Abstract:
:Several structures including subthalamic nucleus (STN), the caudal zona incerta (cZI), the prelemniscal radiation (Raprl), and the thalamic ventral intermediate nucleus (Vim) have been reported to be useful for improving symptoms of Parkinson's disease (PD). However, the effect of each target is still unclear. Therefore, we investigated each structure's effects and adverse effects using a directional lead implanted in the posterior STN adjacent to the cZI and Raprl in two patients with tremor-dominant PD. In Case 1, maximal reduction of tremor was obtained by stimulation toward the Vim, and stimulation toward the thalamic reticular nucleus (TRN) reduced verbal fluency, but did not induce dysarthria. In Case 2, maximal reduction of tremor was obtained by stimulation toward the dorsal STN and Raprl. Maximal reduction of rigidity was achieved by stimulation toward the dorsal STN, Raprl, and cZI. Bradykiensia was improved by stimulation in all directions, but dyskinesia and dysarthria were evoked by stimulation toward the dorsal STN and cZI. The directional lead may elucidate the stimulation effect of each structure and broaden target selection depending on patients' symptoms and adverse effects.
journal_name
Neurol Med Chir (Tokyo)journal_title
Neurologia medico-chirurgicaauthors
Sasagawa A,Enatsu R,Kitagawa M,Mikami T,Nakayama-Kamada C,Kuribara T,Hirano T,Arihara M,Mikuni Ndoi
10.2176/nmc.tn.2020-0210subject
Has Abstractpub_date
2020-12-15 00:00:00pages
622-628issue
12eissn
0470-8105issn
1349-8029journal_volume
60pub_type
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