L-DOPA-INDUCED DYSKINESIA AND STEREOTACTIC SURGERY FOR PARKINSON'S DISEASE. Commentaries
Identifieur interne : 000656 ( PascalFrancis/Corpus ); précédent : 000655; suivant : 000657L-DOPA-INDUCED DYSKINESIA AND STEREOTACTIC SURGERY FOR PARKINSON'S DISEASE. Commentaries
Auteurs : Jorge Guridi ; Jose A. Obeso ; Maria C. Rodriguez-Oroz ; Andres A. Lozano ; Miguel Manrique ; Philip A. Starr ; Julie G. Pilitsis ; Roy A. E. Bakay ; Marwan I. Hariz ; Ventura Arjona ; Jose G. Martin-RodriguezSource :
- Neurosurgery [ 0148-396X ] ; 2008.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
OBJECTIVE: To assess the impact of different surgical targets and techniques, such as ablation and deep brain stimulation, to treat patients with L-dopa-induced dyskinesia (LID), a major therapeutic complication of Parkinson's disease. METHODS: This review analyzes the effects of early surgical procedures to treat hyper-kinesia and the current methods and targets used to combat LID in Parkinson's disease, which are mainly thalamotomy, pallidotomy, and deep brain stimulation of the globus pallidus internus and the subthalamic nucleus. RESULTS: Available information indicates that surgery of the globus pallidus internus and thalamus (the pallidal receiving area) and of the subthalamic nucleus has a pronounced antidyskinetic effect. This effect is associated with a concomitant improvement in the parkinsonian ("off"-medication) state. Although it is more profound with pallidal and subthalamic surgery, such an effect can also be observed to some extent with thalamic surgery. The latter is attributable to the fact that surgery of the ventralis intermedius is primarily effective for treating tremor. An integral pallidothalamic pathway is needed for dyskinesia to be expressed. Thus, LID is less frequent after subthalamotomy or deep brain stimulation of the subthalamic nucleus through a functional effect mediated by the physiological normalization of the motor system and by an indirect effect associated with a reduction in the daily dose of L-dopa. CONCLUSION: Surgery is the only treatment available for Parkinson's disease that can predictably improve both the parkinsonian motor syndrome and LID. The exact mechanisms involved in these effects are not well understood. Pallidal and thalamic surgery affecting pallidal relays reduce LID frequency by disrupting the pallidothalamic circuit, probably eliminating the neuronal activity associated with dyskinesia. Alternatively, the antidyskinetic effect of subthalamic nucleus surgery may in part be attributable to a reduction in the L-dopa dose as well as to the stabilization of the basal ganglia circuits after the surgical procedure.
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Format Inist (serveur)
NO : | PASCAL 08-0207896 INIST |
---|---|
ET : | L-DOPA-INDUCED DYSKINESIA AND STEREOTACTIC SURGERY FOR PARKINSON'S DISEASE. Commentaries |
AU : | GURIDI (Jorge); OBESO (Jose A.); RODRIGUEZ-OROZ (Maria C.); LOZANO (Andres A.); MANRIQUE (Miguel); STARR (Philip A.); PILITSIS (Julie G.); BAKAY (Roy A. E.); HARIZ (Marwan I.); ARJONA (Ventura); MARTIN-RODRIGUEZ (Jose G.) |
AF : | Division of Neurosurgery, Neuroscience Department, University Clinic, University of Navarra/Pamplona/Espagne (1 aut., 2 aut., 3 aut., 5 aut.); Division of Neurosurgery, Toronto Western Hospital, University of Toronto/Toronto/Canada (4 aut.) |
DT : | Publication en série; Article; Commentaire; Niveau analytique |
SO : | Neurosurgery; ISSN 0148-396X; Coden NRSRDY; Etats-Unis; Da. 2008; Vol. 62; No. 2; Pp. 311-325; Bibl. 126 ref. |
LA : | Anglais |
EA : | OBJECTIVE: To assess the impact of different surgical targets and techniques, such as ablation and deep brain stimulation, to treat patients with L-dopa-induced dyskinesia (LID), a major therapeutic complication of Parkinson's disease. METHODS: This review analyzes the effects of early surgical procedures to treat hyper-kinesia and the current methods and targets used to combat LID in Parkinson's disease, which are mainly thalamotomy, pallidotomy, and deep brain stimulation of the globus pallidus internus and the subthalamic nucleus. RESULTS: Available information indicates that surgery of the globus pallidus internus and thalamus (the pallidal receiving area) and of the subthalamic nucleus has a pronounced antidyskinetic effect. This effect is associated with a concomitant improvement in the parkinsonian ("off"-medication) state. Although it is more profound with pallidal and subthalamic surgery, such an effect can also be observed to some extent with thalamic surgery. The latter is attributable to the fact that surgery of the ventralis intermedius is primarily effective for treating tremor. An integral pallidothalamic pathway is needed for dyskinesia to be expressed. Thus, LID is less frequent after subthalamotomy or deep brain stimulation of the subthalamic nucleus through a functional effect mediated by the physiological normalization of the motor system and by an indirect effect associated with a reduction in the daily dose of L-dopa. CONCLUSION: Surgery is the only treatment available for Parkinson's disease that can predictably improve both the parkinsonian motor syndrome and LID. The exact mechanisms involved in these effects are not well understood. Pallidal and thalamic surgery affecting pallidal relays reduce LID frequency by disrupting the pallidothalamic circuit, probably eliminating the neuronal activity associated with dyskinesia. Alternatively, the antidyskinetic effect of subthalamic nucleus surgery may in part be attributable to a reduction in the L-dopa dose as well as to the stabilization of the basal ganglia circuits after the surgical procedure. |
CC : | 002B25J |
FD : | Dyskinésie; Maladie de Parkinson; Pathologie du système nerveux; Dopa; Stéréotaxie; Chirurgie; Encéphale; Noyau sousthalamique; Thalamotomie |
FG : | Syndrome extrapyramidal; Mouvement involontaire; Trouble neurologique; Pathologie de l'encéphale; Maladie dégénérative; Pathologie du système nerveux central |
ED : | Dyskinesia; Parkinson disease; Nervous system diseases; Dopa; Stereotaxia; Surgery; Encephalon; Subthalamic nucleus; Thalamotomy |
EG : | Extrapyramidal syndrome; Involuntary movement; Neurological disorder; Cerebral disorder; Degenerative disease; Central nervous system disease |
SD : | Disquinesia; Parkinson enfermedad; Sistema nervioso patología; Dopa; Estereotaxia; Cirugía; Encéfalo; Núcleo subtalámico; Talamotomía |
LO : | INIST-18396.354000173717260040 |
ID : | 08-0207896 |
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Pascal:08-0207896Le document en format XML
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<front><div type="abstract" xml:lang="en">OBJECTIVE: To assess the impact of different surgical targets and techniques, such as ablation and deep brain stimulation, to treat patients with L-dopa-induced dyskinesia (LID), a major therapeutic complication of Parkinson's disease. METHODS: This review analyzes the effects of early surgical procedures to treat hyper-kinesia and the current methods and targets used to combat LID in Parkinson's disease, which are mainly thalamotomy, pallidotomy, and deep brain stimulation of the globus pallidus internus and the subthalamic nucleus. RESULTS: Available information indicates that surgery of the globus pallidus internus and thalamus (the pallidal receiving area) and of the subthalamic nucleus has a pronounced antidyskinetic effect. This effect is associated with a concomitant improvement in the parkinsonian ("off"-medication) state. Although it is more profound with pallidal and subthalamic surgery, such an effect can also be observed to some extent with thalamic surgery. The latter is attributable to the fact that surgery of the ventralis intermedius is primarily effective for treating tremor. An integral pallidothalamic pathway is needed for dyskinesia to be expressed. Thus, LID is less frequent after subthalamotomy or deep brain stimulation of the subthalamic nucleus through a functional effect mediated by the physiological normalization of the motor system and by an indirect effect associated with a reduction in the daily dose of L-dopa. CONCLUSION: Surgery is the only treatment available for Parkinson's disease that can predictably improve both the parkinsonian motor syndrome and LID. The exact mechanisms involved in these effects are not well understood. Pallidal and thalamic surgery affecting pallidal relays reduce LID frequency by disrupting the pallidothalamic circuit, probably eliminating the neuronal activity associated with dyskinesia. Alternatively, the antidyskinetic effect of subthalamic nucleus surgery may in part be attributable to a reduction in the L-dopa dose as well as to the stabilization of the basal ganglia circuits after the surgical procedure.</div>
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<fC03 i1="07" i2="X" l="FRE"><s0>Encéphale</s0>
<s5>12</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG"><s0>Encephalon</s0>
<s5>12</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA"><s0>Encéfalo</s0>
<s5>12</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE"><s0>Noyau sousthalamique</s0>
<s5>13</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Subthalamic nucleus</s0>
<s5>13</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Núcleo subtalámico</s0>
<s5>13</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE"><s0>Thalamotomie</s0>
<s5>14</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG"><s0>Thalamotomy</s0>
<s5>14</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA"><s0>Talamotomía</s0>
<s5>14</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Syndrome extrapyramidal</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Mouvement involontaire</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Involuntary movement</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Movimiento involuntario</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Trouble neurologique</s0>
<s5>40</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Neurological disorder</s0>
<s5>40</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Trastorno neurológico</s0>
<s5>40</s5>
</fC07>
<fC07 i1="04" i2="X" l="FRE"><s0>Pathologie de l'encéphale</s0>
<s5>41</s5>
</fC07>
<fC07 i1="04" i2="X" l="ENG"><s0>Cerebral disorder</s0>
<s5>41</s5>
</fC07>
<fC07 i1="04" i2="X" l="SPA"><s0>Encéfalo patología</s0>
<s5>41</s5>
</fC07>
<fC07 i1="05" i2="X" l="FRE"><s0>Maladie dégénérative</s0>
<s5>42</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>Degenerative disease</s0>
<s5>42</s5>
</fC07>
<fC07 i1="05" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0>
<s5>42</s5>
</fC07>
<fC07 i1="06" i2="X" l="FRE"><s0>Pathologie du système nerveux central</s0>
<s5>43</s5>
</fC07>
<fC07 i1="06" i2="X" l="ENG"><s0>Central nervous system disease</s0>
<s5>43</s5>
</fC07>
<fC07 i1="06" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0>
<s5>43</s5>
</fC07>
<fN21><s1>133</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
</fN82>
</pA>
</standard>
<server><NO>PASCAL 08-0207896 INIST</NO>
<ET>L-DOPA-INDUCED DYSKINESIA AND STEREOTACTIC SURGERY FOR PARKINSON'S DISEASE. Commentaries</ET>
<AU>GURIDI (Jorge); OBESO (Jose A.); RODRIGUEZ-OROZ (Maria C.); LOZANO (Andres A.); MANRIQUE (Miguel); STARR (Philip A.); PILITSIS (Julie G.); BAKAY (Roy A. E.); HARIZ (Marwan I.); ARJONA (Ventura); MARTIN-RODRIGUEZ (Jose G.)</AU>
<AF>Division of Neurosurgery, Neuroscience Department, University Clinic, University of Navarra/Pamplona/Espagne (1 aut., 2 aut., 3 aut., 5 aut.); Division of Neurosurgery, Toronto Western Hospital, University of Toronto/Toronto/Canada (4 aut.)</AF>
<DT>Publication en série; Article; Commentaire; Niveau analytique</DT>
<SO>Neurosurgery; ISSN 0148-396X; Coden NRSRDY; Etats-Unis; Da. 2008; Vol. 62; No. 2; Pp. 311-325; Bibl. 126 ref.</SO>
<LA>Anglais</LA>
<EA>OBJECTIVE: To assess the impact of different surgical targets and techniques, such as ablation and deep brain stimulation, to treat patients with L-dopa-induced dyskinesia (LID), a major therapeutic complication of Parkinson's disease. METHODS: This review analyzes the effects of early surgical procedures to treat hyper-kinesia and the current methods and targets used to combat LID in Parkinson's disease, which are mainly thalamotomy, pallidotomy, and deep brain stimulation of the globus pallidus internus and the subthalamic nucleus. RESULTS: Available information indicates that surgery of the globus pallidus internus and thalamus (the pallidal receiving area) and of the subthalamic nucleus has a pronounced antidyskinetic effect. This effect is associated with a concomitant improvement in the parkinsonian ("off"-medication) state. Although it is more profound with pallidal and subthalamic surgery, such an effect can also be observed to some extent with thalamic surgery. The latter is attributable to the fact that surgery of the ventralis intermedius is primarily effective for treating tremor. An integral pallidothalamic pathway is needed for dyskinesia to be expressed. Thus, LID is less frequent after subthalamotomy or deep brain stimulation of the subthalamic nucleus through a functional effect mediated by the physiological normalization of the motor system and by an indirect effect associated with a reduction in the daily dose of L-dopa. CONCLUSION: Surgery is the only treatment available for Parkinson's disease that can predictably improve both the parkinsonian motor syndrome and LID. The exact mechanisms involved in these effects are not well understood. Pallidal and thalamic surgery affecting pallidal relays reduce LID frequency by disrupting the pallidothalamic circuit, probably eliminating the neuronal activity associated with dyskinesia. Alternatively, the antidyskinetic effect of subthalamic nucleus surgery may in part be attributable to a reduction in the L-dopa dose as well as to the stabilization of the basal ganglia circuits after the surgical procedure.</EA>
<CC>002B25J</CC>
<FD>Dyskinésie; Maladie de Parkinson; Pathologie du système nerveux; Dopa; Stéréotaxie; Chirurgie; Encéphale; Noyau sousthalamique; Thalamotomie</FD>
<FG>Syndrome extrapyramidal; Mouvement involontaire; Trouble neurologique; Pathologie de l'encéphale; Maladie dégénérative; Pathologie du système nerveux central</FG>
<ED>Dyskinesia; Parkinson disease; Nervous system diseases; Dopa; Stereotaxia; Surgery; Encephalon; Subthalamic nucleus; Thalamotomy</ED>
<EG>Extrapyramidal syndrome; Involuntary movement; Neurological disorder; Cerebral disorder; Degenerative disease; Central nervous system disease</EG>
<SD>Disquinesia; Parkinson enfermedad; Sistema nervioso patología; Dopa; Estereotaxia; Cirugía; Encéfalo; Núcleo subtalámico; Talamotomía</SD>
<LO>INIST-18396.354000173717260040</LO>
<ID>08-0207896</ID>
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