1999 Fiscal Year Final Research Report Summary
DEEP BRAIN STIMULATION FOR THE TREATMENT OF INVOLUNTARY MOVEMENT DISORDERS
| Project/Area Number |
09470302
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Cerebral neurosurgery
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| Research Institution | NIHON UNIVERSITY |
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Principal Investigator |
KATAYAMA Yoichi SCHOOL OF ENGINEERING,NIHON UNIVERSITY,PROFESSOR, 医学部, 教授 (00125048)
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| Co-Investigator(Kenkyū-buntansha) |
HIRAYAMA Heruyasu SCHOOL OF MEDICINE,NIHON UNIVERSITY,ASSISTANT PROF., 医学部, 講師 (10189871)
YAMAMOTO Takamitsu SCHOOL OF MEDICINE,NIHON UNIVERSITY,ASSOCIATE PROF., 医学部, 助教授 (50158284)
SEKINE Yosifumi SCHOOL OF ENGINEERING,NIHON UNIVERSITY,PROFESSOR, 理工学部, 教授 (90059965)
KOSHINAGA Morimichi SCHOOL OF MEDICINE,NIHON UNIVERSITY,INSTRUCTOR, 医学部, 助手 (30267067)
KAWAMATA Tatsuro SCHOOL OF MEDICINE,NIHON UNIVERSITY,INSTRUCTOR, 医学部, 助手 (20234122)
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| Project Period (FY) |
1997 – 1999
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| Keywords | GLOBUS PALLIDUS / INVOLUNTARY MOVEMENT / PARKINSON'S DISEASE / SUBTHALAMIC NUCLEUS |
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| Research Abstract |
We studied about the effects of chronic deep brain stimulation for the treatment of involuntary movement disorders, and the results of a double blinded evaluation of the effects of globus pallidus (Gpi; n = 7) and subthalamic nucleus (STN; n = 11) stimulation in patients with advanced Parkinson's disease are summarized in this report. The patients were evaluated at 6-8 months after surgery. In order to determine the benefits afforded by the stimulation to the actual daily activities, the patients were maintained on-medication with optimal doses and schedules. The stimulation was turned off overnight for at least 12 hours. It was turned on in the morning (or maintained turned off), and the best and worst scores during daytime actibity were recorded, as on-period and off-period scores, respectively. A reduction in total motor score on the Unified Parkinson's Disease Rating Scale was clearly elicited by Gpi and STN stimulation at both the off-period (-57% and -29%, respectively) and the on-period (-36% and -25%, respectively). The difference in effects between Gpi and STN stimulation appeared to be due largely to an unintended difference in the patients preoperative symptoms. The benefits provided by stimulation to the actual daily activities appears to be limited in patients who have become unresponsive to a large dose of levodopa. Two advantages of Gpi and STN stimulation were identified. The stimulation can supplement a reduced action of levodopa during the off-period. Secondary, the stimulation can replace part of the action of levodopa during the on-period. More importantly, the stimulation improves the daily activities in dopa-intolerant patients who are being administered a small dose of levodopa because of unbearable side effects.
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