Related Experiment Video
Updated: Jul 14, 2026
06:45
Rating L-DOPA-Induced Dyskinesias in the Unilaterally 6-OHDA-Lesioned Rat Model of Parkinson's Disease
Published on: October 4, 2021
Motor cortex stimulation for levodopa-resistant akinesia: case report
Naoki Tani1, Youichi Saitoh, Haruhiko Kishima
1Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Summary
Motor cortex stimulation (MCS) offers significant, long-term improvement for levodopa-resistant akinesia patients. This innovative treatment shows promise for Parkinson
Area of Science:
- Neuroscience
- Neurosurgery
- Neurology
Background:
- Levodopa-resistant akinesia presents a significant challenge in Parkinson's disease management.
- Progressive supranuclear palsy and pure akinesia are considered in differential diagnosis for severe akinesia without tremor or rigidity.
Observation:
- A patient with severe akinesia and gait disturbance, unresponsive to levodopa, was treated with motor cortex stimulation (MCS).
- Initial assessment included high-frequency repetitive transcranial magnetic stimulation (rTMS) of the primary motor cortex, which yielded dramatic improvement.
Findings:
- Chronic subdural electrodes implanted over the bilateral motor cortex resulted in remarkable improvement in the Unified Parkinson's Disease Rating Scale over one year.
- The patient demonstrated a four-fold increase in walking speed post-surgery.
- H2 15O PET imaging revealed increased regional cerebral blood flow (rCBF) in the supplementary motor area and dorsolateral prefrontal cortex following MCS.
Implications:
- Motor cortex stimulation (MCS) emerges as a potential alternative therapeutic strategy for patients experiencing akinesia, particularly those with Parkinson's disease resistant to levodopa.
- The positive response to both rTMS and chronic MCS suggests a viable treatment avenue for specific patient populations.
Related Concept Videos
01:24Parkinson's Disease: Treatment
Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of its...
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of its...
01:20Motor Unit Stimulation
When the neuron of a motor unit fires an action potential, it triggers a series of events, leading to a twitch contraction in the muscle fibers. The process of excitation-contraction coupling is crucial in relaying the action potential to the muscle fibers.
The latent period of contraction marks the onset of excitation-contraction coupling, when the action potential propagates across the sarcolemma, preparing the muscle fibers for contraction. As the fibers enter the contraction phase, the...
The latent period of contraction marks the onset of excitation-contraction coupling, when the action potential propagates across the sarcolemma, preparing the muscle fibers for contraction. As the fibers enter the contraction phase, the...
01:24Parkinson Disease l: Introduction
Parkinson’s disease is a chronic, progressive neurodegenerative disorder that primarily affects movement. It is characterized by motor symptoms such as resting tremors, muscle rigidity, bradykinesia (slowness of movement), and postural instability. Patients may notice hand tremors at rest, stiffness during movement, or a shuffling gait. In addition to motor features, non-motor symptoms include sleep disturbances, mood and behavioral changes, constipation, and cognitive impairment, all of which...