Bilateral deep brain stimulation in Parkinson's disease : a multicentre study with 4 years follow-up. Commentary
Identifieur interne : 000260 ( France/Analysis ); précédent : 000259; suivant : 000261Bilateral deep brain stimulation in Parkinson's disease : a multicentre study with 4 years follow-up. Commentary
Auteurs : Hans-Joachim Freund [Allemagne] ; M. C. Rodriguez-Oroz [Espagne] ; J. A. Obeso [Espagne] ; A. E. Lang [Canada] ; J.-L. Houeto [France] ; P. Pollak [France] ; S. Rehncrona [France] ; J. Kulisevsky [Espagne] ; A. Albanese [Italie] ; J. Volkmann [Allemagne] ; M. I. Hariz [Royaume-Uni] ; N. P. Quinn [Royaume-Uni] ; J. D. Speelman [Pays-Bas] ; J. Guridi [Espagne] ; I. Zamarbide [Espagne] ; A. Gironell [Espagne] ; J. Molet [Espagne] ; B. Pascual-Sedano [Espagne] ; B. Pidoux [France] ; A. M. Bonnet [France] ; Yves Agid [France] ; J. Xie [France] ; A.-L. Benabid [France] ; A. M. Lozano [Canada] ; J. Saint-Cyr [Canada] ; L. Romito [Italie] ; M. F. Contarino [Italie] ; M. Scerrati [Italie] ; V. Fraix [France] ; N. Van Blercom [France]Source :
- Brain [ 0006-8950 ] ; 2005.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Deep brain stimulation (DBS) is associated with significant improvement of motor complications in patients with severe Parkinson's disease after some 6-12 months of treatment. Long-term results in a large number of patients have been reported only from a single study centre. We report 69 Parkinson's disease patients treated with bilateral DBS of the subthalamic nucleus (STN, n = 49) or globus pallidus internus (GPi, n = 20) included in a multicentre study. Patients were assessed preoperatively and at I year and 3-4 years after surgery. The primary outcome measure was the change in the 'off' medication score of the Unified Parkinson's Disease Rating Scale motor part (UPDRS-III) at 3-4 years. Stimulation of the STN or GPi induced a significant improvement (50 and 39%; P < 0.0001) of the 'off' medication UPDRS-III score at 3-4 years with respect to baseline. Stimulation improved cardinal features and activities of daily living (ADL) (P < 0.0001 and P < 0.02 for STN and GPi, respectively) and prolonged the 'on' time spent with good mobility without dyskinesias (P < 0.00001). Daily dosage of levodopa was significantly reduced (35%) in the STN-treated group only (P< 0.001). Comparison of the improvement induced by stimulation at I year with 3-4 years showed a significant worsening in the 'on' medication motor states of the UPDRS-II, ADL and gait in both STN and GPi groups, and speech and postural stability in the STN-treated group. Adverse events (AEs) included cognitive decline, speech difficulty, instability, gait disorders and depression. These were more common in patients treated with DBS of the STN. No patient abandoned treatment as a result of these side effects. This experience, which represents the first multicentre study assessing the long-term efficacy of either STN or GPi stimulation, shows a significant and substantial clinically important therapeutic benefit for at least 3-4 years in a large cohort of patients with severe Parkinson's disease.
Affiliations:
- Allemagne, Canada, Espagne, France, Italie, Pays-Bas, Royaume-Uni
- Angleterre, Catalogne, Grand Londres, Hollande-Septentrionale, Latium, Lombardie, Schleswig-Holstein, Île-de-France
- Amsterdam, Barcelone, Kiel, Londres, Milan, Paris, Rome
- Hôpital de la Salpêtrière
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Pascal:05-0453617Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Bilateral deep brain stimulation in Parkinson's disease : a multicentre study with 4 years follow-up. Commentary</title><author><name sortKey="Freund, Hans Joachim" sort="Freund, Hans Joachim" uniqKey="Freund H" first="Hans-Joachim" last="Freund">Hans-Joachim Freund</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology Heinrich-Heine- University Dusseldorf</s1><s3>DEU</s3><sZ>1 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Department of Neurology Heinrich-Heine- University Dusseldorf</wicri:noRegion><wicri:noRegion>Department of Neurology Heinrich-Heine- University Dusseldorf</wicri:noRegion></affiliation></author><author><name sortKey="Rodriguez Oroz, M C" sort="Rodriguez Oroz, M C" uniqKey="Rodriguez Oroz M" first="M. C." last="Rodriguez-Oroz">M. C. 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Pollak</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Service de Neurologie, University Hospital of Grenoble</s1><s3>FRA</s3><sZ>6 aut.</sZ><sZ>22 aut.</sZ><sZ>23 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>University Hospital of Grenoble</wicri:noRegion><wicri:noRegion>Service de Neurologie, University Hospital of Grenoble</wicri:noRegion></affiliation></author><author><name sortKey="Rehncrona, S" sort="Rehncrona, S" uniqKey="Rehncrona S" first="S." last="Rehncrona">S. Rehncrona</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Neurosurgery Service, Lund University Hospital</s1><s2>Sweden</s2><s3>FRA</s3><sZ>7 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Sweden</wicri:noRegion><wicri:noRegion>Lund University Hospital</wicri:noRegion><wicri:noRegion>Sweden</wicri:noRegion></affiliation></author><author><name sortKey="Kulisevsky, J" sort="Kulisevsky, J" uniqKey="Kulisevsky J" first="J." last="Kulisevsky">J. Kulisevsky</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Department of Neurology, Hospital de Sant Pau</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>8 aut.</sZ><sZ>16 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Albanese, A" sort="Albanese, A" uniqKey="Albanese A" first="A." last="Albanese">A. Albanese</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Istituto Nazionale Neurologico Carlo Besta and Universita Cattolica</s1><s2>Milan</s2><s3>ITA</s3><sZ>9 aut.</sZ><sZ>26 aut.</sZ><sZ>28 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Volkmann, J" sort="Volkmann, J" uniqKey="Volkmann J" first="J." last="Volkmann">J. Volkmann</name><affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Neurologische Klinik der Christian -Albrecht -Universität</s1><s2>Kiel</s2><s3>DEU</s3><sZ>10 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="2">Schleswig-Holstein</region><settlement type="city">Kiel</settlement></placeName></affiliation></author><author><name sortKey="Hariz, M I" sort="Hariz, M I" uniqKey="Hariz M" first="M. I." last="Hariz">M. I. Hariz</name><affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Institute of Neurology, Queen Square</s1><s2>London</s2><s3>GBR</s3><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Quinn, N P" sort="Quinn, N P" uniqKey="Quinn N" first="N. P." last="Quinn">N. P. Quinn</name><affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Institute of Neurology, Queen Square</s1><s2>London</s2><s3>GBR</s3><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Speelman, J D" sort="Speelman, J D" uniqKey="Speelman J" first="J. D." last="Speelman">J. D. Speelman</name><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>Department of Neurology, Academic Medical Center</s1><s2>Amsterdam</s2><s3>NLD</s3><sZ>13 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Guridi, J" sort="Guridi, J" uniqKey="Guridi J" first="J." last="Guridi">J. Guridi</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA</s1><s2>Pamplona</s2><s3>ESP</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Pamplona</wicri:noRegion></affiliation></author><author><name sortKey="Zamarbide, I" sort="Zamarbide, I" uniqKey="Zamarbide I" first="I." last="Zamarbide">I. Zamarbide</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA</s1><s2>Pamplona</s2><s3>ESP</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Pamplona</wicri:noRegion></affiliation></author><author><name sortKey="Gironell, A" sort="Gironell, A" uniqKey="Gironell A" first="A." last="Gironell">A. Gironell</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Department of Neurology, Hospital de Sant Pau</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>8 aut.</sZ><sZ>16 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Molet, J" sort="Molet, J" uniqKey="Molet J" first="J." last="Molet">J. Molet</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Department of Neurology, Hospital de Sant Pau</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>8 aut.</sZ><sZ>16 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Pascual Sedano, B" sort="Pascual Sedano, B" uniqKey="Pascual Sedano B" first="B." last="Pascual-Sedano">B. Pascual-Sedano</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Department of Neurology, Hospital de Sant Pau</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>8 aut.</sZ><sZ>16 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Pidoux, B" sort="Pidoux, B" uniqKey="Pidoux B" first="B." last="Pidoux">B. Pidoux</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Groupe Hospitalier Pitié-Salpetrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>19 aut.</sZ><sZ>20 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Bonnet, A M" sort="Bonnet, A M" uniqKey="Bonnet A" first="A. M." last="Bonnet">A. M. Bonnet</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Groupe Hospitalier Pitié-Salpetrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>19 aut.</sZ><sZ>20 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Agid, Y" sort="Agid, Y" uniqKey="Agid Y" first="Y." last="Agid">Yves Agid</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Groupe Hospitalier Pitié-Salpetrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>19 aut.</sZ><sZ>20 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation></author><author><name sortKey="Xie, J" sort="Xie, J" uniqKey="Xie J" first="J." last="Xie">J. Xie</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Service de Neurologie, University Hospital of Grenoble</s1><s3>FRA</s3><sZ>6 aut.</sZ><sZ>22 aut.</sZ><sZ>23 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>University Hospital of Grenoble</wicri:noRegion><wicri:noRegion>Service de Neurologie, University Hospital of Grenoble</wicri:noRegion></affiliation></author><author><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A.-L." last="Benabid">A.-L. Benabid</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Service de Neurologie, University Hospital of Grenoble</s1><s3>FRA</s3><sZ>6 aut.</sZ><sZ>22 aut.</sZ><sZ>23 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>University Hospital of Grenoble</wicri:noRegion><wicri:noRegion>Service de Neurologie, University Hospital of Grenoble</wicri:noRegion></affiliation></author><author><name sortKey="Lozano, A M" sort="Lozano, A M" uniqKey="Lozano A" first="A. M." last="Lozano">A. M. Lozano</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Division of Neurology, Toronto Western Hospital, Movement Disorders Clinic</s1><s2>Toronto</s2><s3>CAN</s3><sZ>4 aut.</sZ><sZ>24 aut.</sZ><sZ>25 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Saint Cyr, J" sort="Saint Cyr, J" uniqKey="Saint Cyr J" first="J." last="Saint-Cyr">J. Saint-Cyr</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Division of Neurology, Toronto Western Hospital, Movement Disorders Clinic</s1><s2>Toronto</s2><s3>CAN</s3><sZ>4 aut.</sZ><sZ>24 aut.</sZ><sZ>25 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Romito, L" sort="Romito, L" uniqKey="Romito L" first="L." last="Romito">L. Romito</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Istituto Nazionale Neurologico Carlo Besta and Universita Cattolica</s1><s2>Milan</s2><s3>ITA</s3><sZ>9 aut.</sZ><sZ>26 aut.</sZ><sZ>28 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Contarino, M F" sort="Contarino, M F" uniqKey="Contarino M" first="M. F." last="Contarino">M. F. Contarino</name><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Department of Neuroscience, Universitá Catttolica del Sacro Cuore</s1><s2>Rome</s2><s3>ITA</s3><sZ>27 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Scerrati, M" sort="Scerrati, M" uniqKey="Scerrati M" first="M." last="Scerrati">M. Scerrati</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Istituto Nazionale Neurologico Carlo Besta and Universita Cattolica</s1><s2>Milan</s2><s3>ITA</s3><sZ>9 aut.</sZ><sZ>26 aut.</sZ><sZ>28 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Fraix, V" sort="Fraix, V" uniqKey="Fraix V" first="V." last="Fraix">V. Fraix</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Service de Neurologie, University Hospital of Grenoble</s1><s3>FRA</s3><sZ>6 aut.</sZ><sZ>22 aut.</sZ><sZ>23 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>University Hospital of Grenoble</wicri:noRegion><wicri:noRegion>Service de Neurologie, University Hospital of Grenoble</wicri:noRegion></affiliation></author><author><name sortKey="Van Blercom, N" sort="Van Blercom, N" uniqKey="Van Blercom N" first="N." last="Van Blercom">N. Van Blercom</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Service de Neurologie, University Hospital of Grenoble</s1><s3>FRA</s3><sZ>6 aut.</sZ><sZ>22 aut.</sZ><sZ>23 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>University Hospital of Grenoble</wicri:noRegion><wicri:noRegion>Service de Neurologie, University Hospital of Grenoble</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">05-0453617</idno><date when="2005">2005</date><idno type="stanalyst">PASCAL 05-0453617 INIST</idno><idno type="RBID">Pascal:05-0453617</idno><idno type="wicri:Area/PascalFrancis/Corpus">000880</idno><idno type="wicri:Area/PascalFrancis/Curation">000443</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000818</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000818</idno><idno type="wicri:doubleKey">0006-8950:2005:Freund H:bilateral:deep:brain</idno><idno type="wicri:Area/Main/Merge">002E86</idno><idno type="wicri:Area/Main/Curation">002B46</idno><idno type="wicri:Area/Main/Exploration">002B46</idno><idno type="wicri:Area/France/Extraction">000260</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Bilateral deep brain stimulation in Parkinson's disease : a multicentre study with 4 years follow-up. Commentary</title><author><name sortKey="Freund, Hans Joachim" sort="Freund, Hans Joachim" uniqKey="Freund H" first="Hans-Joachim" last="Freund">Hans-Joachim Freund</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology Heinrich-Heine- University Dusseldorf</s1><s3>DEU</s3><sZ>1 aut.</sZ></inist:fA14><country>Allemagne</country><wicri:noRegion>Department of Neurology Heinrich-Heine- University Dusseldorf</wicri:noRegion><wicri:noRegion>Department of Neurology Heinrich-Heine- University Dusseldorf</wicri:noRegion></affiliation></author><author><name sortKey="Rodriguez Oroz, M C" sort="Rodriguez Oroz, M C" uniqKey="Rodriguez Oroz M" first="M. C." last="Rodriguez-Oroz">M. C. Rodriguez-Oroz</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA</s1><s2>Pamplona</s2><s3>ESP</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Pamplona</wicri:noRegion></affiliation></author><author><name sortKey="Obeso, J A" sort="Obeso, J A" uniqKey="Obeso J" first="J. A." last="Obeso">J. A. Obeso</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA</s1><s2>Pamplona</s2><s3>ESP</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Pamplona</wicri:noRegion></affiliation></author><author><name sortKey="Lang, A E" sort="Lang, A E" uniqKey="Lang A" first="A. E." last="Lang">A. E. Lang</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Division of Neurology, Toronto Western Hospital, Movement Disorders Clinic</s1><s2>Toronto</s2><s3>CAN</s3><sZ>4 aut.</sZ><sZ>24 aut.</sZ><sZ>25 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Houeto, J L" sort="Houeto, J L" uniqKey="Houeto J" first="J.-L." last="Houeto">J.-L. Houeto</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Groupe Hospitalier Pitié-Salpetrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>19 aut.</sZ><sZ>20 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P." last="Pollak">P. Pollak</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Service de Neurologie, University Hospital of Grenoble</s1><s3>FRA</s3><sZ>6 aut.</sZ><sZ>22 aut.</sZ><sZ>23 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>University Hospital of Grenoble</wicri:noRegion><wicri:noRegion>Service de Neurologie, University Hospital of Grenoble</wicri:noRegion></affiliation></author><author><name sortKey="Rehncrona, S" sort="Rehncrona, S" uniqKey="Rehncrona S" first="S." last="Rehncrona">S. Rehncrona</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Neurosurgery Service, Lund University Hospital</s1><s2>Sweden</s2><s3>FRA</s3><sZ>7 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Sweden</wicri:noRegion><wicri:noRegion>Lund University Hospital</wicri:noRegion><wicri:noRegion>Sweden</wicri:noRegion></affiliation></author><author><name sortKey="Kulisevsky, J" sort="Kulisevsky, J" uniqKey="Kulisevsky J" first="J." last="Kulisevsky">J. Kulisevsky</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Department of Neurology, Hospital de Sant Pau</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>8 aut.</sZ><sZ>16 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Albanese, A" sort="Albanese, A" uniqKey="Albanese A" first="A." last="Albanese">A. Albanese</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Istituto Nazionale Neurologico Carlo Besta and Universita Cattolica</s1><s2>Milan</s2><s3>ITA</s3><sZ>9 aut.</sZ><sZ>26 aut.</sZ><sZ>28 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Volkmann, J" sort="Volkmann, J" uniqKey="Volkmann J" first="J." last="Volkmann">J. Volkmann</name><affiliation wicri:level="3"><inist:fA14 i1="09"><s1>Neurologische Klinik der Christian -Albrecht -Universität</s1><s2>Kiel</s2><s3>DEU</s3><sZ>10 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="2">Schleswig-Holstein</region><settlement type="city">Kiel</settlement></placeName></affiliation></author><author><name sortKey="Hariz, M I" sort="Hariz, M I" uniqKey="Hariz M" first="M. I." last="Hariz">M. I. Hariz</name><affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Institute of Neurology, Queen Square</s1><s2>London</s2><s3>GBR</s3><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Quinn, N P" sort="Quinn, N P" uniqKey="Quinn N" first="N. P." last="Quinn">N. P. Quinn</name><affiliation wicri:level="3"><inist:fA14 i1="10"><s1>Institute of Neurology, Queen Square</s1><s2>London</s2><s3>GBR</s3><sZ>11 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Speelman, J D" sort="Speelman, J D" uniqKey="Speelman J" first="J. D." last="Speelman">J. D. Speelman</name><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>Department of Neurology, Academic Medical Center</s1><s2>Amsterdam</s2><s3>NLD</s3><sZ>13 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Amsterdam</settlement><region nuts="2" type="province">Hollande-Septentrionale</region></placeName></affiliation></author><author><name sortKey="Guridi, J" sort="Guridi, J" uniqKey="Guridi J" first="J." last="Guridi">J. Guridi</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA</s1><s2>Pamplona</s2><s3>ESP</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Pamplona</wicri:noRegion></affiliation></author><author><name sortKey="Zamarbide, I" sort="Zamarbide, I" uniqKey="Zamarbide I" first="I." last="Zamarbide">I. Zamarbide</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA</s1><s2>Pamplona</s2><s3>ESP</s3><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>14 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Espagne</country><wicri:noRegion>Pamplona</wicri:noRegion></affiliation></author><author><name sortKey="Gironell, A" sort="Gironell, A" uniqKey="Gironell A" first="A." last="Gironell">A. Gironell</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Department of Neurology, Hospital de Sant Pau</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>8 aut.</sZ><sZ>16 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Molet, J" sort="Molet, J" uniqKey="Molet J" first="J." last="Molet">J. Molet</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Department of Neurology, Hospital de Sant Pau</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>8 aut.</sZ><sZ>16 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Pascual Sedano, B" sort="Pascual Sedano, B" uniqKey="Pascual Sedano B" first="B." last="Pascual-Sedano">B. Pascual-Sedano</name><affiliation wicri:level="3"><inist:fA14 i1="07"><s1>Department of Neurology, Hospital de Sant Pau</s1><s2>Barcelona</s2><s3>ESP</s3><sZ>8 aut.</sZ><sZ>16 aut.</sZ><sZ>17 aut.</sZ><sZ>18 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Pidoux, B" sort="Pidoux, B" uniqKey="Pidoux B" first="B." last="Pidoux">B. Pidoux</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Groupe Hospitalier Pitié-Salpetrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>19 aut.</sZ><sZ>20 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Bonnet, A M" sort="Bonnet, A M" uniqKey="Bonnet A" first="A. M." last="Bonnet">A. M. Bonnet</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Groupe Hospitalier Pitié-Salpetrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>19 aut.</sZ><sZ>20 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Agid, Y" sort="Agid, Y" uniqKey="Agid Y" first="Y." last="Agid">Yves Agid</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Groupe Hospitalier Pitié-Salpetrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>5 aut.</sZ><sZ>19 aut.</sZ><sZ>20 aut.</sZ><sZ>21 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation></author><author><name sortKey="Xie, J" sort="Xie, J" uniqKey="Xie J" first="J." last="Xie">J. Xie</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Service de Neurologie, University Hospital of Grenoble</s1><s3>FRA</s3><sZ>6 aut.</sZ><sZ>22 aut.</sZ><sZ>23 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>University Hospital of Grenoble</wicri:noRegion><wicri:noRegion>Service de Neurologie, University Hospital of Grenoble</wicri:noRegion></affiliation></author><author><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A.-L." last="Benabid">A.-L. Benabid</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Service de Neurologie, University Hospital of Grenoble</s1><s3>FRA</s3><sZ>6 aut.</sZ><sZ>22 aut.</sZ><sZ>23 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>University Hospital of Grenoble</wicri:noRegion><wicri:noRegion>Service de Neurologie, University Hospital of Grenoble</wicri:noRegion></affiliation></author><author><name sortKey="Lozano, A M" sort="Lozano, A M" uniqKey="Lozano A" first="A. M." last="Lozano">A. M. Lozano</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Division of Neurology, Toronto Western Hospital, Movement Disorders Clinic</s1><s2>Toronto</s2><s3>CAN</s3><sZ>4 aut.</sZ><sZ>24 aut.</sZ><sZ>25 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Saint Cyr, J" sort="Saint Cyr, J" uniqKey="Saint Cyr J" first="J." last="Saint-Cyr">J. Saint-Cyr</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Division of Neurology, Toronto Western Hospital, Movement Disorders Clinic</s1><s2>Toronto</s2><s3>CAN</s3><sZ>4 aut.</sZ><sZ>24 aut.</sZ><sZ>25 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto</wicri:noRegion></affiliation></author><author><name sortKey="Romito, L" sort="Romito, L" uniqKey="Romito L" first="L." last="Romito">L. Romito</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Istituto Nazionale Neurologico Carlo Besta and Universita Cattolica</s1><s2>Milan</s2><s3>ITA</s3><sZ>9 aut.</sZ><sZ>26 aut.</sZ><sZ>28 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Contarino, M F" sort="Contarino, M F" uniqKey="Contarino M" first="M. F." last="Contarino">M. F. Contarino</name><affiliation wicri:level="3"><inist:fA14 i1="12"><s1>Department of Neuroscience, Universitá Catttolica del Sacro Cuore</s1><s2>Rome</s2><s3>ITA</s3><sZ>27 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Rome</settlement><region nuts="2">Latium</region></placeName></affiliation></author><author><name sortKey="Scerrati, M" sort="Scerrati, M" uniqKey="Scerrati M" first="M." last="Scerrati">M. Scerrati</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Istituto Nazionale Neurologico Carlo Besta and Universita Cattolica</s1><s2>Milan</s2><s3>ITA</s3><sZ>9 aut.</sZ><sZ>26 aut.</sZ><sZ>28 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Fraix, V" sort="Fraix, V" uniqKey="Fraix V" first="V." last="Fraix">V. Fraix</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Service de Neurologie, University Hospital of Grenoble</s1><s3>FRA</s3><sZ>6 aut.</sZ><sZ>22 aut.</sZ><sZ>23 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>University Hospital of Grenoble</wicri:noRegion><wicri:noRegion>Service de Neurologie, University Hospital of Grenoble</wicri:noRegion></affiliation></author><author><name sortKey="Van Blercom, N" sort="Van Blercom, N" uniqKey="Van Blercom N" first="N." last="Van Blercom">N. Van Blercom</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Service de Neurologie, University Hospital of Grenoble</s1><s3>FRA</s3><sZ>6 aut.</sZ><sZ>22 aut.</sZ><sZ>23 aut.</sZ><sZ>29 aut.</sZ><sZ>30 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>University Hospital of Grenoble</wicri:noRegion><wicri:noRegion>Service de Neurologie, University Hospital of Grenoble</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Brain</title><title level="j" type="abbreviated">Brain</title><idno type="ISSN">0006-8950</idno><imprint><date when="2005">2005</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Brain</title><title level="j" type="abbreviated">Brain</title><idno type="ISSN">0006-8950</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Deep brain stimulation</term><term>Follow up study</term><term>Long term</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Subthalamic nucleus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term><term>Parkinson maladie</term><term>Etude longitudinale</term><term>Long terme</term><term>Noyau sousthalamique</term><term>Stimulation cérébrale profonde</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Deep brain stimulation (DBS) is associated with significant improvement of motor complications in patients with severe Parkinson's disease after some 6-12 months of treatment. Long-term results in a large number of patients have been reported only from a single study centre. We report 69 Parkinson's disease patients treated with bilateral DBS of the subthalamic nucleus (STN, n = 49) or globus pallidus internus (GPi, n = 20) included in a multicentre study. Patients were assessed preoperatively and at I year and 3-4 years after surgery. The primary outcome measure was the change in the 'off' medication score of the Unified Parkinson's Disease Rating Scale motor part (UPDRS-III) at 3-4 years. Stimulation of the STN or GPi induced a significant improvement (50 and 39%; P < 0.0001) of the 'off' medication UPDRS-III score at 3-4 years with respect to baseline. Stimulation improved cardinal features and activities of daily living (ADL) (P < 0.0001 and P < 0.02 for STN and GPi, respectively) and prolonged the 'on' time spent with good mobility without dyskinesias (P < 0.00001). Daily dosage of levodopa was significantly reduced (35%) in the STN-treated group only (P< 0.001). Comparison of the improvement induced by stimulation at I year with 3-4 years showed a significant worsening in the 'on' medication motor states of the UPDRS-II, ADL and gait in both STN and GPi groups, and speech and postural stability in the STN-treated group. Adverse events (AEs) included cognitive decline, speech difficulty, instability, gait disorders and depression. These were more common in patients treated with DBS of the STN. No patient abandoned treatment as a result of these side effects. This experience, which represents the first multicentre study assessing the long-term efficacy of either STN or GPi stimulation, shows a significant and substantial clinically important therapeutic benefit for at least 3-4 years in a large cohort of patients with severe Parkinson's disease.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Canada</li><li>Espagne</li><li>France</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Catalogne</li><li>Grand Londres</li><li>Hollande-Septentrionale</li><li>Latium</li><li>Lombardie</li><li>Schleswig-Holstein</li><li>Île-de-France</li></region><settlement><li>Amsterdam</li><li>Barcelone</li><li>Kiel</li><li>Londres</li><li>Milan</li><li>Paris</li><li>Rome</li></settlement><orgName><li>Hôpital de la Salpêtrière</li></orgName></list><tree><country name="Allemagne"><noRegion><name sortKey="Freund, Hans Joachim" sort="Freund, Hans Joachim" uniqKey="Freund H" first="Hans-Joachim" last="Freund">Hans-Joachim Freund</name></noRegion><name sortKey="Volkmann, J" sort="Volkmann, J" uniqKey="Volkmann J" first="J." last="Volkmann">J. Volkmann</name></country><country name="Espagne"><noRegion><name sortKey="Rodriguez Oroz, M C" sort="Rodriguez Oroz, M C" uniqKey="Rodriguez Oroz M" first="M. C." last="Rodriguez-Oroz">M. C. Rodriguez-Oroz</name></noRegion><name sortKey="Gironell, A" sort="Gironell, A" uniqKey="Gironell A" first="A." last="Gironell">A. Gironell</name><name sortKey="Guridi, J" sort="Guridi, J" uniqKey="Guridi J" first="J." last="Guridi">J. Guridi</name><name sortKey="Kulisevsky, J" sort="Kulisevsky, J" uniqKey="Kulisevsky J" first="J." last="Kulisevsky">J. Kulisevsky</name><name sortKey="Molet, J" sort="Molet, J" uniqKey="Molet J" first="J." last="Molet">J. Molet</name><name sortKey="Obeso, J A" sort="Obeso, J A" uniqKey="Obeso J" first="J. A." last="Obeso">J. A. Obeso</name><name sortKey="Pascual Sedano, B" sort="Pascual Sedano, B" uniqKey="Pascual Sedano B" first="B." last="Pascual-Sedano">B. Pascual-Sedano</name><name sortKey="Zamarbide, I" sort="Zamarbide, I" uniqKey="Zamarbide I" first="I." last="Zamarbide">I. Zamarbide</name></country><country name="Canada"><noRegion><name sortKey="Lang, A E" sort="Lang, A E" uniqKey="Lang A" first="A. E." last="Lang">A. E. Lang</name></noRegion><name sortKey="Lozano, A M" sort="Lozano, A M" uniqKey="Lozano A" first="A. M." last="Lozano">A. M. Lozano</name><name sortKey="Saint Cyr, J" sort="Saint Cyr, J" uniqKey="Saint Cyr J" first="J." last="Saint-Cyr">J. Saint-Cyr</name></country><country name="France"><region name="Île-de-France"><name sortKey="Houeto, J L" sort="Houeto, J L" uniqKey="Houeto J" first="J.-L." last="Houeto">J.-L. Houeto</name></region><name sortKey="Agid, Y" sort="Agid, Y" uniqKey="Agid Y" first="Y." last="Agid">Yves Agid</name><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A.-L." last="Benabid">A.-L. Benabid</name><name sortKey="Bonnet, A M" sort="Bonnet, A M" uniqKey="Bonnet A" first="A. M." last="Bonnet">A. M. Bonnet</name><name sortKey="Fraix, V" sort="Fraix, V" uniqKey="Fraix V" first="V." last="Fraix">V. Fraix</name><name sortKey="Pidoux, B" sort="Pidoux, B" uniqKey="Pidoux B" first="B." last="Pidoux">B. Pidoux</name><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P." last="Pollak">P. Pollak</name><name sortKey="Rehncrona, S" sort="Rehncrona, S" uniqKey="Rehncrona S" first="S." last="Rehncrona">S. Rehncrona</name><name sortKey="Van Blercom, N" sort="Van Blercom, N" uniqKey="Van Blercom N" first="N." last="Van Blercom">N. Van Blercom</name><name sortKey="Xie, J" sort="Xie, J" uniqKey="Xie J" first="J." last="Xie">J. Xie</name></country><country name="Italie"><region name="Lombardie"><name sortKey="Albanese, A" sort="Albanese, A" uniqKey="Albanese A" first="A." last="Albanese">A. Albanese</name></region><name sortKey="Contarino, M F" sort="Contarino, M F" uniqKey="Contarino M" first="M. F." last="Contarino">M. F. Contarino</name><name sortKey="Romito, L" sort="Romito, L" uniqKey="Romito L" first="L." last="Romito">L. Romito</name><name sortKey="Scerrati, M" sort="Scerrati, M" uniqKey="Scerrati M" first="M." last="Scerrati">M. Scerrati</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Hariz, M I" sort="Hariz, M I" uniqKey="Hariz M" first="M. I." last="Hariz">M. I. Hariz</name></region><name sortKey="Quinn, N P" sort="Quinn, N P" uniqKey="Quinn N" first="N. P." last="Quinn">N. P. Quinn</name></country><country name="Pays-Bas"><region name="Hollande-Septentrionale"><name sortKey="Speelman, J D" sort="Speelman, J D" uniqKey="Speelman J" first="J. D." last="Speelman">J. D. Speelman</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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