The effects of pallidotomy on Parkinson's disease: study design and assessment techniques.
Identifieur interne : 003A64 ( Main/Exploration ); précédent : 003A63; suivant : 003A65The effects of pallidotomy on Parkinson's disease: study design and assessment techniques.
Auteurs : R E Gross [Canada] ; A M Lozano ; A E Lang ; R R Tasker ; W D Hutchison ; J O DostrovskySource :
- Acta neurochirurgica. Supplement [ 0065-1419 ] ; 1997.
English descriptors
- KwdEn :
- Adult, Aged, Antiparkinson Agents (adverse effects), Brain Mapping, Dyskinesia, Drug-Induced (diagnosis), Dyskinesia, Drug-Induced (physiopathology), Dyskinesia, Drug-Induced (surgery), Female, Globus Pallidus (physiopathology), Globus Pallidus (surgery), Humans, Levodopa (adverse effects), Male, Middle Aged, Neurologic Examination, Outcome Assessment (Health Care), Parkinson Disease (diagnosis), Parkinson Disease (physiopathology), Parkinson Disease (surgery), Postoperative Complications (diagnosis), Postoperative Complications (physiopathology), Single-Blind Method, Stereotaxic Techniques, Video Recording.
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- diagnosis : Dyskinesia, Drug-Induced, Parkinson Disease, Postoperative Complications.
- physiopathology : Dyskinesia, Drug-Induced, Globus Pallidus, Parkinson Disease, Postoperative Complications.
- surgery : Dyskinesia, Drug-Induced, Globus Pallidus, Parkinson Disease.
- Adult, Aged, Brain Mapping, Female, Humans, Male, Middle Aged, Neurologic Examination, Outcome Assessment (Health Care), Single-Blind Method, Stereotaxic Techniques, Video Recording.
Abstract
Lesions of the internal segment of the globus pallidus are increasingly being utilized in the surgical treatment of advanced Parkinson's disease, yet studies to demonstrate the safety and efficacy of these procedures are only now being completed. The importance of procedural variations between centres in the outcome of pallidotomy is not yet known. In order to compare accurately results between centres, carefully designed, prospective studies are needed. The authors utilized blinded, randomly evaluated videotaped examinations of pre- and post-operative patients undergoing microelectrode-guided GPi pallidotomy. Their results demonstrate significant effects on contralateral akinesia and tremor in the "off" state, and striking attenuation of levodopa-induced dyskinesias in the "on" state. More modest effects on postural stability and gait disturbance were seen only in non-blinded evaluations. This type of study design should enable many of the outstanding issues related to pallidotomy indications, procedures and outcomes to be addressed.
PubMed: 9233409
Affiliations:
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Supplement</title><idno type="ISSN">0065-1419</idno><imprint><date when="1997" type="published">1997</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Antiparkinson Agents (adverse effects)</term><term>Brain Mapping</term><term>Dyskinesia, Drug-Induced (diagnosis)</term><term>Dyskinesia, Drug-Induced (physiopathology)</term><term>Dyskinesia, Drug-Induced (surgery)</term><term>Female</term><term>Globus Pallidus (physiopathology)</term><term>Globus Pallidus (surgery)</term><term>Humans</term><term>Levodopa (adverse effects)</term><term>Male</term><term>Middle Aged</term><term>Neurologic Examination</term><term>Outcome Assessment (Health Care)</term><term>Parkinson Disease (diagnosis)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (surgery)</term><term>Postoperative Complications (diagnosis)</term><term>Postoperative Complications (physiopathology)</term><term>Single-Blind Method</term><term>Stereotaxic Techniques</term><term>Video Recording</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Dyskinesia, Drug-Induced</term><term>Parkinson Disease</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Dyskinesia, Drug-Induced</term><term>Globus Pallidus</term><term>Parkinson Disease</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Dyskinesia, Drug-Induced</term><term>Globus Pallidus</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Brain Mapping</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Neurologic Examination</term><term>Outcome Assessment (Health Care)</term><term>Single-Blind Method</term><term>Stereotaxic Techniques</term><term>Video Recording</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Lesions of the internal segment of the globus pallidus are increasingly being utilized in the surgical treatment of advanced Parkinson's disease, yet studies to demonstrate the safety and efficacy of these procedures are only now being completed. The importance of procedural variations between centres in the outcome of pallidotomy is not yet known. In order to compare accurately results between centres, carefully designed, prospective studies are needed. The authors utilized blinded, randomly evaluated videotaped examinations of pre- and post-operative patients undergoing microelectrode-guided GPi pallidotomy. Their results demonstrate significant effects on contralateral akinesia and tremor in the "off" state, and striking attenuation of levodopa-induced dyskinesias in the "on" state. More modest effects on postural stability and gait disturbance were seen only in non-blinded evaluations. This type of study design should enable many of the outstanding issues related to pallidotomy indications, procedures and outcomes to be addressed.</div></front></TEI><affiliations><list><country><li>Canada</li></country></list><tree><noCountry><name sortKey="Dostrovsky, J O" sort="Dostrovsky, J O" uniqKey="Dostrovsky J" first="J O" last="Dostrovsky">J O Dostrovsky</name><name sortKey="Hutchison, W D" sort="Hutchison, W D" uniqKey="Hutchison W" first="W D" last="Hutchison">W D Hutchison</name><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><name sortKey="Tasker, R R" sort="Tasker, R R" uniqKey="Tasker R" first="R R" last="Tasker">R R Tasker</name></noCountry><country name="Canada"><noRegion><name sortKey="Gross, R E" sort="Gross, R E" uniqKey="Gross R" first="R E" last="Gross">R E Gross</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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