| Project/Area Number |
09670650
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Neurology
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| Research Institution | Shinshu University |
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Principal Investigator |
HASHIMOTO Takao Shinshu University Hospital, Shinshu University School of Medicine, Associate Professor, 医学部・附属病院, 講師 (20201709)
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| Co-Investigator(Kenkyū-buntansha) |
SHINDO Masaomi Center for Health Services, Shinshu University, Professor, 保健管理センター, 教授 (90020924)
柳沢 信夫 信州大学, 医学部, 教授 (00010025)
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| Project Period (FY) |
1997 – 1998
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| Project Status |
Completed (Fiscal Year 1998)
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| Budget Amount *help |
¥3,000,000 (Direct Cost: ¥3,000,000)
Fiscal Year 1998: ¥1,100,000 (Direct Cost: ¥1,100,000)
Fiscal Year 1997: ¥1,900,000 (Direct Cost: ¥1,900,000)
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| Keywords | Parkinson's disease / stereotactic surgery / pallidotomy / cogonitive function / long-latency reflex |
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| Research Abstract |
We studied the effects of posterior internal pallidal ablation (pallidotomy) on parkinsonian symptoms, cognitive function and the long-latency stretch reflex in 12 parkinsonian patients (6 men and 2 women). The surgery was performed using microelectrode and CT guiding. The mean age of the 12 study patients was 54.1 "+"12.6 years (range, 29 - 71) and the mean duration of Parkinson's disease was 6.5 "+" 5.2 (range, 2 - 18). Patients were evaluated according to the United Parkinson's Disease Rating Scale (UPDRS). The evaluations were rated during "wearing-off' period with medication. The 1-month mean subscale of Mentation, Behavior and Mood improved by 81.8% (p < 0.05 by paired t-test). The 1-month mean ADL subscale improved by 44.0% (p < 0.01) and the 1-month mean Motor Examination improved by 53.9% (p < 0.001). Surgery resulted in marked contralateral and moderate ipsilateral amelioration of limb rigidity and bradykinesia. Rest tremor was ameliorated on the contralateral side but not on the ipsilateral side. Neuropsychological testing was performed before and after the surgery in 4 patients. There was post-surgical decline on attention, memory and frontal lobe function within 1 month after surgery, but these functions recovered 1-3 months after surgery. This shot-term decline of cognitive function may be cause by surgical insult to the brain. Stretch reflex of the forearm flexors was measured before and after the surgery in 6 patients. The amplitude of the long-latency stretch reflex of the contralateral hand decreased after surgery. This change may be related to improvement of rigidity.
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