La maladie de Parkinson au Canada (serveur d'exploration)

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eep brain stimulation of the globus pallidus pars interna in advanced Parkinson's disease

Identifieur interne : 000302 ( France/Analysis ); précédent : 000301; suivant : 000303

eep brain stimulation of the globus pallidus pars interna in advanced Parkinson's disease

Auteurs : R. Kumar [Canada] ; A. E. Lang [Canada] ; M. C. Rodriguez-Oroz [Espagne] ; A. M. Lozano [Canada] ; P. Limousin [France] ; P. Pollak [France] ; A. L. Benabid [France] ; J. Guridi [Espagne] ; E. Ramos [Espagne] ; C. Van Der Linden [Belgique] ; A. Vandewalle [Belgique] ; J. Caemaert [Belgique] ; E. Lannoo [Belgique] ; D. Van Den Abbeele [Belgique] ; G. Vingerhoets [Belgique] ; M. Wolters [Belgique] ; J. A. Obeso [Espagne]

Source :

RBID : Pascal:01-0106279

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English descriptors

Abstract

Article abstract-Pallidotomy is now widely performed for the treatment of advanced Parkinson's disease (PD). Preliminary reports of the effect of globus pallidus pars interna deep brain stimulation (GPi DBS) have also been promising. We have analyzed a cohort of 22 consecutive patients enrolled in a multicenter study. Surgery was bilateral in 17 and unilateral in five patients. At 6-month follow-up, the bilaterally GPi-implanted patients demonstrated a marked improvement when examined after drug withdrawal ("off") and under optimal medication ("on") using the Unified Parkinson's Disease Rating Scale (UPDRS). The benefit induced by the stimulation in the "off" medication condition in the total motor score was 31% and in the activities of daily living (ADL) scores was 39%. During the "on" medication period, the reduction in the total "on" dyskinesias score was 66% and in the ADL score was 32%. A similar pattern of improvement was seen in the group of patients with unilateral GPi stimulation, although a second cohort of 12 patients not included in the multicenter study showed greater improvements in "on" motor functioning. Although the effect of DBS is predominantly reversible, electrode insertion alone resulted in measurable clinical effects in the absence of stimulation. Thus, at 6-month follow-up, the benefit observed without stimulation was up to 44% in the "on" dyskinesias score and 29% in timed tapping scores undertaken in the "off" medication state. Complications among 34 patients from all centers included perioperative infection (n=3), hardware fracture (n=2), and premature battery failure (n=3). These results show a positive antiparkinsonian effect of pallidal DBS. No specific complications were observed with bilateral procedures. s disease.


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Pascal:01-0106279

Le document en format XML

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<title xml:lang="en" level="a">eep brain stimulation of the globus pallidus pars interna in advanced Parkinson's disease</title>
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<country>Belgique</country>
<wicri:noRegion>Ghent</wicri:noRegion>
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<author>
<name sortKey="Lannoo, E" sort="Lannoo, E" uniqKey="Lannoo E" first="E." last="Lannoo">E. Lannoo</name>
<affiliation wicri:level="1">
<inist:fA14 i1="05">
<s1>Departments of Neurosurgery and Neurology, University Hospital Ghent</s1>
<s2>Ghent</s2>
<s3>BEL</s3>
<sZ>10 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
<sZ>13 aut.</sZ>
<sZ>14 aut.</sZ>
<sZ>15 aut.</sZ>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>Belgique</country>
<wicri:noRegion>Ghent</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Van Den Abbeele, D" sort="Van Den Abbeele, D" uniqKey="Van Den Abbeele D" first="D." last="Van Den Abbeele">D. Van Den Abbeele</name>
<affiliation wicri:level="1">
<inist:fA14 i1="05">
<s1>Departments of Neurosurgery and Neurology, University Hospital Ghent</s1>
<s2>Ghent</s2>
<s3>BEL</s3>
<sZ>10 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
<sZ>13 aut.</sZ>
<sZ>14 aut.</sZ>
<sZ>15 aut.</sZ>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>Belgique</country>
<wicri:noRegion>Ghent</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Vingerhoets, G" sort="Vingerhoets, G" uniqKey="Vingerhoets G" first="G." last="Vingerhoets">G. Vingerhoets</name>
<affiliation wicri:level="1">
<inist:fA14 i1="05">
<s1>Departments of Neurosurgery and Neurology, University Hospital Ghent</s1>
<s2>Ghent</s2>
<s3>BEL</s3>
<sZ>10 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
<sZ>13 aut.</sZ>
<sZ>14 aut.</sZ>
<sZ>15 aut.</sZ>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>Belgique</country>
<wicri:noRegion>Ghent</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Wolters, M" sort="Wolters, M" uniqKey="Wolters M" first="M." last="Wolters">M. Wolters</name>
<affiliation wicri:level="1">
<inist:fA14 i1="05">
<s1>Departments of Neurosurgery and Neurology, University Hospital Ghent</s1>
<s2>Ghent</s2>
<s3>BEL</s3>
<sZ>10 aut.</sZ>
<sZ>11 aut.</sZ>
<sZ>12 aut.</sZ>
<sZ>13 aut.</sZ>
<sZ>14 aut.</sZ>
<sZ>15 aut.</sZ>
<sZ>16 aut.</sZ>
</inist:fA14>
<country>Belgique</country>
<wicri:noRegion>Ghent</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, Neuroscience Center, Clinica Universitaria and Medical School, University Navarra</s1>
<s2>Pamplona</s2>
<s3>ESP</s3>
<sZ>3 aut.</sZ>
<sZ>17 aut.</sZ>
</inist:fA14>
<country>Espagne</country>
<wicri:noRegion>Pamplona</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series>
<title level="j" type="main">Neurology</title>
<title level="j" type="abbreviated">Neurology</title>
<idno type="ISSN">0028-3878</idno>
<imprint>
<date when="2000">2000</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt>
<title level="j" type="main">Neurology</title>
<title level="j" type="abbreviated">Neurology</title>
<idno type="ISSN">0028-3878</idno>
</seriesStmt>
</fileDesc>
<profileDesc>
<textClass>
<keywords scheme="KwdEn" xml:lang="en">
<term>Brain (vertebrata)</term>
<term>Human</term>
<term>Instrumental stimulation</term>
<term>Pallidum</term>
<term>Parkinson disease</term>
<term>Treatment</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr">
<term>Parkinson maladie</term>
<term>Stimulation instrumentale</term>
<term>Encéphale</term>
<term>Pallidum</term>
<term>Traitement</term>
<term>Homme</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr">
<term>Homme</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front>
<div type="abstract" xml:lang="en">Article abstract-Pallidotomy is now widely performed for the treatment of advanced Parkinson's disease (PD). Preliminary reports of the effect of globus pallidus pars interna deep brain stimulation (GPi DBS) have also been promising. We have analyzed a cohort of 22 consecutive patients enrolled in a multicenter study. Surgery was bilateral in 17 and unilateral in five patients. At 6-month follow-up, the bilaterally GPi-implanted patients demonstrated a marked improvement when examined after drug withdrawal ("off") and under optimal medication ("on") using the Unified Parkinson's Disease Rating Scale (UPDRS). The benefit induced by the stimulation in the "off" medication condition in the total motor score was 31% and in the activities of daily living (ADL) scores was 39%. During the "on" medication period, the reduction in the total "on" dyskinesias score was 66% and in the ADL score was 32%. A similar pattern of improvement was seen in the group of patients with unilateral GPi stimulation, although a second cohort of 12 patients not included in the multicenter study showed greater improvements in "on" motor functioning. Although the effect of DBS is predominantly reversible, electrode insertion alone resulted in measurable clinical effects in the absence of stimulation. Thus, at 6-month follow-up, the benefit observed without stimulation was up to 44% in the "on" dyskinesias score and 29% in timed tapping scores undertaken in the "off" medication state. Complications among 34 patients from all centers included perioperative infection (n=3), hardware fracture (n=2), and premature battery failure (n=3). These results show a positive antiparkinsonian effect of pallidal DBS. No specific complications were observed with bilateral procedures. s disease.</div>
</front>
</TEI>
<affiliations>
<list>
<country>
<li>Belgique</li>
<li>Canada</li>
<li>Espagne</li>
<li>France</li>
</country>
<region>
<li>Auvergne-Rhône-Alpes</li>
<li>Rhône-Alpes</li>
</region>
<settlement>
<li>Grenoble</li>
</settlement>
</list>
<tree>
<country name="Canada">
<noRegion>
<name sortKey="Kumar, R" sort="Kumar, R" uniqKey="Kumar R" first="R." last="Kumar">R. Kumar</name>
</noRegion>
<name sortKey="Lang, A E" sort="Lang, A E" uniqKey="Lang A" first="A. E." last="Lang">A. E. Lang</name>
<name sortKey="Lozano, A M" sort="Lozano, A M" uniqKey="Lozano A" first="A. M." last="Lozano">A. M. Lozano</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="Guridi, J" sort="Guridi, J" uniqKey="Guridi J" first="J." last="Guridi">J. Guridi</name>
<name sortKey="Obeso, J A" sort="Obeso, J A" uniqKey="Obeso J" first="J. A." last="Obeso">J. A. Obeso</name>
<name sortKey="Ramos, E" sort="Ramos, E" uniqKey="Ramos E" first="E." last="Ramos">E. Ramos</name>
</country>
<country name="France">
<region name="Auvergne-Rhône-Alpes">
<name sortKey="Limousin, P" sort="Limousin, P" uniqKey="Limousin P" first="P." last="Limousin">P. Limousin</name>
</region>
<name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A. L." last="Benabid">A. L. Benabid</name>
<name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P." last="Pollak">P. Pollak</name>
</country>
<country name="Belgique">
<noRegion>
<name sortKey="Van Der Linden, C" sort="Van Der Linden, C" uniqKey="Van Der Linden C" first="C." last="Van Der Linden">C. Van Der Linden</name>
</noRegion>
<name sortKey="Caemaert, J" sort="Caemaert, J" uniqKey="Caemaert J" first="J." last="Caemaert">J. Caemaert</name>
<name sortKey="Lannoo, E" sort="Lannoo, E" uniqKey="Lannoo E" first="E." last="Lannoo">E. Lannoo</name>
<name sortKey="Van Den Abbeele, D" sort="Van Den Abbeele, D" uniqKey="Van Den Abbeele D" first="D." last="Van Den Abbeele">D. Van Den Abbeele</name>
<name sortKey="Vandewalle, A" sort="Vandewalle, A" uniqKey="Vandewalle A" first="A." last="Vandewalle">A. Vandewalle</name>
<name sortKey="Vingerhoets, G" sort="Vingerhoets, G" uniqKey="Vingerhoets G" first="G." last="Vingerhoets">G. Vingerhoets</name>
<name sortKey="Wolters, M" sort="Wolters, M" uniqKey="Wolters M" first="M." last="Wolters">M. Wolters</name>
</country>
</tree>
</affiliations>
</record>

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