Bilateral deep brain stimulation in Parkinson's disease: a multicentre study with 4 years follow-up
Identifieur interne : 002B16 ( Istex/Curation ); précédent : 002B15; suivant : 002B17Bilateral deep brain stimulation in Parkinson's disease: a multicentre study with 4 years follow-up
Auteurs : M. C. Rodriguez-Oroz ; J. A. Obeso ; A. E. Lang ; J.-L. Houeto ; P. Pollak ; S. Rehncrona ; J. Kulisevsky ; A. Albanese ; J. Volkmann ; M. I. Hariz ; N. P. Quinn ; J. D. Speelman [Pays-Bas] ; J. Guridi ; I. Zamarbide ; A. Gironell ; J. Molet ; B. Pascual-Sedano ; B. Pidoux ; A. M. Bonnet ; Y. Agid ; J. Xie ; A.-L. Benabid ; A. M. Lozano ; J. Saint-Cyr ; L. Romito ; M. F. Contarino [Italie] ; M. Scerrati ; V. Fraix ; N. Van BlercomSource :
- Brain [ 0006-8950 ] ; 2005-10.
English descriptors
- KwdEn :
- ADL = activities of daily living, AEs = adverse events, DBS = deep brain stimulation, GPi = globus pallidus pars interna, Parkinson's disease, STN = subthalamic nucleus, UPDRS = Unified Parkinson's Disease Rating Scale, deep brain stimulation, globus pallidus pars interna, long-term effects, subthalamic nucleus.
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 1 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 1 year with 3–4 years showed a significant worsening in the ‘on’ medication motor states of the UPDRS-III, 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.
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DOI: 10.1093/brain/awh571
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M. C. Rodriguez-Oroz<affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation>Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Bilateral deep brain stimulation in Parkinson's disease: a multicentre study with 4 years follow-up</title><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><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Division of Neurology, Toronto Western Hospital, Movement Disorders Clinic, Toronto, Canada,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Groupe Hospitalier Pitié-Salpetrière, Paris,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P." last="Pollak">P. Pollak</name><affiliation><mods:affiliation>Service de Neurologie, University Hospital of Grenoble, France,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Rehncrona, S" sort="Rehncrona, S" uniqKey="Rehncrona S" first="S." last="Rehncrona">S. Rehncrona</name><affiliation><mods:affiliation>Neurosurgery Service, Lund University Hospital, Sweden,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Kulisevsky, J" sort="Kulisevsky, J" uniqKey="Kulisevsky J" first="J." last="Kulisevsky">J. Kulisevsky</name><affiliation><mods:affiliation>Department of Neurology, Hospital de Sant Pau, Barcelona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Albanese, A" sort="Albanese, A" uniqKey="Albanese A" first="A." last="Albanese">A. Albanese</name><affiliation><mods:affiliation>Istituto Nazionale Neurologico Carlo Besta and Università Cattolica, Milan, Italy,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Volkmann, J" sort="Volkmann, J" uniqKey="Volkmann J" first="J." last="Volkmann">J. Volkmann</name><affiliation><mods:affiliation>Neurologische Klinik der Christian-Albrecht-Universität, Kiel, Germany,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Institute of Neurology, Queen Square, London, UK,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Institute of Neurology, Queen Square, London, UK,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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="1"><mods:affiliation>Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands and</mods:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Neurology, Academic Medical Center, Amsterdam</wicri:regionArea></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Guridi, J" sort="Guridi, J" uniqKey="Guridi J" first="J." last="Guridi">J. Guridi</name><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Zamarbide, I" sort="Zamarbide, I" uniqKey="Zamarbide I" first="I." last="Zamarbide">I. Zamarbide</name><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Gironell, A" sort="Gironell, A" uniqKey="Gironell A" first="A." last="Gironell">A. Gironell</name><affiliation><mods:affiliation>Department of Neurology, Hospital de Sant Pau, Barcelona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Molet, J" sort="Molet, J" uniqKey="Molet J" first="J." last="Molet">J. Molet</name><affiliation><mods:affiliation>Department of Neurology, Hospital de Sant Pau, Barcelona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Department of Neurology, Hospital de Sant Pau, Barcelona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Pidoux, B" sort="Pidoux, B" uniqKey="Pidoux B" first="B." last="Pidoux">B. Pidoux</name><affiliation><mods:affiliation>Groupe Hospitalier Pitié-Salpetrière, Paris,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Groupe Hospitalier Pitié-Salpetrière, Paris,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Agid, Y" sort="Agid, Y" uniqKey="Agid Y" first="Y." last="Agid">Y. Agid</name><affiliation><mods:affiliation>Groupe Hospitalier Pitié-Salpetrière, Paris,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Xie, J" sort="Xie, J" uniqKey="Xie J" first="J." last="Xie">J. Xie</name><affiliation><mods:affiliation>Service de Neurologie, University Hospital of Grenoble, France,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Service de Neurologie, University Hospital of Grenoble, France,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Division of Neurology, Toronto Western Hospital, Movement Disorders Clinic, Toronto, Canada,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Division of Neurology, Toronto Western Hospital, Movement Disorders Clinic, Toronto, Canada,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Romito, L" sort="Romito, L" uniqKey="Romito L" first="L." last="Romito">L. Romito</name><affiliation><mods:affiliation>Istituto Nazionale Neurologico Carlo Besta and Università Cattolica, Milan, Italy,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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="1"><mods:affiliation>Department of Neuroscience, Universitá Catttolica del Sacro Cuore, Rome, Italy</mods:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Neuroscience, Universitá Catttolica del Sacro Cuore, Rome</wicri:regionArea></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Scerrati, M" sort="Scerrati, M" uniqKey="Scerrati M" first="M." last="Scerrati">M. Scerrati</name><affiliation><mods:affiliation>Istituto Nazionale Neurologico Carlo Besta and Università Cattolica, Milan, Italy,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Fraix, V" sort="Fraix, V" uniqKey="Fraix V" first="V." last="Fraix">V. Fraix</name><affiliation><mods:affiliation>Service de Neurologie, University Hospital of Grenoble, France,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Service de Neurologie, University Hospital of Grenoble, France,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:860820614185D44B4C30C80E241B21643A5636C0</idno><date when="2005" year="2005">2005</date><idno type="doi">10.1093/brain/awh571</idno><idno type="url">https://api-v5.istex.fr/document/860820614185D44B4C30C80E241B21643A5636C0/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">002B16</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">002B16</idno><idno type="wicri:Area/Istex/Curation">002B16</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Bilateral deep brain stimulation in Parkinson's disease: a multicentre study with 4 years follow-up</title><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><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Division of Neurology, Toronto Western Hospital, Movement Disorders Clinic, Toronto, Canada,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Groupe Hospitalier Pitié-Salpetrière, Paris,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P." last="Pollak">P. Pollak</name><affiliation><mods:affiliation>Service de Neurologie, University Hospital of Grenoble, France,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Rehncrona, S" sort="Rehncrona, S" uniqKey="Rehncrona S" first="S." last="Rehncrona">S. Rehncrona</name><affiliation><mods:affiliation>Neurosurgery Service, Lund University Hospital, Sweden,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Kulisevsky, J" sort="Kulisevsky, J" uniqKey="Kulisevsky J" first="J." last="Kulisevsky">J. Kulisevsky</name><affiliation><mods:affiliation>Department of Neurology, Hospital de Sant Pau, Barcelona, Spain,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Albanese, A" sort="Albanese, A" uniqKey="Albanese A" first="A." last="Albanese">A. Albanese</name><affiliation><mods:affiliation>Istituto Nazionale Neurologico Carlo Besta and Università Cattolica, Milan, Italy,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Volkmann, J" sort="Volkmann, J" uniqKey="Volkmann J" first="J." last="Volkmann">J. Volkmann</name><affiliation><mods:affiliation>Neurologische Klinik der Christian-Albrecht-Universität, Kiel, Germany,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Institute of Neurology, Queen Square, London, UK,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Institute of Neurology, Queen Square, London, UK,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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="1"><mods:affiliation>Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands and</mods:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Neurology, Academic Medical Center, Amsterdam</wicri:regionArea></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation></affiliation></author><author><name sortKey="Guridi, J" sort="Guridi, J" uniqKey="Guridi J" first="J." last="Guridi">J. Guridi</name><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Zamarbide, I" sort="Zamarbide, I" uniqKey="Zamarbide I" first="I." last="Zamarbide">I. Zamarbide</name><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Gironell, A" sort="Gironell, A" uniqKey="Gironell A" first="A." last="Gironell">A. Gironell</name><affiliation><mods:affiliation>Department of Neurology, Hospital de Sant Pau, Barcelona, Spain,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Molet, J" sort="Molet, J" uniqKey="Molet J" first="J." last="Molet">J. Molet</name><affiliation><mods:affiliation>Department of Neurology, Hospital de Sant Pau, Barcelona, Spain,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Department of Neurology, Hospital de Sant Pau, Barcelona, Spain,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Pidoux, B" sort="Pidoux, B" uniqKey="Pidoux B" first="B." last="Pidoux">B. Pidoux</name><affiliation><mods:affiliation>Groupe Hospitalier Pitié-Salpetrière, Paris,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Groupe Hospitalier Pitié-Salpetrière, Paris,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Agid, Y" sort="Agid, Y" uniqKey="Agid Y" first="Y." last="Agid">Y. Agid</name><affiliation><mods:affiliation>Groupe Hospitalier Pitié-Salpetrière, Paris,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Xie, J" sort="Xie, J" uniqKey="Xie J" first="J." last="Xie">J. Xie</name><affiliation><mods:affiliation>Service de Neurologie, University Hospital of Grenoble, France,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Service de Neurologie, University Hospital of Grenoble, France,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Division of Neurology, Toronto Western Hospital, Movement Disorders Clinic, Toronto, Canada,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Division of Neurology, Toronto Western Hospital, Movement Disorders Clinic, Toronto, Canada,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Romito, L" sort="Romito, L" uniqKey="Romito L" first="L." last="Romito">L. Romito</name><affiliation><mods:affiliation>Istituto Nazionale Neurologico Carlo Besta and Università Cattolica, Milan, Italy,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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="1"><mods:affiliation>Department of Neuroscience, Universitá Catttolica del Sacro Cuore, Rome, Italy</mods:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Department of Neuroscience, Universitá Catttolica del Sacro Cuore, Rome</wicri:regionArea></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation></affiliation></author><author><name sortKey="Scerrati, M" sort="Scerrati, M" uniqKey="Scerrati M" first="M." last="Scerrati">M. Scerrati</name><affiliation><mods:affiliation>Istituto Nazionale Neurologico Carlo Besta and Università Cattolica, Milan, Italy,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author><author><name sortKey="Fraix, V" sort="Fraix, V" uniqKey="Fraix V" first="V." last="Fraix">V. Fraix</name><affiliation><mods:affiliation>Service de Neurologie, University Hospital of Grenoble, France,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></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><mods:affiliation>Service de Neurologie, University Hospital of Grenoble, France,</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain,</mods:affiliation><wicri:noCountry code="subField"></wicri:noCountry></affiliation></author></analytic><monogr></monogr><series><title level="j">Brain</title><title level="j" type="abbrev">Brain</title><idno type="ISSN">0006-8950</idno><idno type="eISSN">1460-2156</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2005-10">2005-10</date><biblScope unit="volume">128</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="2240">2240</biblScope><biblScope unit="page" to="2249">2249</biblScope></imprint><idno type="ISSN">0006-8950</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0006-8950</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>ADL = activities of daily living</term><term>AEs = adverse events</term><term>DBS = deep brain stimulation</term><term>GPi = globus pallidus pars interna</term><term>Parkinson's disease</term><term>STN = subthalamic nucleus</term><term>UPDRS = Unified Parkinson's Disease Rating Scale</term><term>deep brain stimulation</term><term>globus pallidus pars interna</term><term>long-term effects</term><term>subthalamic nucleus</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></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 1 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 1 year with 3–4 years showed a significant worsening in the ‘on’ medication motor states of the UPDRS-III, 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></record>Pour manipuler ce document sous Unix (Dilib)
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