Levodopa response in long‐term bilateral subthalamic stimulation for Parkinson's disease
Identifieur interne : 002566 ( Main/Exploration ); précédent : 002565; suivant : 002567Levodopa response in long‐term bilateral subthalamic stimulation for Parkinson's disease
Auteurs : Panida Piboolnurak [Canada, Thaïlande] ; Anthony E. Lang [Canada] ; Andres M. Lozano [Canada] ; Janis M. Miyasaki [Canada] ; Jean A. Saint-Cyr [Canada] ; Yu-Yan W. Poon [Canada] ; William D. Hutchison [Canada] ; Jonathan O. Dostrovsky [Canada] ; Elena Moro [Canada]Source :
- Movement Disorders [ 0885-3185 ] ; 2007-05-15.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Antiparkinson Agents (therapeutic use), Deep Brain Stimulation (methods), Deep brain stimulation, Female, Follow-Up Studies, Humans, Levodopa, Levodopa (therapeutic use), Long term, Male, Middle Aged, Nervous system diseases, Parkinson Disease (drug therapy), Parkinson Disease (pathology), Parkinson Disease (surgery), Parkinson disease, Parkinson's disease, Retrospective Studies, Statistics, Nonparametric, Subthalamic Nucleus (surgery), Subthalamic nucleus, Time Factors, Treatment Outcome, deep brain stimulation, levodopa response, long‐term benefit, subthalamic nucleus.
- MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- drug therapy : Parkinson Disease.
- methods : Deep Brain Stimulation.
- pathology : Parkinson Disease.
- surgery : Parkinson Disease, Subthalamic Nucleus.
- Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Statistics, Nonparametric, Time Factors, Treatment Outcome.
Abstract
Subthalamic nucleus deep brain stimulation (STN‐DBS) is effective in advanced Parkinson's disease (PD), but its effects on the levodopa response are unclear. We studied the levodopa response after long‐term STN‐DBS, STN‐DBS efficacy and predictive value of preoperative levodopa response to long‐term DBS benefit in 33 PD patients with bilateral STN‐DBS. Patients were assessed using the Unified Parkinson's Disease Rating Scale preoperatively (with and without medications) and postoperatively (without medications or stimulation, with only medications or stimulation, and with both medications and stimulation). Levodopa response significantly decreased postoperatively by 31.1% at 3 years and 32.3% at 5 years, possibly related to the reduction in medication requirement, direct STN stimulation effect or PD progression. STN‐DBS alone significantly improved motor scores (37.2% at 3 years and 35.1% at 5 years) and activities of daily living scores (27.1% at 3 years and 19.2% at 5 years). Anti‐PD drugs were significantly reduced by 47.9% at 3 years and 39.8% at 5 years. However, the magnitude of the preoperative response to levodopa did not predict DBS benefit at 3 and 5 years. © 2007 Movement Disorder Society
Url:
DOI: 10.1002/mds.21482
Affiliations:
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Le document en format XML
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2007-05-15">2007-05-15</date><biblScope unit="volume">22</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="990">990</biblScope><biblScope unit="page" to="997">997</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">95CF3584350283B4C5E922BD0F94DF07F5E79BDC</idno><idno type="DOI">10.1002/mds.21482</idno><idno type="ArticleID">MDS21482</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antiparkinson Agents (therapeutic use)</term><term>Deep Brain Stimulation (methods)</term><term>Deep brain stimulation</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Levodopa</term><term>Levodopa (therapeutic use)</term><term>Long term</term><term>Male</term><term>Middle Aged</term><term>Nervous system diseases</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (pathology)</term><term>Parkinson Disease (surgery)</term><term>Parkinson disease</term><term>Parkinson's disease</term><term>Retrospective Studies</term><term>Statistics, Nonparametric</term><term>Subthalamic Nucleus (surgery)</term><term>Subthalamic nucleus</term><term>Time Factors</term><term>Treatment Outcome</term><term>deep brain stimulation</term><term>levodopa response</term><term>long‐term benefit</term><term>subthalamic nucleus</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Parkinson Disease</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term><term>Statistics, Nonparametric</term><term>Time Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Long terme</term><term>Lévodopa</term><term>Noyau sousthalamique</term><term>Parkinson maladie</term><term>Stimulation cérébrale profonde</term><term>Système nerveux pathologie</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Subthalamic nucleus deep brain stimulation (STN‐DBS) is effective in advanced Parkinson's disease (PD), but its effects on the levodopa response are unclear. We studied the levodopa response after long‐term STN‐DBS, STN‐DBS efficacy and predictive value of preoperative levodopa response to long‐term DBS benefit in 33 PD patients with bilateral STN‐DBS. Patients were assessed using the Unified Parkinson's Disease Rating Scale preoperatively (with and without medications) and postoperatively (without medications or stimulation, with only medications or stimulation, and with both medications and stimulation). Levodopa response significantly decreased postoperatively by 31.1% at 3 years and 32.3% at 5 years, possibly related to the reduction in medication requirement, direct STN stimulation effect or PD progression. STN‐DBS alone significantly improved motor scores (37.2% at 3 years and 35.1% at 5 years) and activities of daily living scores (27.1% at 3 years and 19.2% at 5 years). Anti‐PD drugs were significantly reduced by 47.9% at 3 years and 39.8% at 5 years. However, the magnitude of the preoperative response to levodopa did not predict DBS benefit at 3 and 5 years. © 2007 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Canada</li><li>Thaïlande</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><region name="Ontario"><name sortKey="Piboolnurak, Panida" sort="Piboolnurak, Panida" uniqKey="Piboolnurak P" first="Panida" last="Piboolnurak">Panida Piboolnurak</name></region><name sortKey="Dostrovsky, Jonathan O" sort="Dostrovsky, Jonathan O" uniqKey="Dostrovsky J" first="Jonathan O." last="Dostrovsky">Jonathan O. Dostrovsky</name><name sortKey="Hutchison, William D" sort="Hutchison, William D" uniqKey="Hutchison W" first="William D." last="Hutchison">William D. Hutchison</name><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name><name sortKey="Miyasaki, Janis M" sort="Miyasaki, Janis M" uniqKey="Miyasaki J" first="Janis M." last="Miyasaki">Janis M. Miyasaki</name><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><name sortKey="Poon, Yu An W" sort="Poon, Yu An W" uniqKey="Poon Y" first="Yu-Yan W." last="Poon">Yu-Yan W. Poon</name><name sortKey="Saint Yr, Jean A" sort="Saint Yr, Jean A" uniqKey="Saint Yr J" first="Jean A." last="Saint-Cyr">Jean A. Saint-Cyr</name></country><country name="Thaïlande"><noRegion><name sortKey="Piboolnurak, Panida" sort="Piboolnurak, Panida" uniqKey="Piboolnurak P" first="Panida" last="Piboolnurak">Panida Piboolnurak</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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