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

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Reassessment of unilateral pallidotomy in Parkinson's disease: A 2-year follow-up study

Identifieur interne : 000C30 ( PascalFrancis/Checkpoint ); précédent : 000C29; suivant : 000C31

Reassessment of unilateral pallidotomy in Parkinson's disease: A 2-year follow-up study

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 :

RBID : Pascal:99-0168124

Descripteurs français

English descriptors

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.


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Pascal:99-0168124

Le document en format XML

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<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>
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<fC07 i1="01" i2="X" l="SPA">
<s0>Sistema nervioso patología</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE">
<s0>Système nerveux central pathologie</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG">
<s0>Central nervous system disease</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA">
<s0>Sistema nervosio central patología</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE">
<s0>Encéphale pathologie</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG">
<s0>Cerebral disorder</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA">
<s0>Encéfalo patología</s0>
<s5>39</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE">
<s0>Extrapyramidal syndrome</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG">
<s0>Extrapyramidal syndrome</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA">
<s0>Extrapiramidal síndrome</s0>
<s5>40</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE">
<s0>Maladie dégénérative</s0>
<s5>41</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG">
<s0>Degenerative disease</s0>
<s5>41</s5>
</fC07>
<fC07 i1="05" i2="X" l="SPA">
<s0>Enfermedad degenerativa</s0>
<s5>41</s5>
</fC07>
<fC07 i1="06" i2="X" l="FRE">
<s0>Chirurgie</s0>
<s5>45</s5>
</fC07>
<fC07 i1="06" i2="X" l="ENG">
<s0>Surgery</s0>
<s5>45</s5>
</fC07>
<fC07 i1="06" i2="X" l="SPA">
<s0>Cirugía</s0>
<s5>45</s5>
</fC07>
<fN21>
<s1>102</s1>
</fN21>
</pA>
</standard>
</inist>
<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>

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