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Dr. Okun

Post of the Week: GPi DBS for Restless Legs in Parkinson's Disease

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Dear forum members,

 

A number of years ago it was reported that GPi DBS and pallidotomy could both help RLS in Dystonia and Parkinson's disease respectively. This group proposes the GPi as a potential target for RLS in PD. Also remember that after STN DBS for PD, RLS may emerge as a result of over-aggressive dopaminergic medication reduction.

 

Sleep Med. 2012 Sep 17. pii: S1389-9457(12)00261-4. doi: 10.1016/j.sleep.2012.06.007. [Epub ahead of print]

Globus pallidus deep brain stimulation for refractory idiopathic restless legs syndrome.

Ondo WG, Jankovic J, Simpson R, Jimenez-Shahed J.

 

Source

Department of Neurology, University of Texas Health Science Center at Houston, Houston, TX, United States. Electronic address: William.Ondo@uth.tmc.edu.

 

Abstract

 

OBJECTIVE:

The neuroanatomic substrate of restless legs syndrome (RLS) is unknown. Deep brain stimulation (DBS) of the globus pallidus internus (GPi) and other targets is used to treat Parkinson's disease (PD), and RLS symptoms associated with PD have been reported to improve when GPi DBS is used in that population. We wish to test whether GPi DBS can improve idiopathic RLS.

METHOD:

We implanted bilateral GPi DBS in a subject with refractory idiopathic RLS.

RESULTS:

The GPi cells recordings were dissimilar to those of PD. Clinically, the patient had a good, but far from complete, response, which more prominently affected the urge to move and involuntary movements than the painful component.

CONCLUSION:

DBS for RLS remains investigational.

Copyright © 2012. Published by Elsevier B.V.

PMID: 22995627 [PubMed - as supplied by publisher]

 

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