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Parkinson's disease: neurosurgery at an earlier stage?
  1. V Mesnage1,
  2. J–L Houeto1,
  3. M–L Welter1,
  4. Y Agid1,
  5. B Pidoux2,
  6. D Dormont3,
  7. P Cornu4
  1. 1Centre d’Investigation Clinique, Fédération de Neurologie and INSERM U 289, Hôpital de la Salpêtriére, Paris, France
  2. 2Fédération de Neurophysiologie Clinique, Hôpital de la Salpêtriére
  3. 3Service de Neuroradiologie, Hôpital de la Salpêtriére
  4. 4Service de Neurochirurgie, Hôpital de la Salpêtriére
  1. Correspondence to:
 Dr Y Agid, Centre d'Investigation Clinique, Hôpital de la Salpêtriére, 47 boulevard de l'Hôpital, 75013 Paris, France;
 agid{at}ccr.jussieu.fr

https://doi.org/10.1136/jnnp.73.6.778

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    Bilateral high frequency stimulation of the subthalamic nucleus (STN) is an alternative treatment for advanced forms of levodopa-responsive Parkinson's disease (PD) with severe motor complications.1 Most patients so far treated in this way had their disease for an average of 15 years,2 no longer worked, were socially isolated and dependent on their families. As this neurosurgical treatment remarkably improves parkinsonian motor disability and levodopa induced dyskinaesias, we wondered whether operating earlier during the course of the disease would enable patients to maintain their previous social and professional status. A retrospective analysis of 41 successive severely disabled PD patients operated in our department3 showed that four of them, who had disease duration of less than …

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    Footnotes

    • Competing interests: none declared.