The neurophysiology and effect of deep brain stimulation in a patient with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced parkinsonism.

Abstract

Parkinsonism caused by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) exposure was first identified in intravenous drug users. This neurotoxicant has since been used extensively in nonhuman primates to induce an experimental model of Parkinson disease (PD). In this study, the authors examined the intraoperative physiological characteristics and efficacy of subthalamic nucleus deep brain stimulation (DBS) in 1 of only 4 known living patients with MPTP-induced parkinsonism. The physiological recordings were consistent with recordings from MPTP-treated primates and humans with PD, thus providing further validation for the MPTP model in the study of the neurophysiology of the nigrostriatal dopaminergic deficit in PD. Furthermore, DBS produced a significant clinical improvement in this patient similar to the improvement seen after DBS in patients with idiopathic PD. This unique case has important implications for translational research that employs the MPTP-primate model for symptomatic therapy in PD.