Treatment of Parkinson’s disease (continued)
_______________________: 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.
____________________________________________: 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).
________________________: 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).