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