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

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Pallidal deep brain stimulation and L-dopa do not improve qualitative aspects of skilled reaching in Parkinson's disease.

Identifieur interne : 001267 ( PubMed/Curation ); précédent : 001266; suivant : 001268

Pallidal deep brain stimulation and L-dopa do not improve qualitative aspects of skilled reaching in Parkinson's disease.

Auteurs : Kyle G. Melvin [Canada] ; Jon Doan ; Sergio M. Pellis ; Lesley Brown ; Ian Q. Whishaw ; Oksana Suchowersky

Source :

RBID : pubmed:15836914

English descriptors

Abstract

To determine effects of dopaminergic medication and pallidal deep brain stimulation (DBS) on skilled reach in Parkinson's disease (PD).

DOI: 10.1016/j.bbr.2004.12.001
PubMed: 15836914

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pubmed:15836914

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<title xml:lang="en">Pallidal deep brain stimulation and L-dopa do not improve qualitative aspects of skilled reaching in Parkinson's disease.</title>
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<name sortKey="Melvin, Kyle G" sort="Melvin, Kyle G" uniqKey="Melvin K" first="Kyle G" last="Melvin">Kyle G. Melvin</name>
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<nlm:affiliation>Department of Clinical Neurosciences, Faculty of Medicine, Movement Disorders Program, Foothills Hospital, University of Calgary, Area 33350, Hospital Dr NW, Calgary, Alta., Canada T2N 4N1. kgmelvin@ucalgary.ca</nlm:affiliation>
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<wicri:regionArea>Department of Clinical Neurosciences, Faculty of Medicine, Movement Disorders Program, Foothills Hospital, University of Calgary, Area 33350, Hospital Dr NW, Calgary, Alta.</wicri:regionArea>
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<name sortKey="Doan, Jon" sort="Doan, Jon" uniqKey="Doan J" first="Jon" last="Doan">Jon Doan</name>
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<name sortKey="Pellis, Sergio M" sort="Pellis, Sergio M" uniqKey="Pellis S" first="Sergio M" last="Pellis">Sergio M. Pellis</name>
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<name sortKey="Brown, Lesley" sort="Brown, Lesley" uniqKey="Brown L" first="Lesley" last="Brown">Lesley Brown</name>
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<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Antiparkinson Agents (therapeutic use)</term>
<term>Case-Control Studies</term>
<term>Deep Brain Stimulation (methods)</term>
<term>Follow-Up Studies</term>
<term>Functional Laterality</term>
<term>Globus Pallidus (drug effects)</term>
<term>Globus Pallidus (physiopathology)</term>
<term>Globus Pallidus (radiation effects)</term>
<term>Humans</term>
<term>Levodopa (therapeutic use)</term>
<term>Middle Aged</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson Disease (therapy)</term>
<term>Prospective Studies</term>
<term>Psychomotor Performance (drug effects)</term>
<term>Psychomotor Performance (physiology)</term>
<term>Psychomotor Performance (radiation effects)</term>
<term>Statistics, Nonparametric</term>
<term>Treatment Outcome</term>
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<term>Antiparkinson Agents</term>
<term>Levodopa</term>
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<term>Globus Pallidus</term>
<term>Psychomotor Performance</term>
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<term>Deep Brain Stimulation</term>
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<term>Psychomotor Performance</term>
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<term>Globus Pallidus</term>
<term>Parkinson Disease</term>
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<term>Psychomotor Performance</term>
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<div type="abstract" xml:lang="en">To determine effects of dopaminergic medication and pallidal deep brain stimulation (DBS) on skilled reach in Parkinson's disease (PD).</div>
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<Day>05</Day>
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<ArticleTitle>Pallidal deep brain stimulation and L-dopa do not improve qualitative aspects of skilled reaching in Parkinson's disease.</ArticleTitle>
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<AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">To determine effects of dopaminergic medication and pallidal deep brain stimulation (DBS) on skilled reach in Parkinson's disease (PD).</AbstractText>
<AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">PD is a neurodegenerative disorder affecting motor control. While speed and execution of movements are improved by L-dopa, not all motor symptoms are alleviated. Little is known about the effects of DBS or medication on reaching.</AbstractText>
<AbstractText Label="DESIGN METHOD" NlmCategory="UNASSIGNED">Eight PD patients with unilateral pallidal DBS reached with the contra-lateral hand for a piece of food, placing it in the mouth, and returning to starting position. Testing was performed on no treatment, medication only, DBS only, and combined treatment. Reaches were digitally recorded and analyzed on a 21 point scale adapted from Eshkol-Wachman Notation. Analysis was blinded, with patients compared to age-matched controls.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Patients were tested 6-13 months after surgery. All showed significant improvement clinically and in UPDRS (III) scores. The following data were obtained on the reaching scale: normal controls 16.5-21.0 (mean 18.3), no treatment 3.0-12.5 (mean 7.4), medication only 7.0-14.0 (mean 10.3), DBS only 4.5-16.0 (mean 9.2), combined treatment 4.0-15.0 (mean 9.5). The difference between controls and all treatment groups was statistically significant (P<0.005). All aspects of reach were compromised. No significant differences were found among the four conditions.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">This study is consistent with accumulating evidence that some aspects of motor performance in PD patients, such as reaching, are resistant to L-dopa. Also, pallidal DBS does not improve those parameters that are resistant to L-dopa, either alone or in combination with medication.</AbstractText>
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