ParkinsonCanadaV1, Main, Exploration, bibRecord, 002B10

Pallidal deep brain stimulation and L-dopa do not improve qualitative aspects of skilled reaching in parkinson's disease

Identifieur interne : 002B10 ( Main/Exploration ); précédent : 002B09; suivant : 002B11

Pallidal deep brain stimulation and L-dopa do not improve qualitative aspects of skilled reaching in parkinson's disease

Auteurs : Kyle G. Melvin [Canada] ; Jon Doan [Canada] ; Sergio M. Pellis [Canada] ; Lesley Brown [Canada] ; Ian Q. Whishaw [Canada] ; Oksana Suchowersky [Canada]

Source :

Behavioural brain research [ 0166-4328 ] ; 2005.

RBID : Pascal:05-0256907

Descripteurs français

Pascal (Inist)
- Lévodopa, Habileté, Mouvement orienté, Motricité, Parkinson maladie, Homme, Antiparkinsonien, Contrôle moteur.
Wicri :
- topic : Homme.

English descriptors

KwdEn :
- Adult, Aged, Aged, 80 and over, Antiparkinson Agents (therapeutic use), Antiparkinson agent, Case-Control Studies, Deep Brain Stimulation (methods), Follow-Up Studies, Functional Laterality, Globus Pallidus (drug effects), Globus Pallidus (physiopathology), Globus Pallidus (radiation effects), Goal directed movement, Human, Humans, Levodopa, Levodopa (therapeutic use), Middle Aged, Motor control, Motricity, Parkinson Disease (physiopathology), Parkinson Disease (therapy), Parkinson disease, Prospective Studies, Psychomotor Performance (drug effects), Psychomotor Performance (physiology), Psychomotor Performance (radiation effects), Skill, Statistics, Nonparametric, Treatment Outcome.
MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- drug effects : Globus Pallidus, Psychomotor Performance.
- methods : Deep Brain Stimulation.
- physiology : Psychomotor Performance.
- physiopathology : Globus Pallidus, Parkinson Disease.
- radiation effects : Globus Pallidus, Psychomotor Performance.
- therapy : Parkinson Disease.
- Adult, Aged, Aged, 80 and over, Case-Control Studies, Follow-Up Studies, Functional Laterality, Humans, Middle Aged, Prospective Studies, Statistics, Nonparametric, Treatment Outcome.

Abstract

Objective: To determine effects of dopaminergic medication and pallidal deep brain stimulation (DBS) on skilled reach in Parkinson's disease (PD). Background: PD is a neurodegenerative disorder affecting motor control. While speed and execution of movements are improved by L-dopa, not all motor symptoms are alleviated. Little is known about the effects of DBS or medication on reaching. Design method: Eight PD patients with unilateral pallidal DBS reached with the contra-lateral hand for a piece of food, placing it in the mouth, and returning to starting position. Testing was performed on no treatment, medication only, DBS only, and combined treatment. Reaches were digitally recorded and analyzed on a 21 point scale adapted from Eshkol-Wachman Notation. Analysis was blinded, with patients compared to age-matched controls. Results: Patients were tested 6-13 months after surgery. All showed significant improvement clinically and in UPDRS (III) scores. The following data were obtained on the reaching scale: normal controls 16.5-21.0 (mean 18.3), no treatment 3.0-12.5 (mean 7.4), medication only 7.0-14.0 (mean 10.3), DBS only 4.5-16.0 (mean 9.2), combined treatment 4.0-15.0 (mean 9.5). The difference between controls and all treatment groups was statistically significant (P< 0.005). All aspects of reach were compromised. No significant differences were found among the four conditions. Conclusions: This study is consistent with accumulating evidence that some aspects of motor performance in PD patients, such as reaching, are resistant to L-dopa. Also, pallidal DBS does not improve those parameters that are resistant to L-dopa, either alone or in combination with medication.

Affiliations:

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<term>Aged</term>
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<term>Antiparkinson Agents (therapeutic use)</term>
<term>Antiparkinson agent</term>
<term>Case-Control Studies</term>
<term>Deep Brain Stimulation (methods)</term>
<term>Follow-Up Studies</term>
<term>Functional Laterality</term>
<term>Globus Pallidus (drug effects)</term>
<term>Globus Pallidus (physiopathology)</term>
<term>Globus Pallidus (radiation effects)</term>
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<term>Levodopa (therapeutic use)</term>
<term>Middle Aged</term>
<term>Motor control</term>
<term>Motricity</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson Disease (therapy)</term>
<term>Parkinson disease</term>
<term>Prospective Studies</term>
<term>Psychomotor Performance (drug effects)</term>
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<term>Psychomotor Performance</term>
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<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term>
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<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Psychomotor Performance</term>
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<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Globus Pallidus</term>
<term>Parkinson Disease</term>
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<keywords scheme="MESH" qualifier="radiation effects" xml:lang="en"><term>Globus Pallidus</term>
<term>Psychomotor Performance</term>
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<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term>
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<term>Aged</term>
<term>Aged, 80 and over</term>
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<term>Follow-Up Studies</term>
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<term>Mouvement orienté</term>
<term>Motricité</term>
<term>Parkinson maladie</term>
<term>Homme</term>
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<front><div type="abstract" xml:lang="en">Objective: To determine effects of dopaminergic medication and pallidal deep brain stimulation (DBS) on skilled reach in Parkinson's disease (PD). Background: PD is a neurodegenerative disorder affecting motor control. While speed and execution of movements are improved by L-dopa, not all motor symptoms are alleviated. Little is known about the effects of DBS or medication on reaching. Design method: Eight PD patients with unilateral pallidal DBS reached with the contra-lateral hand for a piece of food, placing it in the mouth, and returning to starting position. Testing was performed on no treatment, medication only, DBS only, and combined treatment. Reaches were digitally recorded and analyzed on a 21 point scale adapted from Eshkol-Wachman Notation. Analysis was blinded, with patients compared to age-matched controls. Results: Patients were tested 6-13 months after surgery. All showed significant improvement clinically and in UPDRS (III) scores. The following data were obtained on the reaching scale: normal controls 16.5-21.0 (mean 18.3), no treatment 3.0-12.5 (mean 7.4), medication only 7.0-14.0 (mean 10.3), DBS only 4.5-16.0 (mean 9.2), combined treatment 4.0-15.0 (mean 9.5). The difference between controls and all treatment groups was statistically significant (P< 0.005). All aspects of reach were compromised. No significant differences were found among the four conditions. Conclusions: This study is consistent with accumulating evidence that some aspects of motor performance in PD patients, such as reaching, are resistant to L-dopa. Also, pallidal DBS does not improve those parameters that are resistant to L-dopa, either alone or in combination with medication.</div>
</front>
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La maladie de Parkinson au Canada (serveur d'exploration)

Pallidal deep brain stimulation and L-dopa do not improve qualitative aspects of skilled reaching in parkinson's disease

Pallidal deep brain stimulation and L-dopa do not improve qualitative aspects of skilled reaching in parkinson's disease

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English descriptors

Abstract

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