Comparison of clinical motor outcomes between unilateral pallidotomy versus subthalamotomy in patients with idiopathic Parkinson's Disease

Abstract

BackgroundPallidotomy and subthalamotomy are two common surgical procedures that target specific brain regions to alleviate motor symptoms. This study aims to compare the clinical motor outcomes of these two surgical techniques in patients with idiopathic Parkinson's disease.MethodsBetween 2021 to 2024 in Al-Salam hospital, the general authority of healthcare, Port Said, Suez Canal University Hospital, Ismailia, and affiliated hospitals, A total of 20 patients with idiopathic Parkinson's disease were randomly divided into two equal groups of 10 patients each. One group underwent unilateral pallidotomy, while the other group was treated with subthalamotomy. ResultsSubthalamotomy showed significant improvement in UPDRS III from 56.60±5.04 to 28.40±6.7 (49.8%) and from 35.40±6.06 to 14.80±2.74 (58.2%) in the Off and On periods retrospectively. Schwab & England ADL score improved from 42.0±10.32 to 86.00±8.43 (51.2%) and from 70.0±9.42 to 95.0±5.27 (26.3%) in the Off and On periods retrospectively. LDED reduce by 50.65% in comparison to LDED pre-operative.Pallidotomy showed significant improvement in UPDRS III from 48.50±8.97 to 27.0±11.48 (44.3%) and from 26.20±7.55 to 12.90±8.41 (50.8%) in the Off and On periods retrospectively. Schwab & England ADL score improved from 37.0±9.48 to 78.0±14.76 (52.6%) and from 59.0±7.37 to 90.0±12.47 (34.4%) in the Off and On periods retrospectively, No LDED reduction occurred.ConclusionSubthalamotomy may offer slight advantages in reducing medication requirements and improving activities of daily living. Subthalamotomy was associated with a higher risk of adverse effects compared to pallidotomy. However, Pallidotomy is advised if the main complaint of patient is dyskinesia.