Postural control in Parkinson's disease after unilateral posteroventral pallidotomy
Identifieur interne : 000154 ( PascalFrancis/Checkpoint ); précédent : 000153; suivant : 000155Postural control in Parkinson's disease after unilateral posteroventral pallidotomy
Auteurs : Deborah Roberts [États-Unis] ; Averell Overby [États-Unis] ; Joseph Jankovic [États-Unis] ; Sharon Olson [États-Unis] ; Eugene Lai [États-Unis] ; J Krauss [États-Unis] ; Robert Grossman [États-Unis]Source :
- Brain [ 0006-8950 ] ; 2000.
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Abstract
Postural control changes were studied in 27 patients with Parkinson's disease after unilateral posteroventral pallidotomy (PVP). Patients were evaluated before PVP and at 3, 6 and 12 months post-PVP, both off' and on' parkinsonian medications, with selected evaluation tools representing functional performance, functional balance and posturographic components of balance. The majority of variables in the off' state were significantly improved at 3 months post-PVP. Improvement was maintained at 6 months but had declined for some variables by the 12 month follow-up. Standing up from a chair (P = 0.009), the balance and gait sections of the Performance-Oriented Assessment (P ≤ 0.0004), and the limits of stability (LOS) posturography variables (P < 0.0005) of the average time to reach a target, the number of targets missed and the initial excursion distance to the target (P = 0.029) retained significant improvement at the 12 month follow-up. When the patients were in the on' state, LOS posturography variables of average time to target, average path length deviation, and the number of targets missed were the only variables significantly improved at 3 months post-PVP (P = -0.013) and this improvement was maintained at 12 months post-PVP (P = 0.012-0.041). Unilateral PVP improves axial symptoms of Parkinson's disease involved in functional performance such as gait disturbance as well as improving postural stability in the 'off' state. Generally, the maximum improvement is seen at 3 months post-PVP with many variables remaining significantly improved at 12 months post-PVP. Axial dyskinesias in the on' state are also significantly reduced with the improvement maintained at 12 months post-PVP. These findings suggest that unilateral pallidotomy is not only effective in abolishing levodopa-induced dyskinesias, but that it also improves the axial signs of Parkinson's disease.
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type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Jankovic, Joseph" sort="Jankovic, Joseph" uniqKey="Jankovic J" first="Joseph" last="Jankovic">Joseph Jankovic</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName><placeName><settlement type="city">Houston</settlement><region type="state">Texas</region></placeName><orgName type="university" n="3">Baylor College of Medicine</orgName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Department of Neurology, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName><placeName><settlement 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Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">00-0487652</idno><date when="2000">2000</date><idno type="stanalyst">PASCAL 00-0487652 INIST</idno><idno type="RBID">Pascal:00-0487652</idno><idno type="wicri:Area/PascalFrancis/Corpus">000157</idno><idno type="wicri:Area/PascalFrancis/Curation">000009</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000154</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Postural control in Parkinson's disease after unilateral posteroventral pallidotomy</title><author><name sortKey="Roberts Warrior, Deborah" sort="Roberts Warrior, Deborah" uniqKey="Roberts Warrior D" first="Deborah" last="Roberts">Deborah Roberts</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Texas Woman's University, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Overby, Averell" sort="Overby, Averell" uniqKey="Overby A" first="Averell" last="Overby">Averell Overby</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Ohio University</s1><s2>Athens, Ohio</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Ohio</region></placeName></affiliation></author><author><name sortKey="Jankovic, Joseph" sort="Jankovic, Joseph" uniqKey="Jankovic J" first="Joseph" last="Jankovic">Joseph Jankovic</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName><placeName><settlement type="city">Houston</settlement><region type="state">Texas</region></placeName><orgName type="university" n="3">Baylor College of Medicine</orgName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Department of Neurology, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName><placeName><settlement type="city">Houston</settlement><region type="state">Texas</region></placeName><orgName type="university" n="3">Baylor College of Medicine</orgName></affiliation></author><author><name sortKey="Olson, Sharon" sort="Olson, Sharon" uniqKey="Olson S" first="Sharon" last="Olson">Sharon Olson</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Texas Woman's University, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Lai, Eugene C" sort="Lai, Eugene C" uniqKey="Lai E" first="Eugene" last="Lai">Eugene Lai</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Department of Neurology, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Krauss, J K" sort="Krauss, J K" uniqKey="Krauss J" first="J" last="Krauss">J Krauss</name><affiliation wicri:level="2"><inist:fA14 i1="05"><s1>Department of Neurosurgery, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Grossman, Robert" sort="Grossman, Robert" uniqKey="Grossman R" first="Robert" last="Grossman">Robert Grossman</name><affiliation wicri:level="2"><inist:fA14 i1="05"><s1>Department of Neurosurgery, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Brain</title><title level="j" type="abbreviated">Brain</title><idno type="ISSN">0006-8950</idno><imprint><date when="2000">2000</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Brain</title><title level="j" type="abbreviated">Brain</title><idno type="ISSN">0006-8950</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Human</term><term>Parkinson disease</term><term>Postural fitting</term><term>Surgery</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term><term>Chirurgie</term><term>Ajustement postural</term><term>Traitement</term><term>Homme</term><term>Pallidotomie</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Chirurgie</term><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Postural control changes were studied in 27 patients with Parkinson's disease after unilateral posteroventral pallidotomy (PVP). Patients were evaluated before PVP and at 3, 6 and 12 months post-PVP, both off' and on' parkinsonian medications, with selected evaluation tools representing functional performance, functional balance and posturographic components of balance. The majority of variables in the off' state were significantly improved at 3 months post-PVP. Improvement was maintained at 6 months but had declined for some variables by the 12 month follow-up. Standing up from a chair (P = 0.009), the balance and gait sections of the Performance-Oriented Assessment (P ≤ 0.0004), and the limits of stability (LOS) posturography variables (P < 0.0005) of the average time to reach a target, the number of targets missed and the initial excursion distance to the target (P = 0.029) retained significant improvement at the 12 month follow-up. When the patients were in the on' state, LOS posturography variables of average time to target, average path length deviation, and the number of targets missed were the only variables significantly improved at 3 months post-PVP (P = -0.013) and this improvement was maintained at 12 months post-PVP (P = 0.012-0.041). Unilateral PVP improves axial symptoms of Parkinson's disease involved in functional performance such as gait disturbance as well as improving postural stability in the 'off' state. Generally, the maximum improvement is seen at 3 months post-PVP with many variables remaining significantly improved at 12 months post-PVP. Axial dyskinesias in the on' state are also significantly reduced with the improvement maintained at 12 months post-PVP. These findings suggest that unilateral pallidotomy is not only effective in abolishing levodopa-induced dyskinesias, but that it also improves the axial signs of Parkinson's disease.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0006-8950</s0></fA01><fA03 i2="1"><s0>Brain</s0></fA03><fA05><s2>123</s2></fA05><fA06><s3>p.10</s3></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Postural control in Parkinson's disease after unilateral posteroventral pallidotomy</s1></fA08><fA11 i1="01" i2="1"><s1>ROBERTS-WARRIOR (Deborah)</s1></fA11><fA11 i1="02" i2="1"><s1>OVERBY (Averell)</s1></fA11><fA11 i1="03" i2="1"><s1>JANKOVIC (Joseph)</s1></fA11><fA11 i1="04" i2="1"><s1>OLSON (Sharon)</s1></fA11><fA11 i1="05" i2="1"><s1>LAI (Eugene C.)</s1></fA11><fA11 i1="06" i2="1"><s1>KRAUSS (J. K.)</s1></fA11><fA11 i1="07" i2="1"><s1>GROSSMAN (Robert)</s1></fA11><fA14 i1="01"><s1>Texas Woman's University, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ></fA14><fA14 i1="02"><s1>Ohio University</s1><s2>Athens, Ohio</s2><s3>USA</s3><sZ>2 aut.</sZ></fA14><fA14 i1="03"><s1>Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ></fA14><fA14 i1="04"><s1>Department of Neurology, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ></fA14><fA14 i1="05"><s1>Department of Neurosurgery, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>6 aut.</sZ><sZ>7 aut.</sZ></fA14><fA20><s1>2141-2149</s1></fA20><fA21><s1>2000</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>998</s2><s5>354000092209490150</s5></fA43><fA44><s0>0000</s0><s1>© 2000 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>1 p.1/4</s0></fA45><fA47 i1="01" i2="1"><s0>00-0487652</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Brain</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>Postural control changes were studied in 27 patients with Parkinson's disease after unilateral posteroventral pallidotomy (PVP). Patients were evaluated before PVP and at 3, 6 and 12 months post-PVP, both off' and on' parkinsonian medications, with selected evaluation tools representing functional performance, functional balance and posturographic components of balance. The majority of variables in the off' state were significantly improved at 3 months post-PVP. Improvement was maintained at 6 months but had declined for some variables by the 12 month follow-up. Standing up from a chair (P = 0.009), the balance and gait sections of the Performance-Oriented Assessment (P ≤ 0.0004), and the limits of stability (LOS) posturography variables (P < 0.0005) of the average time to reach a target, the number of targets missed and the initial excursion distance to the target (P = 0.029) retained significant improvement at the 12 month follow-up. When the patients were in the on' state, LOS posturography variables of average time to target, average path length deviation, and the number of targets missed were the only variables significantly improved at 3 months post-PVP (P = -0.013) and this improvement was maintained at 12 months post-PVP (P = 0.012-0.041). Unilateral PVP improves axial symptoms of Parkinson's disease involved in functional performance such as gait disturbance as well as improving postural stability in the 'off' state. Generally, the maximum improvement is seen at 3 months post-PVP with many variables remaining significantly improved at 12 months post-PVP. Axial dyskinesias in the on' state are also significantly reduced with the improvement maintained at 12 months post-PVP. These findings suggest that unilateral pallidotomy is not only effective in abolishing levodopa-induced dyskinesias, but that it also improves the axial signs of Parkinson's disease.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17G</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Parkinson maladie</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Parkinson disease</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Chirurgie</s0><s5>04</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Surgery</s0><s5>04</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Cirugía</s0><s5>04</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Ajustement postural</s0><s5>07</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Postural fitting</s0><s5>07</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Ajuste postural</s0><s5>07</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Traitement</s0><s5>17</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Treatment</s0><s5>17</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Tratamiento</s0><s5>17</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Homme</s0><s5>20</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Human</s0><s5>20</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Hombre</s0><s5>20</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Pallidotomie</s0><s4>INC</s4><s5>86</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Système nerveux pathologie</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Système nerveux central pathologie</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Encéphale pathologie</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Extrapyramidal syndrome</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>41</s5></fC07><fN21><s1>325</s1></fN21></pA></standard></inist><affiliations><list><country><li>États-Unis</li></country><region><li>Ohio</li><li>Texas</li></region><settlement><li>Houston</li></settlement><orgName><li>Baylor College of Medicine</li></orgName></list><tree><country name="États-Unis"><region name="Texas"><name sortKey="Roberts Warrior, Deborah" sort="Roberts Warrior, Deborah" uniqKey="Roberts Warrior D" first="Deborah" last="Roberts">Deborah Roberts</name></region><name sortKey="Grossman, Robert" sort="Grossman, Robert" uniqKey="Grossman R" first="Robert" last="Grossman">Robert Grossman</name><name sortKey="Jankovic, Joseph" sort="Jankovic, Joseph" uniqKey="Jankovic J" first="Joseph" last="Jankovic">Joseph Jankovic</name><name sortKey="Jankovic, Joseph" sort="Jankovic, Joseph" uniqKey="Jankovic J" first="Joseph" last="Jankovic">Joseph Jankovic</name><name sortKey="Krauss, J K" sort="Krauss, J K" uniqKey="Krauss J" first="J" last="Krauss">J Krauss</name><name sortKey="Lai, Eugene C" sort="Lai, Eugene C" uniqKey="Lai E" first="Eugene" last="Lai">Eugene Lai</name><name sortKey="Lai, Eugene C" sort="Lai, Eugene C" uniqKey="Lai E" first="Eugene" last="Lai">Eugene Lai</name><name sortKey="Olson, Sharon" sort="Olson, Sharon" uniqKey="Olson S" first="Sharon" last="Olson">Sharon Olson</name><name sortKey="Overby, Averell" sort="Overby, Averell" uniqKey="Overby A" first="Averell" last="Overby">Averell Overby</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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