Neurotransmitter levels in basal ganglia during levodopa and deep brain stimulation treatment in Parkinson's disease. Issue 5 (7th September 2014)

• Record Type: Journal Article
• Authors: Zsigmond, Peter; Nord, Maria; Kullman, Anita; Diczfalusy, Elin; Wårdell, Karin; Dizdar, Nil
• Is Part Of: Neurology and clinical neuroscience. Volume 2:Issue 5(2014:Sep.)
• Page Start: 149
• Page End: 155
• Publication Date: 2014-09-07
• Subjects: Neurology -- Periodicals; Neurosciences -- Periodicals; 616.8
• DOI: 10.1111/ncn3.109
• Languages: English
• ISSNs: 2049-4173

Abstract

<abstract abstract-type="main" id="ncn3109-abs-0001"> <title>Abstract</title> <sec id="ncn3109-sec-0001" sec-type="section"> <title>Background</title> <p>The mechanism by which deep brain stimulation of the nucleus subthalamicus improves Parkinson's disease symptoms remains unclear. In a previous perioperative study, we showed that there might be alterations of neurotransmitter levels in the globus pallidum interna during deep brain stimulation of the nucleus subthalamicus.</p> </sec> <sec id="ncn3109-sec-0002" sec-type="section"> <title>Aim</title> <p>In this study, we examined whether deep brain stimulation of the nucleus subthalamicus and levodopa infusion interact and affect the levels of neurotransmitters.</p> </sec> <sec id="ncn3109-sec-0003" sec-type="section"> <title>Methods</title> <p>Five patients with advanced Parkinson's disease took part in the study. During subthalamic nucleus surgery, microdialysis catheters were inserted bilaterally in the globus pallidum interna and unilaterally in the right putamen. A study protocol was set up and was followed for 3 days. Levodopa infusion with and without concomitant bilateral deep brain stimulation of the nucleus subthalamicus was also carried out.</p> </sec> <sec id="ncn3109-sec-0004" sec-type="section"> <title>Results</title> <p>The putaminal dopamine levels increased during deep brain stimulation of the nucleus subthalamicus. In addition, an increase of gamma amino buturic acid concentrations in the globus pallidum interna during deep brain stimulation of the nucleus subthalamicus and during levodopa infusion was found.</p> </sec> <sec id="ncn3109-sec-0005" sec-type="section"> <title>Conclusions</title> <p>These findings provide evidence that the subthalamic nucleus has a direct action on the substantia nigra pars compacta, and that deep brain stimulation of the nucleus subthalamicus might indirectly release putaminal dopamine. There is also evidence that deep brain stimulation of the nucleus subthalamicus interferes with levodopa therapy resulting in higher levels of levodopa in the brain, explaining why it is possible to decrease levodopa medication after deep brain stimulation surgery.</p> </sec> </abstract>