Somatosensory status of parkinsonian patients before and after chemothalamectomy

Proctor, Florry; Riklan, Manuel; Cooper, Irving S.; Teuber, Hans‐Lukas

doi:10.1212/wnl.13.11.906

Cited by 19 publications

(5 citation statements)

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“…Sensory symptoms in Parkinson`s disease (PD) are not uncommon [1–3]. It is a matter of debate whether sensory abnormalities in PD precede [1] or follow motor symptoms [4] or antiparkinson therapy [5] and whether they are of peripheral or central origin. Since the sensory sural nerve action potential amplitude (SNAP) was reported to be reduced in Parkin‐ associated PD [6], the aim of our study was to investigate whether there are sensory abnormalities in asymptomatic Parkin‐ mutation carriers preceding motor symptoms and thus help to determine the origin of somatosensory signs.…”

Section: Introductionmentioning

confidence: 99%

Somatosensory function in asymptomatic Parkin‐mutation carriers

Gierthmühlen

Schumacher

Deuschl

et al. 2010

Euro J of Neurology

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Section: Introductionmentioning

confidence: 99%

Somatosensory function in asymptomatic Parkin‐mutation carriers

Gierthmühlen

Schumacher

Deuschl

et al. 2010

Euro J of Neurology

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“…It is unclear whether these symptoms are of primary3 or of secondary origin attributable to motor symptoms such as rigidity and bradykinesia 4. Mutations in the PINK1 (PARK6) gene have been identified as one cause of recessively inherited parkinsonism 5.…”

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confidence: 99%

Somatosensory processing in a German family with PINK1 mutations: its potential role in Parkinson disease

Gierthmühlen

Lienau²,

Maag³

et al. 2009

Journal of Neurology, Neurosurgery & Psychiatry

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Background: It is unclear whether sensory symptoms in Parkinson disease (PD) are of primary or of secondary origin attributable to motor symptoms such as rigidity and bradykinesia.Objective: The aim of this study was to elucidate whether sensory abnormalities are present and may precede motor symptoms in familial parkinsonism by characterizing sensory function in symptomatic and asymptomatic PINK1 mutation carriers. Methods: Fourteen family members with PINK1 mutation and 14 healthy controls were examined clinically, with nerve conduction studies and quantitative sensory testing (QST). Results: Thresholds for mechanical detection, mechanical pain and pressure pain were higher in PINK1 mutation carriers compared to controls. Higher thresholds for mechanical detection, mechanical pain and pressure pain were even found in asymptomatic, clinically not or only mildly affected PINK1 mutation carriers. Conclusions: Data suggest that PINK1-associated PD is associated with a primary hypofunction of nociceptive and non-nociceptive afferent systems that can already be found at the time when motor signs of PD are only subtle. As nerve conduction studies did not reveal differences between PINK1 mutation carriers and controls, we propose that the somatosensory impairment is related to abnormal central somatosensory processing.

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“…In a recent study Proctor, Riklan, Cooper, and Teuber (1963) reported decrement in two-point discrimination and punctuate pressure thresholds immediately after chemothalamotomy. Significantly higher thresholds for punctuate pressure were still evident five months postoperatively.…”

Section: Resultsmentioning

confidence: 95%

Psychological aspects of diencephalotomy

Jurko¹,

Andy²

1964

Journal of Neurology, Neurosurgery & Psychiatry

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The short-and long-term effects of surgery of the basal ganglia on behaviour have received relatively little attention. In previous studies emphasis has been on the more immediate post-operative changes for evaluating the effects of surgical lesions on intellectual and perceptual functions. With respect to intelligence only one aspect, intelligence quotient (I.Q.), was emphasized. The objectives in this study were to evaluate several aspects of intelligence and simple perception for relatively longer post-operative periods.METHOD PATIENTS This study was done on 25 patients (10 men and 15 women). Mean age was 54-2 years (range 40-70 years); mean educational level 13-8 years; mean duration of illness 5 4 years (range 1-10 years). The patients all showed some degree of generalized Parkinson involvement. The chief complaints ranged from moderate and unilateral to quite severe and bilateral tremor and rigidity. All patients were right-handed, i.e., left brain dominant.SURGERY Unilateral brain lesions were made under local anaesthesia. A 20-gauge barrel electrode with a 4 to 10 mm. non-insulated tip was inserted into the diencephalon through a frontal burr hole (Andy, 1959). The sites of coagulation were primarily in the posterior ventral thalamus-subthalamic region (Andy, Jurko, and Sias, 1963 514following intervals: one week pre-operatively; five days post-operatively; two months post-operatively; six to eight months post-operatively; and one and a half to two years post-operatively. All patients were tested throughout the study by the same examiner.EVALUATION OF DATA Since the Wechsler adult intelligence scale is a test which gives well-defined numerical scores continuously distributed, mean scores could be obtained and appropriately compared pre-and postoperatively with the parametric t test. However, the tests in the visual-motor performance and the simple perception groups present scoring difficulties. Tests like the Bender-Gestalt are commonly evaluated by clinical judgment and there is no widely accepted method of numerical evaluation. Observations like those made for linear deviation in the memory-for-designs test are also difficult to present in numerical scores. For tests like trail making the standardized scoring is dependent upon the patient's ability easily to execute motor movements and do require modification when used on the Parkinson patient. The spiral aftereffect has such a limited spread of scores that it is usually evaluated in terms of a cut-off score (normal vs. abnormal). In view of these difficulties the most feasible presentation of the data for the visualmotor performance and simple perception groups appeared to be reduction to categorized form. Though this type of evaluation does not permit the use of the more exacting statistical methods possible with mean scores, it avoids a deceptive aura of mathematical rigour not inherent in these types of tests. Since pre-operative performance was near optimum and in only isolated instances was there a better score post-operatively, the follow-up ...

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Somatosensory status of parkinsonian patients before and after chemothalamectomy

Cited by 19 publications

References 0 publications

Somatosensory function in asymptomatic Parkin‐mutation carriers

Somatosensory function in asymptomatic Parkin‐mutation carriers

Somatosensory processing in a German family with PINK1 mutations: its potential role in Parkinson disease

Psychological aspects of diencephalotomy

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