Subthalamic nucleus stimulation : Improvements in outcome with reprogramming
Identifieur interne : 000806 ( PascalFrancis/Corpus ); précédent : 000805; suivant : 000807Subthalamic nucleus stimulation : Improvements in outcome with reprogramming
Auteurs : Elena Moro ; Yu-Yan W. Poon ; Andres M. Lozano ; Jean A. Saint-Cyr ; Anthony E. LangSource :
- Archives of neurology : (Chicago) [ 0003-9942 ] ; 2006.
Descripteurs français
- Pascal (Inist)
English descriptors
Abstract
Background: Deep brain stimulation (DBS) is currently the most effective surgical treatment for advanced Parkinson disease (PD). Even when the electrode is well positioned in the target, the optimization of clinical results depends on careful programming of electrical parameters and changes in antiparkinsonian drug dosages. Objective: To determine whether stable outcomes from subthalamic nucleus DBS for PD can be improved by revising stimulation parameters and drug dosages through "hands-on" involvement of a neurologist expert in both movement disorders and DBS programming. Methods: In 44 consecutive patients with PD with long-term stable response to subthalamic nucleus DBS (mean±SD,3.5±1.7 years), we compared scores from the Unified Parkinson's Disease Rating Scale parts II through IV obtained immediately before and following a formal reprogramming of their stimulation. The reprogramming was performed by a neurologist expert in both PD and DBS and accompanied by further medication adjustments. The patients were subsequently followed up for as long as 14 months. Results: In 24 patients (54.6%), the scores on the Unified Parkinson's Disease Rating Scale parts II and III significantly improved by 15.0% and 25.9%, respectively. Anti-PD drugs were significantly reduced (by 25.9%). No improvement was observed in 16 patients (36.4%), and the conditions of 4 patients (9.1%) worsened. Conclusions: Further improvement of parkinsonian signs can be achieved in the majority of patients even after longterm stable stimulation. Improved patient outcomes from subthalamic nucleus DBS are obtained when postoperative care is personally managed by a neurologist expert in movement disorders and DBS who is directly responsible for stimulation programming and simultaneous drug adjustments based on observed clinical responses to changing stimulation parameters.
Notice en format standard (ISO 2709)
Pour connaître la documentation sur le format Inist Standard.
| pA |
|
|---|
Format Inist (serveur)
| NO : | PASCAL 06-0451707 INIST |
|---|---|
| ET : | Subthalamic nucleus stimulation : Improvements in outcome with reprogramming |
| AU : | MORO (Elena); POON (Yu-Yan W.); LOZANO (Andres M.); SAINT-CYR (Jean A.); LANG (Anthony E.) |
| AF : | Movement Disorders Center, Toronto Western Hospital, University Health Network, University of Toronto/Toronto, Ontario/Canada (1 aut., 2 aut., 5 aut.); Department of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto/Toronto, Ontario/Canada (3 aut., 4 aut.) |
| DT : | Publication en série; Niveau analytique |
| SO : | Archives of neurology : (Chicago); ISSN 0003-9942; Coden ARNEAS; Etats-Unis; Da. 2006; Vol. 63; No. 9; Pp. 1266-1272; Bibl. 22 ref. |
| LA : | Anglais |
| EA : | Background: Deep brain stimulation (DBS) is currently the most effective surgical treatment for advanced Parkinson disease (PD). Even when the electrode is well positioned in the target, the optimization of clinical results depends on careful programming of electrical parameters and changes in antiparkinsonian drug dosages. Objective: To determine whether stable outcomes from subthalamic nucleus DBS for PD can be improved by revising stimulation parameters and drug dosages through "hands-on" involvement of a neurologist expert in both movement disorders and DBS programming. Methods: In 44 consecutive patients with PD with long-term stable response to subthalamic nucleus DBS (mean±SD,3.5±1.7 years), we compared scores from the Unified Parkinson's Disease Rating Scale parts II through IV obtained immediately before and following a formal reprogramming of their stimulation. The reprogramming was performed by a neurologist expert in both PD and DBS and accompanied by further medication adjustments. The patients were subsequently followed up for as long as 14 months. Results: In 24 patients (54.6%), the scores on the Unified Parkinson's Disease Rating Scale parts II and III significantly improved by 15.0% and 25.9%, respectively. Anti-PD drugs were significantly reduced (by 25.9%). No improvement was observed in 16 patients (36.4%), and the conditions of 4 patients (9.1%) worsened. Conclusions: Further improvement of parkinsonian signs can be achieved in the majority of patients even after longterm stable stimulation. Improved patient outcomes from subthalamic nucleus DBS are obtained when postoperative care is personally managed by a neurologist expert in movement disorders and DBS who is directly responsible for stimulation programming and simultaneous drug adjustments based on observed clinical responses to changing stimulation parameters. |
| CC : | 002B17; 002B26I; 002A25D01 |
| FD : | Système nerveux pathologie; Noyau sousthalamique; Amélioration; Pronostic |
| FG : | Encéphale; Système nerveux central |
| ED : | Nervous system diseases; Subthalamic nucleus; Improvement; Prognosis |
| EG : | Encephalon; Central nervous system |
| SD : | Sistema nervioso patología; Núcleo subtalámico; Mejora; Pronóstico |
| LO : | INIST-2048B.354000157190580070 |
| ID : | 06-0451707 |
Links to Exploration step
Pascal:06-0451707Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Subthalamic nucleus stimulation : Improvements in outcome with reprogramming</title><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation><inist:fA14 i1="01"><s1>Movement Disorders Center, Toronto Western Hospital, University Health Network, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Poon, Yu Yan W" sort="Poon, Yu Yan W" uniqKey="Poon Y" first="Yu-Yan W." last="Poon">Yu-Yan W. Poon</name><affiliation><inist:fA14 i1="01"><s1>Movement Disorders Center, Toronto Western Hospital, University Health Network, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14></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><inist:fA14 i1="02"><s1>Department of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Saint Cyr, Jean A" sort="Saint Cyr, Jean A" uniqKey="Saint Cyr J" first="Jean A." last="Saint-Cyr">Jean A. Saint-Cyr</name><affiliation><inist:fA14 i1="02"><s1>Department of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14></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><inist:fA14 i1="01"><s1>Movement Disorders Center, Toronto Western Hospital, University Health Network, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">06-0451707</idno><date when="2006">2006</date><idno type="stanalyst">PASCAL 06-0451707 INIST</idno><idno type="RBID">Pascal:06-0451707</idno><idno type="wicri:Area/PascalFrancis/Corpus">000806</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Subthalamic nucleus stimulation : Improvements in outcome with reprogramming</title><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation><inist:fA14 i1="01"><s1>Movement Disorders Center, Toronto Western Hospital, University Health Network, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Poon, Yu Yan W" sort="Poon, Yu Yan W" uniqKey="Poon Y" first="Yu-Yan W." last="Poon">Yu-Yan W. Poon</name><affiliation><inist:fA14 i1="01"><s1>Movement Disorders Center, Toronto Western Hospital, University Health Network, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14></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><inist:fA14 i1="02"><s1>Department of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14></affiliation></author><author><name sortKey="Saint Cyr, Jean A" sort="Saint Cyr, Jean A" uniqKey="Saint Cyr J" first="Jean A." last="Saint-Cyr">Jean A. Saint-Cyr</name><affiliation><inist:fA14 i1="02"><s1>Department of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14></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><inist:fA14 i1="01"><s1>Movement Disorders Center, Toronto Western Hospital, University Health Network, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14></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="2006">2006</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>Improvement</term><term>Nervous system diseases</term><term>Prognosis</term><term>Subthalamic nucleus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term><term>Noyau sousthalamique</term><term>Amélioration</term><term>Pronostic</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: Deep brain stimulation (DBS) is currently the most effective surgical treatment for advanced Parkinson disease (PD). Even when the electrode is well positioned in the target, the optimization of clinical results depends on careful programming of electrical parameters and changes in antiparkinsonian drug dosages. Objective: To determine whether stable outcomes from subthalamic nucleus DBS for PD can be improved by revising stimulation parameters and drug dosages through "hands-on" involvement of a neurologist expert in both movement disorders and DBS programming. Methods: In 44 consecutive patients with PD with long-term stable response to subthalamic nucleus DBS (mean±SD,3.5±1.7 years), we compared scores from the Unified Parkinson's Disease Rating Scale parts II through IV obtained immediately before and following a formal reprogramming of their stimulation. The reprogramming was performed by a neurologist expert in both PD and DBS and accompanied by further medication adjustments. The patients were subsequently followed up for as long as 14 months. Results: In 24 patients (54.6%), the scores on the Unified Parkinson's Disease Rating Scale parts II and III significantly improved by 15.0% and 25.9%, respectively. Anti-PD drugs were significantly reduced (by 25.9%). No improvement was observed in 16 patients (36.4%), and the conditions of 4 patients (9.1%) worsened. Conclusions: Further improvement of parkinsonian signs can be achieved in the majority of patients even after longterm stable stimulation. Improved patient outcomes from subthalamic nucleus DBS are obtained when postoperative care is personally managed by a neurologist expert in movement disorders and DBS who is directly responsible for stimulation programming and simultaneous drug adjustments based on observed clinical responses to changing stimulation parameters.</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>63</s2></fA05><fA06><s2>9</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Subthalamic nucleus stimulation : Improvements in outcome with reprogramming</s1></fA08><fA11 i1="01" i2="1"><s1>MORO (Elena)</s1></fA11><fA11 i1="02" i2="1"><s1>POON (Yu-Yan W.)</s1></fA11><fA11 i1="03" i2="1"><s1>LOZANO (Andres M.)</s1></fA11><fA11 i1="04" i2="1"><s1>SAINT-CYR (Jean A.)</s1></fA11><fA11 i1="05" i2="1"><s1>LANG (Anthony E.)</s1></fA11><fA14 i1="01"><s1>Movement Disorders Center, Toronto Western Hospital, University Health Network, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></fA14><fA20><s1>1266-1272</s1></fA20><fA21><s1>2006</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>2048B</s2><s5>354000157190580070</s5></fA43><fA44><s0>0000</s0><s1>© 2006 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>22 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>06-0451707</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>Background: Deep brain stimulation (DBS) is currently the most effective surgical treatment for advanced Parkinson disease (PD). Even when the electrode is well positioned in the target, the optimization of clinical results depends on careful programming of electrical parameters and changes in antiparkinsonian drug dosages. Objective: To determine whether stable outcomes from subthalamic nucleus DBS for PD can be improved by revising stimulation parameters and drug dosages through "hands-on" involvement of a neurologist expert in both movement disorders and DBS programming. Methods: In 44 consecutive patients with PD with long-term stable response to subthalamic nucleus DBS (mean±SD,3.5±1.7 years), we compared scores from the Unified Parkinson's Disease Rating Scale parts II through IV obtained immediately before and following a formal reprogramming of their stimulation. The reprogramming was performed by a neurologist expert in both PD and DBS and accompanied by further medication adjustments. The patients were subsequently followed up for as long as 14 months. Results: In 24 patients (54.6%), the scores on the Unified Parkinson's Disease Rating Scale parts II and III significantly improved by 15.0% and 25.9%, respectively. Anti-PD drugs were significantly reduced (by 25.9%). No improvement was observed in 16 patients (36.4%), and the conditions of 4 patients (9.1%) worsened. Conclusions: Further improvement of parkinsonian signs can be achieved in the majority of patients even after longterm stable stimulation. Improved patient outcomes from subthalamic nucleus DBS are obtained when postoperative care is personally managed by a neurologist expert in movement disorders and DBS who is directly responsible for stimulation programming and simultaneous drug adjustments based on observed clinical responses to changing stimulation parameters.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B26I</s0></fC02><fC02 i1="03" i2="X"><s0>002A25D01</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Système nerveux pathologie</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Noyau sousthalamique</s0><s5>09</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Subthalamic nucleus</s0><s5>09</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Núcleo subtalámico</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Amélioration</s0><s5>10</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Improvement</s0><s5>10</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Mejora</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Pronostic</s0><s5>11</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Prognosis</s0><s5>11</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Pronóstico</s0><s5>11</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Encéphale</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Encephalon</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Encéfalo</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Système nerveux central</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Central nervous system</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Sistema nervioso central</s0><s5>38</s5></fC07><fN21><s1>296</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard><server><NO>PASCAL 06-0451707 INIST</NO><ET>Subthalamic nucleus stimulation : Improvements in outcome with reprogramming</ET><AU>MORO (Elena); POON (Yu-Yan W.); LOZANO (Andres M.); SAINT-CYR (Jean A.); LANG (Anthony E.)</AU><AF>Movement Disorders Center, Toronto Western Hospital, University Health Network, University of Toronto/Toronto, Ontario/Canada (1 aut., 2 aut., 5 aut.); Department of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto/Toronto, Ontario/Canada (3 aut., 4 aut.)</AF><DT>Publication en série; Niveau analytique</DT><SO>Archives of neurology : (Chicago); ISSN 0003-9942; Coden ARNEAS; Etats-Unis; Da. 2006; Vol. 63; No. 9; Pp. 1266-1272; Bibl. 22 ref.</SO><LA>Anglais</LA><EA>Background: Deep brain stimulation (DBS) is currently the most effective surgical treatment for advanced Parkinson disease (PD). Even when the electrode is well positioned in the target, the optimization of clinical results depends on careful programming of electrical parameters and changes in antiparkinsonian drug dosages. Objective: To determine whether stable outcomes from subthalamic nucleus DBS for PD can be improved by revising stimulation parameters and drug dosages through "hands-on" involvement of a neurologist expert in both movement disorders and DBS programming. Methods: In 44 consecutive patients with PD with long-term stable response to subthalamic nucleus DBS (mean±SD,3.5±1.7 years), we compared scores from the Unified Parkinson's Disease Rating Scale parts II through IV obtained immediately before and following a formal reprogramming of their stimulation. The reprogramming was performed by a neurologist expert in both PD and DBS and accompanied by further medication adjustments. The patients were subsequently followed up for as long as 14 months. Results: In 24 patients (54.6%), the scores on the Unified Parkinson's Disease Rating Scale parts II and III significantly improved by 15.0% and 25.9%, respectively. Anti-PD drugs were significantly reduced (by 25.9%). No improvement was observed in 16 patients (36.4%), and the conditions of 4 patients (9.1%) worsened. Conclusions: Further improvement of parkinsonian signs can be achieved in the majority of patients even after longterm stable stimulation. Improved patient outcomes from subthalamic nucleus DBS are obtained when postoperative care is personally managed by a neurologist expert in movement disorders and DBS who is directly responsible for stimulation programming and simultaneous drug adjustments based on observed clinical responses to changing stimulation parameters.</EA><CC>002B17; 002B26I; 002A25D01</CC><FD>Système nerveux pathologie; Noyau sousthalamique; Amélioration; Pronostic</FD><FG>Encéphale; Système nerveux central</FG><ED>Nervous system diseases; Subthalamic nucleus; Improvement; Prognosis</ED><EG>Encephalon; Central nervous system</EG><SD>Sistema nervioso patología; Núcleo subtalámico; Mejora; Pronóstico</SD><LO>INIST-2048B.354000157190580070</LO><ID>06-0451707</ID></server></inist></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Canada/explor/ParkinsonCanadaV1/Data/PascalFrancis/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 000806 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/PascalFrancis/Corpus/biblio.hfd -nk 000806 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Canada
|area= ParkinsonCanadaV1
|flux= PascalFrancis
|étape= Corpus
|type= RBID
|clé= Pascal:06-0451707
|texte= Subthalamic nucleus stimulation : Improvements in outcome with reprogramming
}}
| This area was generated with Dilib version V0.6.29. |  |