ParkinsonCanadaV1, PascalFrancis, Corpus, bibRecord, 000306

Unilateral subdural motor cortex stimulation improves essential tremor but not Parkinson's disease

Identifieur interne : 000306 ( PascalFrancis/Corpus ); précédent : 000305; suivant : 000307

Unilateral subdural motor cortex stimulation improves essential tremor but not Parkinson's disease

Auteurs : Elena Moro ; Jason M. Schwalb ; Panida Piboolnurak ; Yu-Yan W. Poon ; Clement Hamani ; Serena W. Hung ; Tamara Arenovich ; Anthony E. Lang ; Robert Chen ; Andres M. Lozano

Source :

Brain [ 0006-8950 ] ; 2011.

RBID : Pascal:11-0320384

Descripteurs français

Pascal (Inist)
- Tremblement, Maladie de Parkinson, Pathologie du système nerveux, Sousdural, Cortex moteur.

English descriptors

KwdEn :
- Motor cortex, Nervous system diseases, Parkinson disease, Subdural, Tremor.

Abstract

Epidural motor cortex stimulation has been reported to be effective in treating some movement disorders. Nevertheless, clinical results have been variable and no double-blinded evaluations have been reported. The aim of this study was to investigate efficacy and safety of unilateral subdural motor cortex stimulation in patients with essential tremor and Parkinson's disease. Six patients with essential tremor and five parkinsonian patients were selected. Craniotomy was performed under local anaesthesia with conscious sedation. A four contact electrode (Resume II model 3587, Medtronic, Inc) was positioned on the motor cortex, after identification of the area with direct monopolar cortical stimulation. Soon after surgery, a variety of different settings of stimulation were assessed using standard rating scales to select the optimal stimulation parameters. The effects of chronic stimulation were evaluated in both groups of patients after 3 months (double-blinded fashion) and 1 year (open fashion). In essential tremor, contralateral hand tremor scores significantly improved (P=0.04) with stimulation during the double-blinded study, whereas in Parkinson's disease, there were no changes in the OFF medication/on stimulation motor scores compared with off stimulation. At 1 year, tremor was improved by stimulation in two out of three patients with essential tremor available at follow-up, whereas no improvement was observed in the five parkinsonian patients. One parkinsonian patient had a cortical venous infarct. Three other patients had self-limiting seizures with aggressive trials of stimulation in the period of dosage selection. These findings suggest that unilateral subdural motor cortex stimulation may be useful for contralateral hand tremor in selected patients with essential tremor but was not effective in improving parkinsonian signs in our series.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

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Format Inist (serveur)

NO :	PASCAL 11-0320384 INIST
ET :	Unilateral subdural motor cortex stimulation improves essential tremor but not Parkinson's disease
AU :	MORO (Elena); SCHWALB (Jason M.); PIBOOLNURAK (Panida); POON (Yu-Yan W.); HAMANI (Clement); HUNG (Serena W.); ARENOVICH (Tamara); LANG (Anthony E.); CHEN (Robert); LOZANO (Andres M.)
AF :	Movement Disorders Centre, Division of Neurology, Department of Medicine, University of Toronto, Toronto Western Hospital, University Health Network/Toronto, M5T 2S8/Canada (1 aut., 3 aut., 4 aut., 6 aut., 8 aut., 9 aut.); Department of Neurosurgery, Toronto Western Hospital, University of Toronto, University Health Network/Toronto, M5T 2S8/Canada (2 aut., 5 aut., 10 aut.); Department of Neurosurgery, Henry Ford Health System/West Bloomfield, MI 48322/Etats-Unis (2 aut.); Parkinson's Disease and Movement Disorders Institute, Weill Cornell Medical College/New York, NY 10021/Etats-Unis (3 aut.); Department of Neurology, Medical College of Wisconsin/Milwaukee, WI 53226/Etats-Unis (6 aut.); Biostatistical Consulting Service, Clinical Research Department, Centre for Addiction and Mental Health/Toronto, M5T 1 R8/Canada (7 aut.)
DT :	Publication en série; Niveau analytique
SO :	Brain; ISSN 0006-8950; Royaume-Uni; Da. 2011; Vol. 134; No. p. 7; Pp. 2096-2105; Bibl. 1/2 p.
LA :	Anglais
EA :	Epidural motor cortex stimulation has been reported to be effective in treating some movement disorders. Nevertheless, clinical results have been variable and no double-blinded evaluations have been reported. The aim of this study was to investigate efficacy and safety of unilateral subdural motor cortex stimulation in patients with essential tremor and Parkinson's disease. Six patients with essential tremor and five parkinsonian patients were selected. Craniotomy was performed under local anaesthesia with conscious sedation. A four contact electrode (Resume II model 3587, Medtronic, Inc) was positioned on the motor cortex, after identification of the area with direct monopolar cortical stimulation. Soon after surgery, a variety of different settings of stimulation were assessed using standard rating scales to select the optimal stimulation parameters. The effects of chronic stimulation were evaluated in both groups of patients after 3 months (double-blinded fashion) and 1 year (open fashion). In essential tremor, contralateral hand tremor scores significantly improved (P=0.04) with stimulation during the double-blinded study, whereas in Parkinson's disease, there were no changes in the OFF medication/on stimulation motor scores compared with off stimulation. At 1 year, tremor was improved by stimulation in two out of three patients with essential tremor available at follow-up, whereas no improvement was observed in the five parkinsonian patients. One parkinsonian patient had a cortical venous infarct. Three other patients had self-limiting seizures with aggressive trials of stimulation in the period of dosage selection. These findings suggest that unilateral subdural motor cortex stimulation may be useful for contralateral hand tremor in selected patients with essential tremor but was not effective in improving parkinsonian signs in our series.
CC :	002B17; 002B17G
FD :	Tremblement; Maladie de Parkinson; Pathologie du système nerveux; Sousdural; Cortex moteur
FG :	Encéphale; Système nerveux central; Voie motrice; Mouvement involontaire; Trouble neurologique; Pathologie de l'encéphale; Syndrome extrapyramidal; Maladie dégénérative; Pathologie du système nerveux central
ED :	Tremor; Parkinson disease; Nervous system diseases; Subdural; Motor cortex
EG :	Encephalon; Central nervous system; Motor pathway; Involuntary movement; Neurological disorder; Cerebral disorder; Extrapyramidal syndrome; Degenerative disease; Central nervous system disease
SD :	Temblor; Parkinson enfermedad; Sistema nervioso patología; Subdural; Corteza motora
LO :	INIST-998.354000190474150180
ID :	11-0320384

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Pascal:11-0320384

Le document en format XML

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<keywords scheme="Pascal" xml:lang="fr"><term>Tremblement</term>
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<front><div type="abstract" xml:lang="en">Epidural motor cortex stimulation has been reported to be effective in treating some movement disorders. Nevertheless, clinical results have been variable and no double-blinded evaluations have been reported. The aim of this study was to investigate efficacy and safety of unilateral subdural motor cortex stimulation in patients with essential tremor and Parkinson's disease. Six patients with essential tremor and five parkinsonian patients were selected. Craniotomy was performed under local anaesthesia with conscious sedation. A four contact electrode (Resume II model 3587, Medtronic, Inc) was positioned on the motor cortex, after identification of the area with direct monopolar cortical stimulation. Soon after surgery, a variety of different settings of stimulation were assessed using standard rating scales to select the optimal stimulation parameters. The effects of chronic stimulation were evaluated in both groups of patients after 3 months (double-blinded fashion) and 1 year (open fashion). In essential tremor, contralateral hand tremor scores significantly improved (P=0.04) with stimulation during the double-blinded study, whereas in Parkinson's disease, there were no changes in the OFF medication/on stimulation motor scores compared with off stimulation. At 1 year, tremor was improved by stimulation in two out of three patients with essential tremor available at follow-up, whereas no improvement was observed in the five parkinsonian patients. One parkinsonian patient had a cortical venous infarct. Three other patients had self-limiting seizures with aggressive trials of stimulation in the period of dosage selection. These findings suggest that unilateral subdural motor cortex stimulation may be useful for contralateral hand tremor in selected patients with essential tremor but was not effective in improving parkinsonian signs in our series.</div>
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<ET>Unilateral subdural motor cortex stimulation improves essential tremor but not Parkinson's disease</ET>
<AU>MORO (Elena); SCHWALB (Jason M.); PIBOOLNURAK (Panida); POON (Yu-Yan W.); HAMANI (Clement); HUNG (Serena W.); ARENOVICH (Tamara); LANG (Anthony E.); CHEN (Robert); LOZANO (Andres M.)</AU>
<AF>Movement Disorders Centre, Division of Neurology, Department of Medicine, University of Toronto, Toronto Western Hospital, University Health Network/Toronto, M5T 2S8/Canada (1 aut., 3 aut., 4 aut., 6 aut., 8 aut., 9 aut.); Department of Neurosurgery, Toronto Western Hospital, University of Toronto, University Health Network/Toronto, M5T 2S8/Canada (2 aut., 5 aut., 10 aut.); Department of Neurosurgery, Henry Ford Health System/West Bloomfield, MI 48322/Etats-Unis (2 aut.); Parkinson's Disease and Movement Disorders Institute, Weill Cornell Medical College/New York, NY 10021/Etats-Unis (3 aut.); Department of Neurology, Medical College of Wisconsin/Milwaukee, WI 53226/Etats-Unis (6 aut.); Biostatistical Consulting Service, Clinical Research Department, Centre for Addiction and Mental Health/Toronto, M5T 1 R8/Canada (7 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Brain; ISSN 0006-8950; Royaume-Uni; Da. 2011; Vol. 134; No. p. 7; Pp. 2096-2105; Bibl. 1/2 p.</SO>
<LA>Anglais</LA>
<EA>Epidural motor cortex stimulation has been reported to be effective in treating some movement disorders. Nevertheless, clinical results have been variable and no double-blinded evaluations have been reported. The aim of this study was to investigate efficacy and safety of unilateral subdural motor cortex stimulation in patients with essential tremor and Parkinson's disease. Six patients with essential tremor and five parkinsonian patients were selected. Craniotomy was performed under local anaesthesia with conscious sedation. A four contact electrode (Resume II model 3587, Medtronic, Inc) was positioned on the motor cortex, after identification of the area with direct monopolar cortical stimulation. Soon after surgery, a variety of different settings of stimulation were assessed using standard rating scales to select the optimal stimulation parameters. The effects of chronic stimulation were evaluated in both groups of patients after 3 months (double-blinded fashion) and 1 year (open fashion). In essential tremor, contralateral hand tremor scores significantly improved (P=0.04) with stimulation during the double-blinded study, whereas in Parkinson's disease, there were no changes in the OFF medication/on stimulation motor scores compared with off stimulation. At 1 year, tremor was improved by stimulation in two out of three patients with essential tremor available at follow-up, whereas no improvement was observed in the five parkinsonian patients. One parkinsonian patient had a cortical venous infarct. Three other patients had self-limiting seizures with aggressive trials of stimulation in the period of dosage selection. These findings suggest that unilateral subdural motor cortex stimulation may be useful for contralateral hand tremor in selected patients with essential tremor but was not effective in improving parkinsonian signs in our series.</EA>
<CC>002B17; 002B17G</CC>
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<ED>Tremor; Parkinson disease; Nervous system diseases; Subdural; Motor cortex</ED>
<EG>Encephalon; Central nervous system; Motor pathway; Involuntary movement; Neurological disorder; Cerebral disorder; Extrapyramidal syndrome; Degenerative disease; Central nervous system disease</EG>
<SD>Temblor; Parkinson enfermedad; Sistema nervioso patología; Subdural; Corteza motora</SD>
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	La maladie de Parkinson au Canada (serveur d'exploration)
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La maladie de Parkinson au Canada (serveur d'exploration)

Unilateral subdural motor cortex stimulation improves essential tremor but not Parkinson's disease

Unilateral subdural motor cortex stimulation improves essential tremor but not Parkinson's disease

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