gait and akinesia, thus canceling out the antiparkinsonian effect of levodopa. Our results indicate that stimulation had a striking different effect on parkinsonism and dyskinesia when applied at two different loci of the GP and that stimulation applied in the posteroventral GP produced opposite effects on rigidity and on akinesia. We conclude that parkinsonian signs and LID are a reflection of at least two different anatomofunctional systems within the GP and that this functional organization of the GP needs to be considered when determining the optimal target for surgical treatment of PD.
Supported by PHRC 1995 and PHRC 1994 AOA 94001.
Received March 12, 1997. Accepted in final form June 18, 1997.
This article has been cited by other articles:
|
|
 |
|
  C. W. Olanow, M. B. Stern, and K. Sethi The scientific and clinical basis for the treatment of Parkinson disease (2009) Neurology, May 26, 2009; 72(21_Supplement_4): S1 - S136. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. D. Johnson and C. C. McIntyre Quantifying the Neural Elements Activated and Inhibited by Globus Pallidus Deep Brain Stimulation J Neurophysiol, November 1, 2008; 100(5): 2549 - 2563. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S Tisch, L Zrinzo, P Limousin, K P Bhatia, N Quinn, K Ashkan, and M Hariz Effect of electrode contact location on clinical efficacy of pallidal deep brain stimulation in primary generalised dystonia J. Neurol. Neurosurg. Psychiatry, December 1, 2007; 78(12): 1314 - 1319. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Damier, S. Thobois, T. Witjas, E. Cuny, P. Derost, S. Raoul, P. Mertens, J.-C. Peragut, J.-J. Lemaire, P. Burbaud, et al. Bilateral Deep Brain Stimulation of the Globus Pallidus to Treat Tardive Dyskinesia Arch Gen Psychiatry, February 1, 2007; 64(2): 170 - 176. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J L Houeto, C Karachi, L Mallet, B Pillon, J Yelnik, V Mesnage, M L Welter, S Navarro, A Pelissolo, P Damier, et al. Tourette's syndrome and deep brain stimulation J. Neurol. Neurosurg. Psychiatry, July 1, 2005; 76(7): 992 - 995. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Bar-Gad, S. Elias, E. Vaadia, and H. Bergman Complex Locking Rather Than Complete Cessation of Neuronal Activity in the Globus Pallidus of a 1-Methyl-4-Phenyl-1,2,3,6-Tetrahydropyridine-Treated Primate in Response to Pallidal Microstimulation J. Neurosci., August 18, 2004; 24(33): 7410 - 7419. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Devos, E. Labyt, P. Derambure, J. L. Bourriez, F. Cassim, N. Reyns, S. Blond, J. D. Guieu, A. Destee, and L. Defebvre Subthalamic nucleus stimulation modulates motor cortex oscillatory activity in Parkinson's disease Brain, February 1, 2004; 127(2): 408 - 419. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Silberstein, A. A. Kuhn, A. Kupsch, T. Trottenberg, J. K. Krauss, J. C. Wohrle, P. Mazzone, A. Insola, V. Di Lazzaro, A. Oliviero, et al. Patterning of globus pallidus local field potentials differs between Parkinson's disease and dystonia Brain, December 1, 2003; 126(12): 2597 - 2608. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-L. Houeto, M.-L. Welter, P.-B. Bejjani, S. T. du Montcel, A.-M. Bonnet, V. Mesnage, S. Navarro, B. Pidoux, D. Dormont, P. Cornu, et al. Subthalamic Stimulation in Parkinson Disease: Intraoperative Predictive Factors Arch Neurol, May 1, 2003; 60(5): 690 - 694. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E. Anderson, N. Postupna, and M. Ruffo Effects of High-Frequency Stimulation in the Internal Globus Pallidus on the Activity of Thalamic Neurons in the Awake Monkey J Neurophysiol, February 1, 2003; 89(2): 1150 - 1160. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B-P Bejjani, I Arnulf, J-L Houeto, D Milea, S Demeret, B Pidoux, P Damier, P Cornu, D Dormont, and Y Agid Concurrent excitatory and inhibitory effects of high frequency stimulation: an oculomotor study J. Neurol. Neurosurg. Psychiatry, April 1, 2002; 72(4): 517 - 522. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. J.G. Vingerhoets, J.-G. Villemure, P. Temperli, C. Pollo, E. Pralong, and J. Ghika Subthalamic DBS replaces levodopa in Parkinson's disease: Two-year follow-up Neurology, February 12, 2002; 58(3): 396 - 401. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.G. Nutt, S.L. Rufener, J.H. Carter, V.C. Anderson, R. Pahwa, J.P. Hammerstad, and K.J. Burchiel Interactions between deep brain stimulation and levodopa in Parkinson's disease Neurology, November 27, 2001; 57(10): 1835 - 1842. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Hammerstad, K. Burchiel, V. Anderson, J. Nutt, J. L. Houeto, A. M. Bonnet, B. Pidoux, D. Dormont, P. Cornu, Y. Agid, et al. Failure of long-term pallidal stimulation corrected by subthalamic stimulation in PD Neurology, August 14, 2001; 57(3): 566 - 567. [Full Text]
|
|
|
|
|
|
J. A. Obeso, M. C. Rodriguez, J. Guridi, L. Alvarez, E. Alvarez, R. Macias, J. L. Juncos, M. DeLong, and A. E. Lang Lesion of the Basal Ganglia and Surgery for Parkinson Disease Arch Neurol, July 1, 2001; 58(7): 1165 - 1166. [Full Text] [PDF]
|
|
|
|
|
|
R. Chen, R. R. Garg, A. M. Lozano, and A. E. Lang Effects of internal globus pallidus stimulation on motor cortex excitability Neurology, March 27, 2001; 56(6): 716 - 723. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Brown, A. Oliviero, P. Mazzone, A. Insola, P. Tonali, and V. Di Lazzaro Dopamine Dependency of Oscillations between Subthalamic Nucleus and Pallidum in Parkinson's Disease J. Neurosci., February 1, 2001; 21(3): 1033 - 1038. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Kishore, D. Panikar, S. Balakrishnan, S. Joseph, and S. Sarma Evidence of functional somatotopy in GPi from results of pallidotomy Brain, December 1, 2000; 123(12): 2491 - 2500. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Saint-Cyr, L. L. Trepanier, R. Kumar, A. M. Lozano, and A. E. Lang Neuropsychological consequences of chronic bilateral stimulation of the subthalamic nucleus in Parkinson's disease Brain, October 1, 2000; 123(10): 2091 - 2108. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Houeto, P. B. Bejjani, P. Damier, C. Staedler, A. M. Bonnet, B. Pidoux, D. Dormont, P. Cornu, and Y. Agid Failure of long-term pallidal stimulation corrected by subthalamic stimulation in PD Neurology, September 12, 2000; 55(5): 728 - 730. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Pillon, C. Ardouin, P. Damier, P. Krack, J. L. Houeto, H. Klinger, A. M. Bonnet, P. Pollak, A. L. Benabid, and Y. Agid Neuropsychological changes between ""off"" and ""on"" STN or GPi stimulation in Parkinson's disease Neurology, August 8, 2000; 55(3): 411 - 418. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. E. Lang Surgery for Parkinson Disease: A Critical Evaluation of the State of the Art Arch Neurol, August 1, 2000; 57(8): 1118 - 1125. [Full Text] [PDF]
|
|
|
|
|
|
J. O. Dostrovsky, R. Levy, J. P. Wu, W. D. Hutchison, R. R. Tasker, and A. M. Lozano Microstimulation-Induced Inhibition of Neuronal Firing in Human Globus Pallidus J Neurophysiol, July 1, 2000; 84(1): 570 - 574. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Jahanshahi, C. M. A. Ardouin, R. G. Brown, J. C. Rothwell, J. Obeso, A. Albanese, M. C. Rodriguez-Oroz, E. Moro, A. L. Benabid, P. Pollak, et al. The impact of deep brain stimulation on executive function in Parkinson's disease Brain, June 1, 2000; 123(6): 1142 - 1154. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B.-P. Bejjani, D. Gervais, I. Arnulf, S. Papadopoulos, S. Demeret, A.-M. Bonnet, P. Cornu, P. Damier, and Y. Agid Axial parkinsonian symptoms can be improved: the role of levodopa and bilateral subthalamic stimulation J. Neurol. Neurosurg. Psychiatry, May 1, 2000; 68(5): 595 - 600. [Abstract] [Full Text]
|
|
|
|
|
|
W. J. Lombardi, R. E. Gross, L. L. Trepanier, A. E. Lang, A. M. Lozano, and J. A. Saint-Cyr Relationship of lesion location to cognitive outcome following microelectrode-guided pallidotomy for Parkinson's disease: Support for the existence of cognitive circuits in the human pallidum Brain, April 1, 2000; 123(4): 746 - 758. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Houeto, P. Damier, P. B. Bejjani, C. Staedler, A. M. Bonnet, I. Arnulf, B. Pidoux, D. Dormont, P. Cornu, and Y. Agid Subthalamic Stimulation in Parkinson Disease: A Multidisciplinary Approach Arch Neurol, April 1, 2000; 57(4): 461 - 465. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Hallett and I. Litvan Evaluation of surgery for Parkinson's disease: A Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology Neurology, December 1, 1999; 53(9): 1910 - 1910. [Full Text] [PDF]
|
|
|
|
 |
|
 B.-P. Bejjani, P. Damier, I. Arnulf, L. Thivard, A.-M. Bonnet, D. Dormont, P. Cornu, B. Pidoux, Y. Samson, and Y. Agid Transient Acute Depression Induced by High-Frequency Deep-Brain Stimulation N. Engl. J. Med., May 13, 1999; 340(19): 1476 - 1480. [Full Text] [PDF]
|
|
|
|
|
|
T. E. Kimber, C. S. Tsai, J. Semmler, B. P. Brophy, and P. D. Thompson Voluntary movement after pallidotomy in severe Parkinson's disease Brain, May 1, 1999; 122(5): 895 - 906. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. E. Gross, W. J. Lombardi, A. E. Lang, J. Duff, W. D. Hutchison, J. A. Saint-Cyr, R. R. Tasker, and A. M. Lozano Relationship of lesion location to clinical outcome following microelectrode-guided pallidotomy for Parkinson's disease Brain, March 1, 1999; 122(3): 405 - 416. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Samii, I. M. Turnbull, A. Kishore, M. Schulzer, E. Mak, S. Yardley, and D. B. Calne Reassessment of unilateral pallidotomy in Parkinson's disease: A 2-year follow-up study Brain, March 1, 1999; 122(3): 417 - 425. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. L. Trepanier, J. A. Saint-Cyr, A. M. Lozano, and A. E. Lang Neuropsychological consequences of posteroventral pallidotomy for the treatment of Parkinson's disease Neurology, July 1, 1998; 51(1): 207 - 215. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
