Journal of Neurology

, Volume 252, Issue 2, pp 208–211 | Cite as

High frequency stimulation of the subthalamic nucleus is efficacious in Parkin disease

  • Luigi M. A. Romito
  • Maria F. Contarino
  • Daniele Ghezzi
  • Angelo Franzini
  • Barbara Garavaglia
  • Alberto Albanese
ORIGINAL COMMUNICATION

Abstract

High frequency stimulation (HFS) of the subthalamic nucleus (STN) is an efficacious symptomatic treatment for Parkinson’s disease. We have analysed the genetic status of a series of consecutive parkinsonian patients implanted for STN HFS and compared the outcome of five carrying mutations in the parkin gene with that of the non-parkin group. All patients obtained sustained control of PD symptoms and achieved functional improvement; in the parkin group the UPDRS motor score improved by 56.4%, the levodopa equivalent daily dosage was reduced by 75.5%. Postoperative medications were reduced more in parkin than in non-parkin patients. We confirm that the current inclusion criteria for STN HFS do not exclude patients carrying mutations in the parkin gene; their clinical outcome is comparable to that of the non-parkin group.

Key words

neurostimulation deep brain stimulation Parkinson’s disease surgery subthalamic stimulation PARK2 parkin disease 

Abbreviations

HFS

High-frequency stimulation

PD

Parkinson’s disease

LEDD

Levodopa equivalent daily dose

STN

Subthalamic nucleus

UPDRS

Unified Parkinson’s disease rating scale

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Khan NL, Graham E, Critchley P, Schrag AE, Wood NW, Lees AJ, Bhatia KP,Quinn N (2003) Parkin disease: a phenotypic study of a large case series. Brain 126:1279–1292Google Scholar
  2. 2.
    Lucking CB, Durr A, Bonifati V, Vaughan J, De Michele G, Gasser T, Harhangi BS, Meco G, Denefle P, Wood NW, Agid Y, Brice A (2000) Association between early-onset Parkinson’s disease and mutations in the parkin gene. French Parkinson’s Disease Genetics Study Group. N Engl J Med 342:1560–1567CrossRefPubMedGoogle Scholar
  3. 3.
    Schrag A, Ben Shlomo Y, Brown R, Marsden CD, Quinn N (1998) Youngonset Parkinson’s disease revisited–clinical features, natural history, and mortality. Mov Disord 13:885–894Google Scholar
  4. 4.
    Romito LM, Scerrati M, Contarino MF, Bentivoglio AR, Tonali P, Albanese A (2002) Long-term follow up of subthalamic nucleus stimulation in Parkinson’s disease. Neurology 58:1546–1550Google Scholar
  5. 5.
    Charles PD, Van Blercom N, Krack P, Lee SL, Xie J, Besson G, Benabid AL, Pollak P (2002) Predictors of effective bilateral subthalamic nucleus stimulation for PD. Neurology 59:932–934PubMedGoogle Scholar
  6. 6.
    Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatry 55:181–184Google Scholar
  7. 7.
    Moro E, Scerrati M, Romito LM, Roselli R, Tonali P, Albanese A (1999) Chronic subthalamic nucleus stimulation reduces medication requirements in Parkinson’s disease. Neurology 53:85–90PubMedGoogle Scholar
  8. 8.
    Ferroli P, Franzini A, Marras C, Maccagnano E, D’Incerti L, Broggi G (2004) A simple method to assess accuracy of deep brain stimulation electrode placement: pre-operative stereotactic CT+ postoperative MR image fusion. Stereotact Funct Neurosurg 82:14–19Google Scholar
  9. 9.
    Kitada T, Asakawa S, Minoshima S, Mizuno Y, Shimizu N (2000) Molecular cloning, gene expression, and identification of a splicing variant of the mouse parkin gene. Mamm Genome 11:417–421CrossRefPubMedGoogle Scholar
  10. 10.
    Romito LM, Raja M, Daniele A, Contarino MF, Bentivoglio AR, Barbier A, Scerrati M, Albanese A (2002) Transient mania with hypersexuality after surgery for high frequency stimulation of the subthalamic nucleus in Parkinson’s disease. Mov Disord 17:1371–1374CrossRefPubMedGoogle Scholar
  11. 11.
    Periquet M, Latouche M, Lohmann E, Rawal N, De Michele G, Ricard S, Teive H, Fraix V, Vidailhet M, Nicholl D, Barone P, Wood NW, Raskin S, Deleuze JF, Agid Y, Durr A, Brice A (2003) Parkin mutations are frequent in patients with isolated early-onset parkinsonism. Brain 126:1271–1278CrossRefPubMedGoogle Scholar

Copyright information

© Steinkopff Verlag 2005

Authors and Affiliations

  • Luigi M. A. Romito
    • 1
    • 2
  • Maria F. Contarino
    • 2
  • Daniele Ghezzi
    • 1
  • Angelo Franzini
    • 1
  • Barbara Garavaglia
    • 1
  • Alberto Albanese
    • 1
    • 2
  1. 1.Istituto Nazionale Neurologico Carlo BestaMilanoItaly
  2. 2.Università Cattolica del Sacro CuoreMilanoItaly

Personalised recommendations