Inhibition of levodopa effects by internal pallidal stimulation

Mov Disord. 1998 Jul;13(4):648-52. doi: 10.1002/mds.870130407.


We report three patients with bilateral GPi stimulation for stage 4 Parkinson's disease (PD) with severe levodopa-induced dyskinesias (LID). In all three it was possible to completely inhibit LID using high-stimulation parameters. Parallel to complete inhibition of LID, an inhibition of the anti-akinetic effect of levodopa was observed, whereas, at the same time, rigidity was markedly improved. GPi stimulation is adaptable over time, and stimulation parameters have to be programmed according to off- and on-period motor symptoms. The main interest of stimulation is the possibility of finding a compromise between LID alleviation in on-phase without loss of the beneficial motor effects and improvement in parkinsonism in off-phase. In some patients, residual dyskinesias have to be accepted so as not to aggravate on-period motor symptoms by a presumed overinhibition of basal ganglia outflow.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiparkinson Agents / administration & dosage
  • Antiparkinson Agents / adverse effects*
  • Combined Modality Therapy
  • Dominance, Cerebral / drug effects
  • Dominance, Cerebral / physiology
  • Dyskinesia, Drug-Induced / diagnosis
  • Dyskinesia, Drug-Induced / physiopathology
  • Dyskinesia, Drug-Induced / therapy*
  • Electric Stimulation Therapy*
  • Electrodes, Implanted
  • Globus Pallidus / drug effects*
  • Globus Pallidus / physiopathology
  • Humans
  • Levodopa / administration & dosage
  • Levodopa / adverse effects*
  • Male
  • Middle Aged
  • Parkinson Disease / physiopathology
  • Parkinson Disease / therapy*


  • Antiparkinson Agents
  • Levodopa