PT  - JOURNAL ARTICLE
AU  - L Alvarez
AU  - R Macias
AU  - N Pavón
AU  - G López
AU  - M C Rodríguez-Oroz
AU  - R Rodríguez
AU  - M Alvarez
AU  - I Pedroso
AU  - J Teijeiro
AU  - R Fernández
AU  - E Casabona
AU  - S Salazar
AU  - C Maragoto
AU  - M Carballo
AU  - I García
AU  - J Guridi
AU  - J L Juncos
AU  - M R DeLong
AU  - J A Obeso
TI  - Therapeutic efficacy of unilateral subthalamotomy in Parkinson’s disease: results in 89 patients followed for up to 36 months
AID  - 10.1136/jnnp.2008.154948
DP  - 2009 Sep 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 979--985
VI  - 80
IP  - 9
4099  - http://jnnp.bmj.com/content/80/9/979.short
4100  - http://jnnp.bmj.com/content/80/9/979.full
SO  - J Neurol Neurosurg Psychiatry2009 Sep 01; 80
AB  - Background: Stereotactic thermocoagulative lesions of the subthalamic nucleus (STN) have been shown to induce significant motor improvement in patients with Parkinson’s disease (PD).Patients and methods: 89 patients with PD were treated with unilateral subthalamotomy. 68 patients were available for evaluations after 12 months, 36 at 24 months and 25 at 36 months.Results: The Unified Parkinson’s Disease Rating Scale (UPDRS) motor scores improved significantly contralaterally to the lesion in the “off” and “on” states throughout the follow-up, except for the “on” state at the last evaluation. Axial features and signs ipsilateral to the lesion progressed steadily throughout the study. Levodopa daily doses were significantly reduced by 45%, 36% and 28% at 12, 24 and 36 months post-surgery. 14 patients (15%) developed postoperative hemichorea-ballism which required pallidotomy in eight. These 14 patients had significantly higher dyskinesia scores (levodopa induced) preoperatively than the entire cohort.Conclusion: Unilateral subthalamotomy was associated with significant and sustained motor benefit contralateral to the lesion. Further work is needed to ascertain what factors led to severe, persistent chorea-ballism in a subset of patients. Subthalamotomy may be considered an option in circumstances when deep brain stimulation is not viable.