Effect of GPi pallidotomy on motor function in XXXX .

@entity1 @entity227 @entity2003 @entity3034 @entity73 @entity2358 @entity910 @entity191
The major motor disturbances in @entity191 are thought to be caused by overactivity of the internal segment of the globus pallidus (GPi), in large part due to excessive drive from the subthalamic nucleus. The excessive inhibitory activity of GPi is thought to "brake' the motor thalamus and the cortical motor system to produce the @entity73 , @entity2003 , and poverty of movement characteristic of @entity191 states. To test the hypothesis that direct reduction of Gpi activity can improve motor function, we studied the effect of GPi pallidotomy in 14 @entity1 . The location of the GPi nucleus was confirmed by microelectrode recording before lesion creation. Standardised videotape recordings before and after operation were randomised and scored by a "blinded' evaluator. 6 months after surgery, total motor score in the "off" state had improved by 30% and the total @entity910 score by 33%. The gait score in the "off" state improved by 15% and a composite postural instability and gait score by 23%. After surgery there was almost total elimination of drug-induced @entity2358 ( @entity910 ), with a 92% reduction on the side contralateral to the pallidotomy. No @entity1 had @entity227 . In these @entity1 GPi pallidotomy enhanced motor performance, reduced @entity910 , improved gait, and eliminated the neural elements responsible for @entity3034 -induced @entity910 .
