Reassessment of unilateral pallidotomy in Parkinson's disease
Identifieur interne : 003718 ( Main/Exploration ); précédent : 003717; suivant : 003719Reassessment of unilateral pallidotomy in Parkinson's disease
Auteurs : A. Samii [Canada] ; I. M. Turnbull [Canada] ; A. Kishore [Canada] ; M. Schulzer [Canada] ; E. Mak [Canada] ; S. Yardley [Canada] ; D. B. Calne [Canada]Source :
- Brain [ 0006-8950 ] ; 1999-03.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- ADL = Activities of Daily Living, Aged, Antiparkinson Agents (administration & dosage), Antiparkinson Agents (therapeutic use), Female, Follow up study, Follow-Up Studies, Functional Laterality, GPi = globus pallidus internus, Gait, Globus Pallidus (physiopathology), Globus Pallidus (surgery), Human, Humans, Male, Middle Aged, Movement Disorders, Neurosurgical Procedures (adverse effects), PPBT = Purdue Pegboard Test, Pallidum, Parkinson Disease (drug therapy), Parkinson Disease (physiopathology), Parkinson Disease (surgery), Parkinson disease, Parkinson's disease, Psychomotor Performance, Stereotaxic surgery, Treatment, Tremor (physiopathology), UPDRS = Unified Parkinson's Disease Rating Scale, Unilateral, dyskinesia, pallidotomy, stereotaxic techniques, tremor.
- MESH :
- chemical , administration & dosage : Antiparkinson Agents.
- chemical , therapeutic use : Antiparkinson Agents.
- adverse effects : Neurosurgical Procedures.
- drug therapy : Parkinson Disease.
- physiopathology : Globus Pallidus, Parkinson Disease, Tremor.
- surgery : Globus Pallidus, Parkinson Disease.
- Aged, Female, Follow-Up Studies, Functional Laterality, Gait, Humans, Male, Middle Aged, Movement Disorders, Psychomotor Performance.
Abstract
Unilateral pallidotomy has gained popularity in treating the motor symptoms of Parkinson's disease. We present the results of a 2-year post-pallidotomy follow-up study. Using the Unified Parkinson's Disease Rating Scale (UPDRS), the Goetz dyskinesia scale and the Purdue Pegboard Test (PPBT), we evaluated 20 patients at regular intervals both off and on medications for 2 years post-pallidotomy. There were no significant changes in the dosages of antiparkinsonian medications from 3 months pre-pallidotomy to 2 years post-pallidotomy. On the side contralateral to the operation, the improvements were preserved in `on'-state dyskinesia (83% reduction from pre-pallidotomy to 2 years post-pallidotomy, P < 0.001) and `off'-state tremor (90% reduction from pre-pallidotomy to 2 years post-pallidotomy, P = 0.005). There were no statistically significant differences between pre-pallidotomy scores and those at 2 years post-pallidotomy in ipsilateral dyskinesia, axial dyskinesia, `off'- or `on'-state PPBT, `off'-state Activities of Daily Living (ADL) and `off'-state gait and postural stability. After 2 years, the `on'-state ADL scores worsened by 75%, compared with pre-pallidotomy (P = 0.005). We conclude that 2 years after pallidotomy, the improvements in dyskinesia and tremor on the side contralateral to pallidotomy are preserved, while the initial improvements in most other deficits disappear, either because of progression of pathology or loss of the early efficacy achieved by surgery.
Url:
DOI: 10.1093/brain/122.3.417
Affiliations:
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Samii</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Neurodegenerative Disorders Centre, Vancouver Hospital and Health Sciences Centre, Vancouver, BC</wicri:regionArea><wicri:noRegion>BC</wicri:noRegion></affiliation></author><author><name sortKey="Turnbull, I M" sort="Turnbull, I M" uniqKey="Turnbull I" first="I. M." last="Turnbull">I. M. Turnbull</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Neurodegenerative Disorders Centre, Vancouver Hospital and Health Sciences Centre, Vancouver, BC</wicri:regionArea><wicri:noRegion>BC</wicri:noRegion></affiliation></author><author><name sortKey="Kishore, A" sort="Kishore, A" uniqKey="Kishore A" first="A." last="Kishore">A. Kishore</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Neurodegenerative Disorders Centre, Vancouver Hospital and Health Sciences Centre, Vancouver, BC</wicri:regionArea><wicri:noRegion>BC</wicri:noRegion></affiliation></author><author><name sortKey="Schulzer, M" sort="Schulzer, M" uniqKey="Schulzer M" first="M." last="Schulzer">M. Schulzer</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Neurodegenerative Disorders Centre, Vancouver Hospital and Health Sciences Centre, Vancouver, BC</wicri:regionArea><wicri:noRegion>BC</wicri:noRegion></affiliation></author><author><name sortKey="Mak, E" sort="Mak, E" uniqKey="Mak E" first="E." last="Mak">E. Mak</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Neurodegenerative Disorders Centre, Vancouver Hospital and Health Sciences Centre, Vancouver, BC</wicri:regionArea><wicri:noRegion>BC</wicri:noRegion></affiliation></author><author><name sortKey="Yardley, S" sort="Yardley, S" uniqKey="Yardley S" first="S." last="Yardley">S. Yardley</name><affiliation wicri:level="1"><country xml:lang="fr">Canada</country><wicri:regionArea>Neurodegenerative Disorders Centre, Vancouver Hospital and Health Sciences Centre, Vancouver, BC</wicri:regionArea><wicri:noRegion>BC</wicri:noRegion></affiliation></author><author><name sortKey="Calne, D B" sort="Calne, D B" uniqKey="Calne D" first="D. B." last="Calne">D. B. 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We present the results of a 2-year post-pallidotomy follow-up study. Using the Unified Parkinson's Disease Rating Scale (UPDRS), the Goetz dyskinesia scale and the Purdue Pegboard Test (PPBT), we evaluated 20 patients at regular intervals both off and on medications for 2 years post-pallidotomy. There were no significant changes in the dosages of antiparkinsonian medications from 3 months pre-pallidotomy to 2 years post-pallidotomy. On the side contralateral to the operation, the improvements were preserved in `on'-state dyskinesia (83% reduction from pre-pallidotomy to 2 years post-pallidotomy, P < 0.001) and `off'-state tremor (90% reduction from pre-pallidotomy to 2 years post-pallidotomy, P = 0.005). There were no statistically significant differences between pre-pallidotomy scores and those at 2 years post-pallidotomy in ipsilateral dyskinesia, axial dyskinesia, `off'- or `on'-state PPBT, `off'-state Activities of Daily Living (ADL) and `off'-state gait and postural stability. After 2 years, the `on'-state ADL scores worsened by 75%, compared with pre-pallidotomy (P = 0.005). We conclude that 2 years after pallidotomy, the improvements in dyskinesia and tremor on the side contralateral to pallidotomy are preserved, while the initial improvements in most other deficits disappear, either because of progression of pathology or loss of the early efficacy achieved by surgery.</div></front></TEI><affiliations><list><country><li>Canada</li></country></list><tree><country name="Canada"><noRegion><name sortKey="Samii, A" sort="Samii, A" uniqKey="Samii A" first="A." last="Samii">A. Samii</name></noRegion><name sortKey="Calne, D B" sort="Calne, D B" uniqKey="Calne D" first="D. B." last="Calne">D. B. Calne</name><name sortKey="Kishore, A" sort="Kishore, A" uniqKey="Kishore A" first="A." last="Kishore">A. Kishore</name><name sortKey="Mak, E" sort="Mak, E" uniqKey="Mak E" first="E." last="Mak">E. Mak</name><name sortKey="Schulzer, M" sort="Schulzer, M" uniqKey="Schulzer M" first="M." last="Schulzer">M. Schulzer</name><name sortKey="Turnbull, I M" sort="Turnbull, I M" uniqKey="Turnbull I" first="I. M." last="Turnbull">I. M. Turnbull</name><name sortKey="Yardley, S" sort="Yardley, S" uniqKey="Yardley S" first="S." last="Yardley">S. Yardley</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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