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Assessment of pallidotomy on physiological and cognitive functions after stereotactic pallidotomy

Research Project

Project/Area Number 09670650
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Neurology
Research InstitutionShinshu University

Principal Investigator

HASHIMOTO Takao  Shinshu University Hospital, Shinshu University School of Medicine, Associate Professor, 医学部・附属病院, 講師 (20201709)

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)
Project Period (FY) 1997 – 1998
Project Status Completed (Fiscal Year 1998)
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)
KeywordsParkinson's disease / stereotactic surgery / pallidotomy / cogonitive function / long-latency reflex
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.

Report

(3 results)
  • 1998 Annual Research Report   Final Research Report Summary
  • 1997 Annual Research Report
  • Research Products

    (21 results)

All Other

All Publications (21 results)

  • [Publications] 橋本隆男: "不随意運動の臨床-成人例-" 脳と発達. 29・3. 193-198 (1997)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] 橋本隆男: "Parkinson病における症状の生理学的機序" 最新医学. 52・7. 6-10 (1997)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] 橋本隆男: "パーキンソン病および関連疾患" 神経治療学. 14・4. 309-311 (1997)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] 柳澤信夫: "パーキンソン病の起立性低血圧に対するL-threo-Dopsの効果" 脳と神経. 50・2. 157-163 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] 橋本隆男: "振戦・無動・筋固縮" 医学のあゆみ. 186・1. 51-54 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Jerrold L.Vitek: "Microelectrode-guided pallidotomy technical approach and its application in medically intractable Parkinson's disease" Journal of Neurosurgery. 88・1. 1027-1043 (1998)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] 橋本隆男: "神経症候・疾患の臨床評価マニュアル" ライフサイエンス出版株式会社, 9 (1996)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Takao Hashimoto, et al: "Pathophysiology of involuntary movements in adults." No to Hattatsu. 29-1. 193-198 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Takao Hashimoto, et al.: "Physiological mechanisms of Parkinson's symptoms." Saishin Igaku. 52-7. 6-10 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Takao Hashimoto, et al.: "Parkinson's disease and other parkinsonian disorders." Neurological therapeutics (Tokyo). 14-4. 309-311 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Nobuo Yanagisawa et al: "Effects of L-threo-Dops on orthostatic hypotention in Parkinson's disease." Brain Nerve (Tokyo). 50-2. 157-163 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Takao Hashimoto et al.: "Tremor, akinesia and rigidity." Igaku no Ayumi. 186-1. 51-54 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Vitek JL,et al.: "Microelectrode-guided pallidotomy : technical approach and its application in medically intractable parkinson's disease" J Neurosurg. 88. 1027-1043 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] Takao Hashimoto: Classification of involuntary movements, In : Manual of Clinical Assessment of Neurological Disorders, ed.by Hirai S.Life Science, Pub.Co., Tokyo, 77-85 (1996)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1998 Final Research Report Summary
  • [Publications] 橋本隆男: "不随意運動の臨床-成人例-" 脳と発達. 29・3. 193-198 (1997)

    • Related Report
      1998 Annual Research Report
  • [Publications] 橋本隆男: "Parkinson病における症状の生理学的機序" 最新医学. 52・7. 6-10 (1997)

    • Related Report
      1998 Annual Research Report
  • [Publications] 橋本隆男: "パーキンソン病および関連疾患" 神経治療学. 14・4. 309-311 (1997)

    • Related Report
      1998 Annual Research Report
  • [Publications] 柳澤信夫: "パーキンソン病の超立性低血圧に対するL-thred-Dopsa効果" 脳と神経. 50・2. 157-163 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 橋本隆男: "振戦・無動・筋固縮" 医学のあゆみ. 186・1. 51-54 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] Jerrold L.Vitek: "Mieroelectrode-guided pallidotomy : technical approach and its application in medically intractable Parkinson's disease" Journal of Neurosurgery. 88・1. 1027-1043 (1998)

    • Related Report
      1998 Annual Research Report
  • [Publications] 橋本隆男: "神経症候・疾患の臨床評価マニュアル" ライフサイエンス出版株式会社, 9 (1996)

    • Related Report
      1998 Annual Research Report

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Published: 1997-04-01   Modified: 2016-04-21  

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