Subthalamic stimulation in Parkinson disease: a multidisciplinary approach

Arch Neurol. 2000 Apr;57(4):461-5. doi: 10.1001/archneur.57.4.461.


Background: High-frequency stimulation of the subthalamic nucleus constitutes a therapeutic advance for severely disabled patients with Parkinson disease.

Objective: To evaluate the efficacy and safety of continuous bilateral high-frequency stimulation of the subthalamic nucleus in patients with Parkinson disease.

Design: A prospective study of patients with Parkinson disease treated at a university hospital.

Patients and methods: Electrodes were implanted bilaterally in the subthalamic nucleus of 23 consecutive patients with Parkinson disease who responded well to levodopa but had severe motor complications. There were 16 men and 7 women (mean +/- SEM age, 53 +/- 2 years) who had a mean +/- SEM disease duration of 14.7 +/- 1.0 years. Targets were determined by 3-dimensional magnetic resonance imaging, combined with intraoperative electrophysiologic recordings and stimulation.

Results: Six months after surgery, motor disability, levodopa-induced motor fluctuations, dyskinesias, and the daily dose of levodopa equivalent decreased significantly by 67%, 78%, 77%, and 61%, respectively, compared with the preoperative state. No significant morbidity was observed, except transient depression in 4 patients.

Conclusions: The beneficial effects of subthalamic stimulation depend on (1) the criteria used for patient selection, (2) the precision with which the subthalamic nucleus is targeted (dependent on the 3-dimensional magnetic resonance imaging and the intraoperative electrophysiologic and clinical assessments), and (3) the long-term postoperative adjustment of stimulation variables.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Electric Stimulation Therapy / adverse effects
  • Electric Stimulation Therapy / methods*
  • Electrodes, Implanted
  • Female
  • Humans
  • Levodopa / adverse effects
  • Levodopa / therapeutic use
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Parkinson Disease / surgery
  • Parkinson Disease / therapy*
  • Prospective Studies
  • Sickness Impact Profile
  • Stereotaxic Techniques
  • Subthalamic Nucleus / physiopathology*
  • Subthalamic Nucleus / surgery*
  • Treatment Outcome


  • Levodopa