• Arun Singh, Stefan Kammermeier, Jan Hinnerk Mehrkens, and Kai Bötzel.
• Department of Neurology, Klinikum Großhadern, Ludwig-Maximilian University, Marchioninistr. 15, 81377 Munich, Germany.
• J. Neurol. Neurosurg. Psychiatr.. 2012 Oct 1;83(10):1022-6.

BackgroundsDeep brain stimulation is widely used for the treatment of movement disorders such as Parkinson's disease and dystonia. After the implantation of electrodes an immediate improvement of clinical symptoms has been described. It is unclear, whether movement kinematics are also changed by this 'microlesion effect'.MethodsTo gain further insight into these mechanisms, we studied arm, hand and finger movements preoperatively and immediately after the implantation of deep brain stimulation electrodes in patients with Parkinson's disease and dystonia.ResultsAfter implantation and without stimulation there was a clear reduction of clinical symptoms in both groups, as has been described previously. However, movement velocity was affected differently. Parkinsonian patients showed increased movement velocity postoperatively, whereas dystonic patients were significantly slower after electrode implantation.ConclusionsLesioning and stimulation of these structures have the same beneficial clinical effects. Furthermore we suggest that globus pallidus internum lesions act by inhibiting a system which mainly acts upon muscular tone and limb posture whereas subthalamic stimulation or lesion causes a more unspecific disinhibition of movements.

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