Ten-Year Outcome of Subthalamic Stimulation in Parkinson Disease: A Blinded Evaluation
Identifieur interne : 000223 ( PascalFrancis/Checkpoint ); précédent : 000222; suivant : 000224Ten-Year Outcome of Subthalamic Stimulation in Parkinson Disease: A Blinded Evaluation
Auteurs : Anna Castrioto [Italie, Canada] ; Andres M. Lozano [Canada] ; Yu-Yan Poon [Canada] ; Anthony E. Lang [Canada] ; Melanie Fallis [Canada] ; Elena Moro [Canada]Source :
- Archives of neurology : (Chicago) [ 0003-9942 ] ; 2011.
Descripteurs français
- Pascal (Inist)
English descriptors
Abstract
Objective: To assess the 10-year motor outcome of deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson disease (PD). Design: Patients with PD with bilateral STN-DBS were assessed according to the Core Assessment Program for Surgical Interventional Therapies in Parkinson's Disease protocol and videotaped at baseline and 1, 5, and 10 years after surgery. An independent rater blinded to stimulation and medication condition scored the 10-year video assessments. Setting: Movement Disorders Centre, Toronto Western Hospital, University Health Network, University of Toronto. Patients: Eighteen patients with advanced PD and 10-year follow-up of STN-DBS. Intervention: Bilateral STN-DBS surgery. Main Outcome Measures: The primary outcome was the change in blinded Unified Parkinson's Disease Rating Scale (UPDRS) motor scores/subscores between the no medication/stimulation condition vs the no medication/no stimulation condition at 10 years. Secondary outcomes were the changes in blinded UPDRS motor scores between the medication/no stimulation and medication/ stimulation conditions, UPDRS II scores, UPDRS IV dyskinesia and motor fluctuations scores, and anti-PD medication dose (levodopa equivalent daily dose) at different points. Results: In the 18 patients available for follow-up at 10 years, STN-DBS still significantly improved the UPDRS total motor score (P = .007) and resting and action tremor (P < .01 and P=.02, respectively) and bradykinesia (P = .01) subscores. The UPDRS II scores in the medication and no medication conditions, UPDRS IV dyskinesia and motor fluctuations scores, and the levodopa equivalent daily dose were also significantly reduced compared with baseline. Axial signs showed the most progressive decline in stimulation and levodopa response over the years. Conclusion: This class III study provides evidence that stimulation-induced motor improvement was sustained overall at 10 years, although part of the initial benefit wore off mainly because of progressive loss of benefit on axial signs over time.
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Lozano</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Department of Neurosurgery, Toronto Western Hospital, University of Toronto, University Health Network</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>2 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Movement Disorders Centre, Division of Neurology, Toronto Western Hospital, University of Toronto, University Health Network</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Movement Disorders Centre, Division of Neurology, Toronto Western Hospital, University of Toronto, University Health Network</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Fallis, Melanie" sort="Fallis, Melanie" uniqKey="Fallis M" first="Melanie" last="Fallis">Melanie Fallis</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Movement Disorders Centre, Division of Neurology, Toronto Western Hospital, University of Toronto, University Health Network</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Movement Disorders Centre, Division of Neurology, Toronto Western Hospital, University of Toronto, University Health Network</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">12-0031788</idno><date when="2011">2011</date><idno type="stanalyst">PASCAL 12-0031788 INIST</idno><idno type="RBID">Pascal:12-0031788</idno><idno type="wicri:Area/PascalFrancis/Corpus">000245</idno><idno type="wicri:Area/PascalFrancis/Curation">000A07</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000223</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000223</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Ten-Year Outcome of Subthalamic Stimulation in Parkinson Disease: A Blinded Evaluation</title><author><name sortKey="Castrioto, Anna" sort="Castrioto, Anna" uniqKey="Castrioto A" first="Anna" last="Castrioto">Anna Castrioto</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Neurologica, Universita degli Studi di Perugia</s1><s2>Perugia</s2><s3>ITA</s3><sZ>1 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Perugia</wicri:noRegion></affiliation><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Movement Disorders Centre, Division of Neurology, Toronto Western Hospital, University of Toronto, University Health Network</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Department of Neurosurgery, Toronto Western Hospital, University of Toronto, University Health Network</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>2 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Movement Disorders Centre, Division of Neurology, Toronto Western Hospital, University of Toronto, University Health Network</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Movement Disorders Centre, Division of Neurology, Toronto Western Hospital, University of Toronto, University Health Network</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Fallis, Melanie" sort="Fallis, Melanie" uniqKey="Fallis M" first="Melanie" last="Fallis">Melanie Fallis</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Movement Disorders Centre, Division of Neurology, Toronto Western Hospital, University of Toronto, University Health Network</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation wicri:level="4"><inist:fA14 i1="02"><s1>Movement Disorders Centre, Division of Neurology, Toronto Western Hospital, University of Toronto, University Health Network</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Archives of neurology : (Chicago)</title><title level="j" type="abbreviated">Arch. neurol. : (Chic.)</title><idno type="ISSN">0003-9942</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Archives of neurology : (Chicago)</title><title level="j" type="abbreviated">Arch. neurol. : (Chic.)</title><idno type="ISSN">0003-9942</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Evaluation</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Prognosis</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Pronostic</term><term>Evaluation</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: To assess the 10-year motor outcome of deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson disease (PD). Design: Patients with PD with bilateral STN-DBS were assessed according to the Core Assessment Program for Surgical Interventional Therapies in Parkinson's Disease protocol and videotaped at baseline and 1, 5, and 10 years after surgery. An independent rater blinded to stimulation and medication condition scored the 10-year video assessments. Setting: Movement Disorders Centre, Toronto Western Hospital, University Health Network, University of Toronto. Patients: Eighteen patients with advanced PD and 10-year follow-up of STN-DBS. Intervention: Bilateral STN-DBS surgery. Main Outcome Measures: The primary outcome was the change in blinded Unified Parkinson's Disease Rating Scale (UPDRS) motor scores/subscores between the no medication/stimulation condition vs the no medication/no stimulation condition at 10 years. Secondary outcomes were the changes in blinded UPDRS motor scores between the medication/no stimulation and medication/ stimulation conditions, UPDRS II scores, UPDRS IV dyskinesia and motor fluctuations scores, and anti-PD medication dose (levodopa equivalent daily dose) at different points. Results: In the 18 patients available for follow-up at 10 years, STN-DBS still significantly improved the UPDRS total motor score (P = .007) and resting and action tremor (P < .01 and P=.02, respectively) and bradykinesia (P = .01) subscores. The UPDRS II scores in the medication and no medication conditions, UPDRS IV dyskinesia and motor fluctuations scores, and the levodopa equivalent daily dose were also significantly reduced compared with baseline. Axial signs showed the most progressive decline in stimulation and levodopa response over the years. Conclusion: This class III study provides evidence that stimulation-induced motor improvement was sustained overall at 10 years, although part of the initial benefit wore off mainly because of progressive loss of benefit on axial signs over time.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0003-9942</s0></fA01><fA02 i1="01"><s0>ARNEAS</s0></fA02><fA03 i2="1"><s0>Arch. neurol. : (Chic.)</s0></fA03><fA05><s2>68</s2></fA05><fA06><s2>12</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Ten-Year Outcome of Subthalamic Stimulation in Parkinson Disease: A Blinded Evaluation</s1></fA08><fA11 i1="01" i2="1"><s1>CASTRIOTO (Anna)</s1></fA11><fA11 i1="02" i2="1"><s1>LOZANO (Andres M.)</s1></fA11><fA11 i1="03" i2="1"><s1>POON (Yu-Yan)</s1></fA11><fA11 i1="04" i2="1"><s1>LANG (Anthony E.)</s1></fA11><fA11 i1="05" i2="1"><s1>FALLIS (Melanie)</s1></fA11><fA11 i1="06" i2="1"><s1>MORO (Elena)</s1></fA11><fA14 i1="01"><s1>Neurologica, Universita degli Studi di Perugia</s1><s2>Perugia</s2><s3>ITA</s3><sZ>1 aut.</sZ></fA14><fA14 i1="02"><s1>Movement Disorders Centre, Division of Neurology, Toronto Western Hospital, University of Toronto, University Health Network</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ></fA14><fA14 i1="03"><s1>Department of Neurosurgery, Toronto Western Hospital, University of Toronto, University Health Network</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>2 aut.</sZ></fA14><fA20><s1>1550-1556</s1></fA20><fA21><s1>2011</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>2048B</s2><s5>354000505699050070</s5></fA43><fA44><s0>0000</s0><s1>© 2012 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>22 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>12-0031788</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Archives of neurology : (Chicago)</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Objective: To assess the 10-year motor outcome of deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson disease (PD). Design: Patients with PD with bilateral STN-DBS were assessed according to the Core Assessment Program for Surgical Interventional Therapies in Parkinson's Disease protocol and videotaped at baseline and 1, 5, and 10 years after surgery. An independent rater blinded to stimulation and medication condition scored the 10-year video assessments. Setting: Movement Disorders Centre, Toronto Western Hospital, University Health Network, University of Toronto. Patients: Eighteen patients with advanced PD and 10-year follow-up of STN-DBS. Intervention: Bilateral STN-DBS surgery. Main Outcome Measures: The primary outcome was the change in blinded Unified Parkinson's Disease Rating Scale (UPDRS) motor scores/subscores between the no medication/stimulation condition vs the no medication/no stimulation condition at 10 years. Secondary outcomes were the changes in blinded UPDRS motor scores between the medication/no stimulation and medication/ stimulation conditions, UPDRS II scores, UPDRS IV dyskinesia and motor fluctuations scores, and anti-PD medication dose (levodopa equivalent daily dose) at different points. Results: In the 18 patients available for follow-up at 10 years, STN-DBS still significantly improved the UPDRS total motor score (P = .007) and resting and action tremor (P < .01 and P=.02, respectively) and bradykinesia (P = .01) subscores. The UPDRS II scores in the medication and no medication conditions, UPDRS IV dyskinesia and motor fluctuations scores, and the levodopa equivalent daily dose were also significantly reduced compared with baseline. Axial signs showed the most progressive decline in stimulation and levodopa response over the years. Conclusion: This class III study provides evidence that stimulation-induced motor improvement was sustained overall at 10 years, although part of the initial benefit wore off mainly because of progressive loss of benefit on axial signs over time.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17G</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Maladie de Parkinson</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Parkinson disease</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Pathologie du système nerveux</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Pronostic</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Prognosis</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Pronóstico</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Evaluation</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Evaluation</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Evaluación</s0><s5>10</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Pathologie de l'encéphale</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Syndrome extrapyramidal</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Pathologie du système nerveux central</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>40</s5></fC07><fN21><s1>016</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>Canada</li><li>Italie</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="Italie"><noRegion><name sortKey="Castrioto, Anna" sort="Castrioto, Anna" uniqKey="Castrioto A" first="Anna" last="Castrioto">Anna Castrioto</name></noRegion></country><country name="Canada"><region name="Ontario"><name sortKey="Castrioto, Anna" sort="Castrioto, Anna" uniqKey="Castrioto A" first="Anna" last="Castrioto">Anna Castrioto</name></region><name sortKey="Fallis, Melanie" sort="Fallis, Melanie" uniqKey="Fallis M" first="Melanie" last="Fallis">Melanie Fallis</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="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><name sortKey="Poon, Yu Yan" sort="Poon, Yu Yan" uniqKey="Poon Y" first="Yu-Yan" last="Poon">Yu-Yan Poon</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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