Reassessment of unilateral pallidotomy in Parkinson's disease. A 2-year follow-up study.
Identifieur interne : 000007 ( Ncbi/Checkpoint ); précédent : 000006; suivant : 000008Reassessment of unilateral pallidotomy in Parkinson's disease. A 2-year follow-up study.
Auteurs : A. Samii [Canada] ; I M Turnbull ; A. Kishore ; M. Schulzer ; E. Mak ; S. Yardley ; D B CalneSource :
- Brain : a journal of neurology [ 0006-8950 ] ; 1999.
English descriptors
- KwdEn :
- Aged, Antiparkinson Agents (administration & dosage), Antiparkinson Agents (therapeutic use), Female, Follow-Up Studies, Functional Laterality, Gait, Globus Pallidus (physiopathology), Globus Pallidus (surgery), Humans, Male, Middle Aged, Movement Disorders, Neurosurgical Procedures (adverse effects), Parkinson Disease (drug therapy), Parkinson Disease (physiopathology), Parkinson Disease (surgery), Psychomotor Performance, Tremor (physiopathology).
- 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.
PubMed: 10094251
Affiliations:
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Kishore</name></author><author><name sortKey="Schulzer, M" sort="Schulzer, M" uniqKey="Schulzer M" first="M" last="Schulzer">M. Schulzer</name></author><author><name sortKey="Mak, E" sort="Mak, E" uniqKey="Mak E" first="E" last="Mak">E. Mak</name></author><author><name sortKey="Yardley, S" sort="Yardley, S" uniqKey="Yardley S" first="S" last="Yardley">S. Yardley</name></author><author><name sortKey="Calne, D B" sort="Calne, D B" uniqKey="Calne D" first="D B" last="Calne">D B Calne</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1999">1999</date><idno type="RBID">pubmed:10094251</idno><idno type="pmid">10094251</idno><idno type="wicri:Area/PubMed/Corpus">001724</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001724</idno><idno type="wicri:Area/PubMed/Curation">001724</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001724</idno><idno type="wicri:Area/PubMed/Checkpoint">001724</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">001724</idno><idno type="wicri:Area/Ncbi/Merge">000007</idno><idno type="wicri:Area/Ncbi/Curation">000007</idno><idno type="wicri:Area/Ncbi/Checkpoint">000007</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Reassessment of unilateral pallidotomy in Parkinson's disease. A 2-year follow-up study.</title><author><name sortKey="Samii, A" sort="Samii, A" uniqKey="Samii A" first="A" last="Samii">A. Samii</name><affiliation wicri:level="1"><nlm:affiliation>Neurodegenerative Disorders Centre, Vancouver Hospital and Health Sciences Centre, BC, Canada.</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Neurodegenerative Disorders Centre, Vancouver Hospital and Health Sciences Centre, 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></author><author><name sortKey="Kishore, A" sort="Kishore, A" uniqKey="Kishore A" first="A" last="Kishore">A. Kishore</name></author><author><name sortKey="Schulzer, M" sort="Schulzer, M" uniqKey="Schulzer M" first="M" last="Schulzer">M. Schulzer</name></author><author><name sortKey="Mak, E" sort="Mak, E" uniqKey="Mak E" first="E" last="Mak">E. Mak</name></author><author><name sortKey="Yardley, S" sort="Yardley, S" uniqKey="Yardley S" first="S" last="Yardley">S. Yardley</name></author><author><name sortKey="Calne, D B" sort="Calne, D B" uniqKey="Calne D" first="D B" last="Calne">D B Calne</name></author></analytic><series><title level="j">Brain : a journal of neurology</title><idno type="ISSN">0006-8950</idno><imprint><date when="1999" type="published">1999</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Antiparkinson Agents (administration & dosage)</term><term>Antiparkinson Agents (therapeutic use)</term><term>Female</term><term>Follow-Up Studies</term><term>Functional Laterality</term><term>Gait</term><term>Globus Pallidus (physiopathology)</term><term>Globus Pallidus (surgery)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Movement Disorders</term><term>Neurosurgical Procedures (adverse effects)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (surgery)</term><term>Psychomotor Performance</term><term>Tremor (physiopathology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antiparkinson Agents</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Neurosurgical Procedures</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Globus Pallidus</term><term>Parkinson Disease</term><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Globus Pallidus</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Follow-Up Studies</term><term>Functional Laterality</term><term>Gait</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Movement Disorders</term><term>Psychomotor Performance</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><affiliations><list><country><li>Canada</li></country></list><tree><noCountry><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></noCountry><country name="Canada"><noRegion><name sortKey="Samii, A" sort="Samii, A" uniqKey="Samii A" first="A" last="Samii">A. Samii</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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