Dopamine transporter changes after unilateral deep brain stimulation in progressive Parkinson’s disease: a case report
A 56-year-old right-handed female PD patient with no family history of PD developed early symptoms of rigidity and mild tremor on the right side in 1995. She accepted left pallidotomy in 1999. After the surgery, pharmacological therapy was started using sustained-release carbidopa-levodopa, adamantanamine, and benzhexol hydrochloride to control her symptoms. By February 2011, her medication was proving ineffective, so the surgeons accepted her as a candidate for DBS to the subthalamic nucleus. In 2011, the motor symptoms in her left limbs were more severe than in the right limb. Her Unified Parkinson’s Disease Rating Scale (UPDRS) score was 19 in the left limb and 11 in the right. After considering the financial circumstances of her family, the surgeons chose to treat the right subthalamic nucleus.\nIn February 2011, 11C-CFT PET was performed after 12 hours off medication to observe dopamine transporter distribution. On the following day, the patient underwent unilateral DBS surgery to the right subthalamic nucleus. In January 2012, a follow-up 11C-CFT PET scan was performed in the “electrodes on” state after 12 hours off medication to assess the longitudinal effect of DBS on the subthalamic nucleus. The patient’s UPDRS and Hoehn and Yahr scores were assessed by the same neurologist on each occasion. The protocol used was approved by the ethics committee at Huashan Hospital, Fudan University, Shanghai, and all examinations were performed with the patient’s informed consent.