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Treatment of Parkinson’s disease (continued)

  • B.

    _______________________: lesions of the internal globus pallidus (pallidotomy) have been attempted to remove the “inhibition” and improve the symptoms of tremor and rigidity.

    • -

      proved to be moderately effective, but did not usually improve the bradykinesia.

  • C.

    ____________________________________________: a relatively recent FDA approved treatment (1997) for Parkinson’s disease is the implantation of stimulating electrodes in the subthalamic nucleus, which can be turned on by the patient (thoracic implant).

    • -

      shown to improve slowness of movement (akinesia, bradykinesia).

  • D.

    ________________________: involves implanting directly into the striatum (caudate or putamen or both) undifferentiated cells from adrenal chromaffin cells or mesencephalic substantia nigra neurons.

    • -

      has provided extremely limited relief of symptoms, and has been shown to have a high rate of perisurgical complications.

    • -

      implants from adrenal chromaffin cells usually do not survive and provide no DA to the striatum.

    • -

      slightly more promising for mesencephalic tissue implant (some DA cells shown to survive, but patients remained symptomatic).

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