Deep brain stimulation in Parkinson's disease following fetal nigral transplantation |
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| Authors: | Jan Herzog MD Oliver Pogarell MD Marcus O Pinsker MD Andreas Kupsch MD PhD Wolfgang H Oertel MD PhD Olle Lindvall MD PhD Günther Deuschl MD PhD Jens Volkmann MD PhD |
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| Institution: | 1. Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany;2. Department of Psychiatry, Ludwig‐Maximilians‐University, Munich, Germany;3. Department of Neurosurgery, Christian‐Albrechts‐University, Kiel, Germany;4. Department of Neurology, Charité Humboldt University, Berlin, Germany;5. Department of Neurology, Philipps‐University, Marburg, Germany;6. Section of Restorative Neurology, Wallenberg Neuroscience Centre, Lund, Sweden |
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| Abstract: | OFF‐period dyskinesias have been reported as a consequence of fetal nigral transplantation for Parkinson's disease. This type of dyskinesias may appear in patients even in the prolonged absence of antiparkinson medication and be aggravated by levodopa. Therefore, pharmacological therapeutic approaches in these patients are limited. Here we report two patients with bilateral fetal nigral grafts in the caudate and putamen subjected to deep brain stimulation (DBS) of the globus pallidus internus (GPi) or subthalamic nucleus (STN). Clinical assessment was performed according to UPDRS and the clinical dyskinesia rating scale. In both patients, we found significant improvement in OFF‐period symptoms as well as levodopa‐induced dyskinesias. However, only GPi‐DBS led to a significant reduction of OFF‐period dyskinesias whereas STN‐DBS did not influence dyskinesias unrelated to external dopaminergic application. These findings, based on two case reports, highlight the pivotal role of the GPi in mediating dyskinesia‐related neural activity within the basal ganglia loop. © 2008 Movement Disorder Society |
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| Keywords: | Parkinson's disease neural transplantation deep brain stimulation dyskinesias |
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