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Deep Brain Stimulation of the Pallidum is Effective and Might Stabilize Striatal D(2) Receptor Binding in
R J Beukers1, M F Contarino, J D Speelman
1Department of Neurology, Academic Medical Centre, University of Amsterdam Amsterdam, Netherlands.
Purpose:
To assess clinical efficacy of deep brain stimulation (DBS) of the pallidum in Myoclonus-Dystonia (M-D) patients, and to compare pre- and post-operative striatal dopamine D2 receptor availability.
Methods:
Clinical parameters were scored using validated rating scales for myoclonus and dystonia. Dopamine D2 receptor binding of three patients was studied before surgery and approximately 2 years post-operatively using 123-I-iodobenzamide Single Photon Emission Computed Tomography. Two patients who did not undergo surgery served as controls.
Results:
Clinically, the three M-D patients improved 83, 17, and 100%, respectively on the myoclonus rating scale and 78, 23, and 65% on the dystonia rating scale after DBS. Dopamine D2 receptor binding did not change after surgery. In the two control subjects, binding has lowered further.
Conclusion:
These findings confirm that DBS of the pallidum has beneficial effects on motor symptoms in M-D and suggest this procedure might stabilize dopamine D2 receptor binding.
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