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Parkinson's patients get bilateral benefits with unilateral brain stim

electrical impulses to block abnormal nerve signals that cause tremors and other symptoms of Parkinson's. A surgeon implants an electrical lead in either the subthalamic nucleus (STN) or the globus pallidus interna (GPi), two areas of the brain that contribute to movement. The stimulating electrode is connected to a control unit, implanted near the collarbone, that determines how much and how frequently stimulation should occur.

Typically, leads are implanted on the side of the brain opposite to where the effect is needed. So leads placed on the left side of the brain alleviate symptoms on the right side of the body. This is the first study to show the implants significantly improve a patient's symptoms on the same side of the body.

"While on stimulation, patients in both groups improved motor performance of the upper extremity, opposite side of stimulation, by approximately 30 percent," said Alberts. "But when we looked to see if they had any effect on the same side of the body, we found that our patients had experienced about a 14 to 17 percent improvement."

Getting substantial improvements on both sides of the body from just one implant is important, because this is brain surgery, said Michael Okun, Co-director of the Movement Disorders Center at the University of Florida and co-author of the study.

"We may learn from future studies that not everyone requires two devices, and this will cut the risk for some patients in half," he said.

The study also found no significant differences in motor function or force production between patients who had stimulation at the STN or GPi sites, a finding Alberts believes to be equally important as the bilateral effects of stimulation.

"STN stimulation has been touted as the target of choice, but we found GPi stimulation to be equally effective in improving upper extremity motor function," said Alberts. "There is some evidence that th
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Contact: David Terraso
david.terraso@icpa.gatech.edu
404-385-2966
Georgia Institute of Technology
21-Oct-2004


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