Skip to main content
SpringerLink
Log in

Motor cortex stimulation for Parkinson’s disease

  • Chapter
Operative Neuromodulation

Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 97/2))

Abstract

In 2000, Canavero and Paolotti reported the improvement of symptoms in a case of advanced Parkinson disease (PD), following chronic epidural motor cortex stimulation (MCS). In 2002, the same group reported the results obtained in 2 patients with PD. Unilateral MCS proved to be beneficial bilaterally. They concluded that MCS may represent a cost-effective alternative to deep brain stimulation. In 2003, Pagni promoted an Italian Multicenter Study and in June 2005 the results in the first 29 cases were reported. Any symptom of PD could be modulated by MCS, but improvement of different symptoms was variable and unpredictable, with some patients being unresponsive. L-Dopa induced dyskinesias, painful dystonia and motor fluctuations were satisfactorily controlled. In the author’s series, 2 patients were unresponsive and 5 patients showed a clinical improvement, particularly evident in the off-medication state; UPDRS-III mean improvement was 30% at 3 months and 22% at 12 months. Quality of life (QOL) also improved. Assessment by the Parkinon’s disease quality of life (PDQL) scale showed a mean decrease by 26% at 12 months. No complication or adverse events were observed. These preliminary data indicated the possibility to modulate PD symptoms by MCS. Several unsettled issues remain such as the optimal electrode position, the best stimulation parameters, the usefulness of unilateral versus bilateral stimulation, the prognostic factors for best selection of patients, and the optimal assessment of clinical effects. The mechanisms of MCS may be only the subject of hypothesis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 299.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Afsharpour S (1985) Topographical projection of the cerebral cortex to the subthalamic nucleus. J Comp Neurol 236: 14–28

    Article  PubMed  CAS  Google Scholar 

  2. Bentivoglio AR, Cavallo MA, Cioni B, Contarino F, Eleopra R, Lavano A, Mazzone P, Meglio M, Signorelli CD, Sturiale C, Valzania F, Zeme S, Zenga F, Pagni CA (2005) Motor cortex stimulation for movement disorders In: Meglio M, Krames E (eds) Proceedings of the 7th Meeting of the International Neuromodulation Society. Medimond, Bologna, pp 5–14

    Google Scholar 

  3. Bentivoglio AR, Cavallo MA, Cioni B, Contarino F, Eleopra R, Lavano A, Mazzone P, Meglio M, Signorelli CD, Sturiale C, Valzania F, Zeme S, Zenga F, Pagni CA (2005) Motor cortex stimulation for movement disorders In: Meglio M (ed) Proceedings of the 14th Meeting of the World Society for Stereotactic and Functional Neurosurgery. Medimond, Bologna, pp 89–97

    Google Scholar 

  4. Brown JA, Lutsep H, Cramer SC, Weinand M (2003) Motor cortex stimulation for enhancement of recovery after stroke: case report. Neurol Res 25: 815–818

    Article  PubMed  Google Scholar 

  5. Brown P (2003) Oscillatory nature of human basal ganglia activity. Relationship to the pathophysiology of Parkinson’s disease. Mov Disord 18: 357–363

    Article  PubMed  Google Scholar 

  6. Bucy PC (1945) Special article: the neural mechanisms of athetosis and tremor. Ann Surg 122: 943–954

    Google Scholar 

  7. Canavero S, Paolotti R (2000) Extradural motor cortex stimulation for advanced Parkinson’s disease. Mov Disord 15: 169–171

    Article  PubMed  CAS  Google Scholar 

  8. Canavero S, Paolotti R, Bonincalzi V, Castellano G, Greco-Crasto S, Rizzo L, Davini O, Zenga F, Ragazzi P (2002) Extradural motor cortex stimulation for advanced Parkinson’s disease: report of two cases. J Neurosurg 97: 1208–1211

    PubMed  Google Scholar 

  9. Devos D, Labyt E, Derambure P, Bourriez JL, Cassim F, Reyns N, Blond S, Guieu JD, Destec A, Defevre L (2004) Subthalamic nucleus stimulation modulates motor cortex oscillatory activity in Parkinson’s disease. Brain 127: 408–419

    Article  PubMed  CAS  Google Scholar 

  10. Drouot X, Oshino S, Jarraya B, Besret L, Kishima H, Dauquet J, Lefaucheur JP, Dolle F, Condè F, et al (2004) Functional recovery in a primate model of Parkinson’s disease following motor cortex stimulation. Neuron 44: 769–778

    Article  PubMed  CAS  Google Scholar 

  11. Dusser de Barenne JG, McCulloch WS (1941) Suppression of motor responses obtained from a area 4 by stimulation of area 4s. J Neurophysiol 4: 311–323

    Google Scholar 

  12. Franzini A, Ferroli P, Servello D, Broggi G (2000) Reversal of thalamic hand syndrome by long term motor cortex stimulation. J Neurosurg 94: 873–875

    Google Scholar 

  13. Ikeguci M, Touge T, Nashiyama Y, Takeuchi H, Kurijama S, Ohkawa M (2003) Effects of successive repetitive transcranial magnetic stimulation on motor performances and brain perfusion in idiopathic Parkinson’s disease. J Neurol Sci 209: 41–46

    Article  Google Scholar 

  14. Katayama Y, Oshima H, Fukaya C, Kawamata T, Yamamoto T (2002) Control of post-stroke movement disorders using chronic motor cortex stimulation. Acta Neurochir Suppl 79: 89–92

    PubMed  CAS  Google Scholar 

  15. Khedr EM, Farweez HM, Islam H (2003) Therapeutic effect of repetitive transcranial magnetic stimulation on motor function in Parkinson’s disease patients. Eur J Neurol 10: 567–572

    Article  PubMed  CAS  Google Scholar 

  16. Kleiner-Fisman G, Fisman DN, Kahn FI, Sime E, Lozano A, Lang AE (2003) Motor cortical stimulation for Parkinsonism in multiple systemic atrophy. Arch Neurol 60: 1554–1558

    Article  PubMed  Google Scholar 

  17. Lefaucheur JP, Drouot X, Von Raison F, Menard-Lefaucheur I, Cesaro P, Nguyen JP (2004) Improvement of motor performances and modulation of cortical excitability by repetitive transcranial magnetic stimulation of the motor cortex in Parkinson’s disease. Clin Neurophysiol 115: 2530–2541

    Article  PubMed  Google Scholar 

  18. Mally J, Stone TW (1999) Improvement in Parkinsonian symptoms after repetitive transcranial magnetic stimulation. J Neurol Sci 162: 179–184

    Article  PubMed  CAS  Google Scholar 

  19. Nambu A, Tokuno H, Hamada I, Kita H, Imanishi M, Akazawa T, Ikeuki Y, Hasegawa N (2000) Excitatory cortical inputs to pallidal neurons via the subthalamic nucleus in the monkey. J Neurophysiol 84: 289–300

    PubMed  CAS  Google Scholar 

  20. Ohnishi T, Hayashi T, Okabe S, Nonaka K, Matsuda H, Imabayashi E, Watabe H, Miyake Y, Ogawa M, Teramoto N, Ohta Y, Ejima N, Sawada T, Ugawa Y (2004) Endogenous dopamine release induced by repetitive transcranial magnetic stimulation over the primary motor cortex: an (11C) raclopride positron emission tomography study in anesthetized macaque monkeys. Biol Psychiatry 55: 484–489

    Article  PubMed  CAS  Google Scholar 

  21. Pagni CA, Altibrandi MG, Bentivoglio AR, Caruso G, Cioni B, Contarino F, Insola A, Lavano A, Maina R, Mazzone P, Signorelli CD, Sturiale C, Valzania F, Zeme S, Zenga F (2005) Extradural motor cortex stimulation for Parkinsin’s disease: history and first results by the study group of the Italian Neurosurgical Society. Acta Neurochir Suppl 93: 113–119

    Article  PubMed  CAS  Google Scholar 

  22. Pagni CA, Zeme S, Zenga F, Maina R, Mastropietro A, Papurello D (2003) Further experience with extradural motor cortex stimulation for treatment of advanced Parkinson’s diseases. Report of 3 new cases. J Neurosurg Sci 47: 189–193

    PubMed  CAS  Google Scholar 

  23. Pagni CA, Zeme S, Zenga F, Maina R (2005) Extradural motor cortex stimulation in advanced Parkinson’s disease: the Turin experience. Neurosurg 57 ONS Suppl 3: ONS-402

    Google Scholar 

  24. Parent A, Hazrati LN (1995) Functional anatomy of the basal ganglia. The place of subthalamic nucleus and external pallidum in basal ganglia circuitry. Brain Res Rev 20: 128–154

    Article  PubMed  CAS  Google Scholar 

  25. Pascual-Leon A, Valls-Sole J, Brasil-Neto JP, Cammarota A, Grafman J, Hallett M (1994) Akinesia in Parkinson’s disease. Effects of subthreshold ripetitive transcranial megnetic stimulation of the motor cortex. Neurology 44: 892–898

    Google Scholar 

  26. Payoux F, Remy P, Damier P, Miloudi M, Loubinoux J, Pidoux B, Gaura V, Rascol O, Samson Y, Agid Y (2004) Subthalamic nucleus stimulation reduces abnormal motor cortical overactivity in Parkinson’s disease. Arch Neurol 61: 1307–1313

    Article  PubMed  Google Scholar 

  27. Patton HD, Amassian VE (1954) Single and multiple unit analysis of cortical stage of pyramidal tract activation. J Neurophysiol 17: 345–363

    PubMed  CAS  Google Scholar 

  28. Ridding MC, Inzelberg R, Rothwell JC (1995) Changes in excitability of motor cortical circuitry in patients with Parkinson’s disease. Ann Neurol 37: 181–188

    Article  PubMed  CAS  Google Scholar 

  29. Shimamoto H, Takasaki K, Shigemori M, Imaizumi T, Ayabe M, Shoji H (2001) Therapeutic effect and mechanism of repetitive transcranial magnetic stimulation in Parkinson’s disease. J Neurol 248Suppl 3: 48–52

    Article  Google Scholar 

  30. Siebner HR, Mentschel C, Auer C, Conrad B (1999) Repetitive transcranial stimulation has a beneficial effect on bradykinesia in Parkinson’s disease. Neuroreport 10: 589–594

    Article  PubMed  CAS  Google Scholar 

  31. Strafella A, Paus T, Fraraccio M, Dagher A (2003) Striatal Dopamine release induced by repetitive transcranial magnetic stimulation of the human motor cortex. Brain 126: 2609–2615

    Article  PubMed  Google Scholar 

  32. Strafella A, Vanderwerf Y, Sadikot AF (2004) Transcranial magnetic stimulation of the human motor cortex influences the neural activity of subthalamic nucleus. Eur J Neurosci 20: 2245–2249

    Article  PubMed  Google Scholar 

  33. Woolsey CN, Erickson T, Gilson WE (1979) Localization in somatic sensory and motor areas of human cerebral cortex as determined by direct recording of evoked potentials and electrical stimulation. J Neurosurg 51: 476–506

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neurochirurgia Funzionale e Spinale, Università Cattolica, Lg A. Gemelli 8, 00168, Roma, Italy

    Beatrice Cioni

Authors
  1. Beatrice Cioni
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Beatrice Cioni .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, University of Athens, Athens, Greece

    Damianos E. Sakas

  2. University Hospital of Wales, Cardiff, UK

    Brian A. Simpson

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer-Verlag

About this chapter

Cite this chapter

Cioni, B. (2007). Motor cortex stimulation for Parkinson’s disease. In: Sakas, D.E., Simpson, B.A. (eds) Operative Neuromodulation. Acta Neurochirurgica Supplements, vol 97/2. Springer, Vienna. https://doi.org/10.1007/978-3-211-33081-4_26

Download citation

  • DOI: https://doi.org/10.1007/978-3-211-33081-4_26

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-211-33080-7

  • Online ISBN: 978-3-211-33081-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation