STN stimulation and neuroprotection in Parkinson’s disease—when beautiful theories meet ugly facts
- Correspondence to: Professor Peter C Warnke The University of Liverpool, Department of Neuroscience, The Walton Centre for Neurology and Neurosurgery, Lower Lane, Liverpool L97LJ, UK; p.c.warnkeliv.ac.uk
STN stimulation does not halt progression of Parkinson’s disease
Repeated claims have been made that inactivation of the subthalamic nucleus (STN) is a neuroprotective measure.1–3 It was postulated that by suppression of the glutamatergic STN, glutamate mediated excitotoxicity exerted on the substantia nigra could be reduced, if not abolished. The paper by Hilker et al in this issue (see page 1217) deals with this topic by looking longitudinally at patients who have undergone successful STN stimulation. The investigators have taken the approach of using objective functional imaging employing 18F-DOPA positron emission tomography (PET), an established objective measure of biological progression in Parkinson’s disease, which was then correlated with clinical progression. They were able to show convincingly that STN stimulation did not halt the progression of Parkinson’s disease.
They have also shown …
