Randomized trial of pallidotomy versus medical therapy for Parkinson's disease.
Published
Journal Article
Thirty-six patients with Parkinson's disease (PD) were randomized to either medical therapy (N = 18) or unilateral GPi pallidotomy (N = 18). The primary outcome variable was the change in total Unified Parkinson's Disease Rating Scale (UPDRS) score at 6 months. Secondary outcome variables included subscores and individual parkinsonian symptoms as determined from the UPDRS. At the six month follow-up, patients receiving pallidotomy had a statistically significant reduction (32% decrease) in the total UPDRS score compared to those randomized to medical therapy (5% increase). Following surgery, patients' showed improvement in all the cardinal motor signs of PD including tremor, rigidity, bradykinesia, gait and balance. Drug-induced dyskinesias were also markedly improved. Although the greatest improvement occurred on the side contralateral to the lesion, significant ipsilateral improvement was also observed for bradykinesia, rigidity and drug-induced dyskinesias. A total of twenty patients have been followed for 2 years to assess the effect of time on clinical outcome. These patients have shown sustained improvement in the total UPDRS (p < 0.0001), "off" motor (p < 0.0001) and complications of therapy subscores (p < 0.0001). Sustained improvement was also seen for tremor, rigidity, bradykinesia, percent on time and drug-induced dyskinesias.
Full Text
Duke Authors
Cited Authors
- Vitek, JL; Bakay, RAE; Freeman, A; Evatt, M; Green, J; McDonald, W; Haber, M; Barnhart, H; Wahlay, N; Triche, S; Mewes, K; Chockkan, V; Zhang, J-Y; DeLong, MR
Published Date
- May 2003
Published In
Volume / Issue
- 53 / 5
Start / End Page
- 558 - 569
PubMed ID
- 12730989
Pubmed Central ID
- 12730989
International Standard Serial Number (ISSN)
- 0364-5134
Digital Object Identifier (DOI)
- 10.1002/ana.10517
Language
- eng
Conference Location
- United States