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JOURNAL OF NEUROSURGICAL SCIENCES

A Journal on Neurosurgery


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Journal of Neurosurgical Sciences 2017 February;61(1):77-87

DOI: 10.23736/S0390-5616.16.03246-X

Copyright © 2015 EDIZIONI MINERVA MEDICA

language: English

Minimally invasive motor cortex stimulation for Parkinson’s disease

Angelo LAVANO , Giusy GUZZI, Marisa DE ROSE, Mary ROMANO, Attilio DELLA TORRE, Giuseppe VESCIO, Federica DEODATO, Francesco LAVANO, Giorgio VOLPENTESTA

Department of Neurosurgery, “Magna Graecia” University, Catanzaro, Italy


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Extra/intradural strip electrode implantation on motor cortex may be possible minimally invasive neurosurgical method for therapeutic neuromodulation in Parkinson’s disease (PD). The aim of this review is to assess motor cortex stimulation (MCS) efficacy and safety in advanced PD. Sixteen published articles were included with a total of 130 PD patients treated. In almost all results are from prospective observational open labeled study, only in two studies blinded assessment was carried out. Negative results are reported in three studies. Significant improvement in motor symptoms with remarkable effect on axial symptoms, L-dopa-induced dyskinesia and quality of life are outlined in thirteen studies. Surgical technique involved implant of four-contact strip electrode over M1 in epidural space with exception of few cases in which implant was carried out in subdural space. Surgical procedure was performed contralateral to most affected side with exception of five patients in which it was carried at dominant hemisphere; in four patients electrode implant was bilateral but stimulation was carried out simultaneously on both sides only in two cases. Complications and adverse events occurred very rarely for extradural MCS whereas with higher rate for subdural MCS. Based on review of current literature extra/intradural MCS represents an alternative to deep brain stimulation (DBS) to surgically treat PD patients who are not candidate for DBS. MCS is a minimally invasive neuromodulation procedure with low morbidity-mortality that can relieve all three major symptoms of PD on both sides simultaneously and bilaterally; it has significant effectiveness on axial symptoms, gait disturbances and therapy complications.


KEY WORDS: Implantable neurostimulators - Motor cortex - Neurosurgical procedures - Parkinson disease

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Publication History

Issue published online: November 16, 2016
Article first published online: April 17, 2015
Manuscript accepted: April 15, 2015
Manuscript received: February 17, 2015

Cite this article as

Lavano A, Guzzi G, De Rose M, Romano M, Della Torre A, Vescio G, et al. Minimally invasive motor cortex stimulation for Parkinson’s disease. J Neurosurg Sci 2017;61:77-87. DOI: 10.23736/S0390-5616.16.03246-X

Corresponding author e-mail

lavano@unicz.it