The effects of subthalamic nucleus deep brain stimulation on parkinsonian tremor
Identifieur interne : 000E68 ( Main/Exploration ); précédent : 000E67; suivant : 000E69The effects of subthalamic nucleus deep brain stimulation on parkinsonian tremor
Auteurs : Alan Diamond [États-Unis] ; Joohi Shahed [États-Unis] ; Joseph Jankovic [États-Unis]Source :
- Journal of the neurological sciences [ 0022-510X ] ; 2007.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Aged, Antiparkinson Agents (therapeutic use), Basal Ganglia (physiopathology), Deep Brain Stimulation (methods), Deep Brain Stimulation (trends), Deep brain stimulation, Electrodes (standards), Evaluation scale, Female, Humans, Male, Middle Aged, Nervous system diseases, Neural Pathways (physiopathology), Parkinson Disease (complications), Parkinson Disease (physiopathology), Parkinson Disease (therapy), Parkinson disease, Prospective Studies, Stereotaxic Techniques, Subthalamic Nucleus (physiology), Subthalamic nucleus, Treatment Outcome, Tremor, Tremor (etiology), Tremor (physiopathology), Tremor (therapy), Ventral Thalamic Nuclei (physiopathology).
- MESH :
- chemical , therapeutic use : Antiparkinson Agents.
- complications : Parkinson Disease.
- etiology : Tremor.
- methods : Deep Brain Stimulation.
- physiology : Subthalamic Nucleus.
- physiopathology : Basal Ganglia, Neural Pathways, Parkinson Disease, Tremor, Ventral Thalamic Nuclei.
- standards : Electrodes.
- therapy : Parkinson Disease, Tremor.
- trends : Deep Brain Stimulation.
- Aged, Female, Humans, Male, Middle Aged, Prospective Studies, Stereotaxic Techniques, Treatment Outcome.
Abstract
Deep brain stimulation (DBS) of the ventral intermediate (Vim) nucleus of the thalamus has been the target of choice for patients with disabling essential tremor or medication refractory parkinsonian tremor. Recently there is evidence that the subthalamic nucleus (STN) should be the targets for patients with tremor associated with Parkinson's disease (PD). To assess the effects of STN DBS on parkinsonian tremor, eight consecutive patients with PD and disabling tremor were videotaped using a standardized tremor protocol. Evaluations were performed at least 12 h after last dose of medication with the DBS turned off followed by optimal DBS on state. A rater blinded to DBS status evaluated randomized video segments with the tremor components of the Unified Parkinson Disease Rating Scale (UPDRS) and Tremor Rating Scale (TRS). Compared with DBS off state there were significant improvements in mean UPDRS tremor score 79.4% (p=0.008), total TRS score 69.9% (p=0.008) and upper extremity 92.5% (p=0.008) TRS subscore. Functional improvement was noted with pouring liquids. Our findings provide support that STN DBS is an effective treatment of tremor associated with PD.
Affiliations:
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Le document en format XML
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<front><div type="abstract" xml:lang="en">Deep brain stimulation (DBS) of the ventral intermediate (Vim) nucleus of the thalamus has been the target of choice for patients with disabling essential tremor or medication refractory parkinsonian tremor. Recently there is evidence that the subthalamic nucleus (STN) should be the targets for patients with tremor associated with Parkinson's disease (PD). To assess the effects of STN DBS on parkinsonian tremor, eight consecutive patients with PD and disabling tremor were videotaped using a standardized tremor protocol. Evaluations were performed at least 12 h after last dose of medication with the DBS turned off followed by optimal DBS on state. A rater blinded to DBS status evaluated randomized video segments with the tremor components of the Unified Parkinson Disease Rating Scale (UPDRS) and Tremor Rating Scale (TRS). Compared with DBS off state there were significant improvements in mean UPDRS tremor score 79.4% (p=0.008), total TRS score 69.9% (p=0.008) and upper extremity 92.5% (p=0.008) TRS subscore. Functional improvement was noted with pouring liquids. Our findings provide support that STN DBS is an effective treatment of tremor associated with PD.</div>
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