Study on the function of the basal ganglia and frontal cortex using depth microrecording and PET scan in relation to the outcome of pallidotomy for the treatment of rigid-akinesia-type Parkinson's disease.

Stereotactic posteroventral pallidotomy was carried out in 13 cases with rigid-akinesia-type Parkinson's disease with the aid of depth microrecording. The outcome of the pallidotomy was classified into four groups: excellent (6 cases), good (3 cases), moderate (3 cases) and fair (1 case). Electrophysiological study during the operation showed continuous high-frequency and high-amplitude spike discharges in the globus pallidus (GPi) in the excellent-response group. Before the operation, a PET study had revealed low regional cerebral glucose metabolism in the prefrontal area in all the patients. Unilateral sequential opposite finger movement induced less increase of regional cerebral blood flow both in the supplementary and primary motor area in the less effective-response groups. The indications of pallidotomy for the treatment of rigid-akinesia-type Parkinson's disease are discussed.