Pallidotomy

Producing a lesion in the posteroventral portion of the medial GLOBUS PALLIDUS to treat PARKINSON DISEASE and other extrapyramidal disorders. The placement of the lesion is aided by STEREOTACTIC TECHNIQUES and imaging procedures.

Also Known As:

Networked: 492 relevant articles (84 outcomes, 55 trials/studies)

Relationship Network

Therapy Context: Research Results

Experts

1.	Lozano, A M: 7 articles (12/2002 - 01/2000)
2.	Lozano, Andres M: 6 articles (10/2013 - 04/2002)
3.	Jankovic, J: 6 articles (01/2007 - 02/2000)
4.	Lang, A E: 6 articles (12/2002 - 01/2000)
5.	Jankovic, Joseph: 5 articles (07/2013 - 06/2003)
6.	Lang, Anthony E: 5 articles (07/2010 - 04/2003)
7.	Hashimoto, Takao: 5 articles (01/2010 - 05/2003)
8.	de Haan, R J: 5 articles (07/2009 - 09/2001)
9.	Schuurman, P R: 5 articles (07/2009 - 09/2001)
10.	Bosch, D A: 5 articles (07/2009 - 09/2001)

Related Diseases

1.	Dyskinesias (Dyskinesia) 05/15/2009 - "Then she started having opisthotonus lasting 20 seconds to an hour several times/day, but over 6 years abnormal movements are markedly improved, and not returned to pre-pallidotomy level. " 01/01/1998 - "At 6-month follow up, a cohort of our first 40 patients undergoing pallidotomy demonstrated the following mean improvements when examined after drug withdrawal (off) and under optimal medication (on): total motor off scores-31%; total off activities of daily living scores-30%; and total on dyskinesias-63% (contralateral and ipsilateral dyskinesias improved 82% and 50%, respectively). " 11/01/1997 - "The efficacy of surgery in the case of hemiballismus demonstrates that pallidotomy can be an effective treatment for this condition and suggests that patterned neuronal activity in the GPi is important in the mechanism of hyperkinetic disorders." 04/01/2000 - "Even when positive clinical results of GPi pallidotomy have recently been reported from several centers, the patients seem to have improved relatively little, the dyskinesias excepted, and the rate of side effects has been quite high. " 02/01/2000 - "According to Visual Analog Scale scores, unilateral pallidotomy significantly improved dyskinesias (P < 0.05) but no other symptoms. "
2.	Parkinson Disease (Parkinson's Disease) 10/09/1997 - "Posteroventral medial pallidotomy sometimes produces striking improvement in patients with advanced Parkinson's disease, but the studies to date have involved small numbers of patients and short-term follow-up. " 09/01/2000 - "Neuropsychological changes 3 months (43 patients) and 12 months (27 patients) after microelectrode-guided pallidotomy for PD are reported in a series of 44 consecutive patients with the disease, who improved neurologically, as measured by the Unified Parkinson's Disease Rating Scale (UPDRS) in both the "off' (p<0.001) and best "on" (p<0.001) states. " 01/01/1998 - "Because interruption of pallidal outflow signals by pallidotomy is believed to play an important role in the motor improvement in Parkinson's disease, the anatomical relationship of the two major pallidofugal tracts, namely the ansa lenticularis (AL) and the fasciculus lenticularis (FL) to the Leksell pallidotomy target (LPT) were studied. " 11/01/2004 - "With the rapid increase in provision of deep brain stimulation for Parkinson's disease, the efficacy of pallidotomy in symptom alleviation appears to be increasingly ignored. " 07/20/2002 - "Although significant improvement of motor function following bilateral pallidotomy for the treatment of Parkinson's disease has been proved, the cognitive sequelae have not been clearly defined. "
3.	Tremor (Tremors) 01/01/2000 - "We here report that although all the motor signs were significantly improved 6 months after pallidotomy, the temporal sequence of tremor response was different from those of other symptoms." 06/01/2000 - "Contemporary combination of pallidotomy and thalamotomy is effective and safe in treating regular parkinsonian symptoms and intractable tremor." 08/01/1994 - "Ventroposterior pallidotomy has been shown to improve not only rigidity and tremor, but also akinesia. " 11/01/1997 - "Based on anatomic studies, surgical misadventures, and empirical observations, there was an abrupt shift regarding the favored target to treat parkinsonian tremor to the thalamus, and most neurosurgeons abandoned pallidotomy in the 1960s. " 04/01/1997 - "The goals of this study were to analyze the effect of pallidotomy on parkinsonian tremor and to ascertain whether an association exists between microrecording findings and tremor outcome. "
4.	Dystonia (Limb Dystonia) 07/01/1998 - "We conclude that pallidotomy is a safe and effective treatment in medically refractory cases of generalized dystonia." 02/01/2011 - "Although the efficacy of both pallidotomy and pallidal deep brain stimulation in dystonia has been encouraging, the evidence is still limited." 01/01/2008 - "This result supports the efficacy of STN deep brain stimulation in dystonia patients, even those with prior pallidotomy." 07/01/1998 - "We systematically evaluated the efficacy of both unilateral and bilateral stereotactic pallidotomy in eight patients with generalized dystonia. " 01/01/2011 - "The authors of the present study have acquired relatively good clinical results, even in patients who previously received bilateral thalamotomy and unilateral pallidotomy for DYT1+ primary generalized dystonia."
5.	Hypokinesia (Bradykinesia) 10/01/1998 - "Posteroventral pallidotomy seems to be beneficial in reducing bradykinesia of upper limb movements but may have "costs" to movement patterning, particularly for reach to grasp movements to objects of differing sizes. " 09/01/2003 - "The UPDRS motor subscale ratings were similar to those reported in the literature: pallidotomy improved the overall motor score and the contralateral bradykinesia + rigidity score, but not the gait + posture score. " 05/01/1999 - "Therefore, any improvement in bradykinesia after pallidotomy must be related to mechanisms other than restoration of pallidothalamocortical connectivity. " 09/01/1998 - "Despite the clinical efficacy of pallidotomy while patients were "off," bradykinesia of elbow flexion movements while patients were "on" is not affected by pallidotomy. " 01/01/1999 - "To the extent that MT and RT are quantitative measures of bradykinesia, our study provides evidence that this parkinsonian feature improves after pallidotomy."

Related Drugs and Biologics

1.	Levodopa (L Dopa)
2.	Dihydroxyphenylalanine (Dopa)
3.	Amantadine (Aman)
4.	Cholinergic Antagonists (Anticholinergics)
5.	N-Methylaspartate (NMDA)
6.	Valproic Acid (Valproate, Semisodium)
7.	Carbon Monoxide
8.	Glucose (Dextrose)
9.	N 30
10.	Dopamine (Intropin)

Related Therapies and Procedures

1.	Deep Brain Stimulation
2.	Microelectrodes
3.	Activities of Daily Living (ADL)
4.	Drug Therapy (Chemotherapy)
5.	Transplantation (Transplant Recipients)