Intraoperative dopamine release during globus pallidus internus stimulation in Parkinson's disease

ABSTRACT Background It is still unclear whether dopamine (DA) levels correlate with Parkinson's disease (PD) severity or play a role in the mechanisms of high‐frequency stimulation (HFS). Methods We have used microdialysis to record pallidal DA in 5 patients with PD undergoing microelectrode‐gu...

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Published in:Movement disorders 2013-12, Vol.28 (14), p.2027-2032
Main Authors: Martinez, Raquel C.R., Hamani, Clement, de Carvalho, Milene Cristina, de Oliveira, Amanda Ribeiro, Alho, Eduardo, Navarro, Jessie, dos Santos Ghilardi, Maria Gabriela, Bor-Seng-Shu, Edson, Heinsen, Helmut, Otoch, José Pinhata, Brandão, Marcus Lira, Barbosa, Egberto Reis, Teixeira, Manoel Jacobsen, Fonoff, Erich Talamoni
Format: Article
Language:English
Subjects:
Aged
Biophysics
Chromatography, Liquid
deep brain stimulation
Deep Brain Stimulation - methods
dopamine
Dopamine - metabolism
Female
Globus Pallidus - physiology
Humans
Intraoperative Period
Male
Microdialysis
Middle Aged
motor symptoms
Movement disorders
Parkinson Disease - metabolism
Parkinson Disease - therapy
Parkinson's disease
Severity of Illness Index
Statistics as Topic
Time Factors
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Summary:ABSTRACT Background It is still unclear whether dopamine (DA) levels correlate with Parkinson's disease (PD) severity or play a role in the mechanisms of high‐frequency stimulation (HFS). Methods We have used microdialysis to record pallidal DA in 5 patients with PD undergoing microelectrode‐guided pallidotomy. Results We found that patients with more severe disease and, consequently, lower pallidal DA did poorly after pallidal lesions. In the operating room, 4 of 5 patients had a significant increase in DA levels during HFS (600%, on average). To test the hypothesis that DA was important for the effects of stimulation, we correlated the amelioration in rigidity observed in the operating room with pallidal DA release. Though rigidity was 56% better during stimulation, no correlation was found between such an improvement and DA release. Conclusions These findings suggest that additional mechanisms not directly dependent on pallidal DA release may be involved in the clinical effects of HFS of the globus pallidus internus. © 2013 International Parkinson and Movement Disorder Society
ISSN:0885-3185
1531-8257
DOI:10.1002/mds.25691