Posteroventral medial pallidotomy for treatment of Parkinson's disease: preoperative magnetic resonance imaging features and clinical outcome.
Identifieur interne : 000280 ( PubMed/Corpus ); précédent : 000279; suivant : 000281Posteroventral medial pallidotomy for treatment of Parkinson's disease: preoperative magnetic resonance imaging features and clinical outcome.
Auteurs : J Desaloms ; J Krauss ; E Lai ; J. Jankovic ; R GrossmanSource :
- Journal of neurosurgery [ 0022-3085 ] ; 1998.
English descriptors
- KwdEn :
- Activities of Daily Living, Adult, Aged, Atrophy, Brain Ischemia (pathology), Brain Ischemia (surgery), Cerebral Cortex (pathology), Cerebral Ventricles (pathology), Female, Follow-Up Studies, Forecasting, Globus Pallidus (pathology), Globus Pallidus (surgery), Humans, Magnetic Resonance Imaging, Male, Mental Processes (physiology), Middle Aged, Motor Skills (physiology), Movement Disorders (physiopathology), Nerve Degeneration (pathology), Nerve Degeneration (surgery), Parkinson Disease (pathology), Parkinson Disease (physiopathology), Parkinson Disease (surgery), Preoperative Care, Prospective Studies, Risk Factors, Stereotaxic Techniques, Treatment Outcome, Wakefulness (physiology).
- MESH :
- pathology : Brain Ischemia, Cerebral Cortex, Cerebral Ventricles, Globus Pallidus, Nerve Degeneration, Parkinson Disease.
- physiology : Mental Processes, Motor Skills, Wakefulness.
- physiopathology : Movement Disorders, Parkinson Disease.
- surgery : Brain Ischemia, Globus Pallidus, Nerve Degeneration, Parkinson Disease.
- Activities of Daily Living, Adult, Aged, Atrophy, Female, Follow-Up Studies, Forecasting, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Preoperative Care, Prospective Studies, Risk Factors, Stereotaxic Techniques, Treatment Outcome.
Abstract
The goal of this study was to investigate the impact of mild or moderate degrees of degenerative or ischemic encephalopathy on predicting clinical outcome following unilateral posteroventral medial pallidotomy for treatment of advanced Parkinson's disease (PD).
DOI: 10.3171/jns.1998.89.2.0194
PubMed: 9688112
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pubmed:9688112Le document en format XML
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<author><name sortKey="Desaloms, J M" sort="Desaloms, J M" uniqKey="Desaloms J" first="J" last="Desaloms">J Desaloms</name>
<affiliation><nlm:affiliation>Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.</nlm:affiliation>
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<author><name sortKey="Krauss, J K" sort="Krauss, J K" uniqKey="Krauss J" first="J" last="Krauss">J Krauss</name>
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<author><name sortKey="Lai, E C" sort="Lai, E C" uniqKey="Lai E" first="E" last="Lai">E Lai</name>
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<author><name sortKey="Jankovic, J" sort="Jankovic, J" uniqKey="Jankovic J" first="J" last="Jankovic">J. Jankovic</name>
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<author><name sortKey="Grossman, R G" sort="Grossman, R G" uniqKey="Grossman R" first="R" last="Grossman">R Grossman</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">Posteroventral medial pallidotomy for treatment of Parkinson's disease: preoperative magnetic resonance imaging features and clinical outcome.</title>
<author><name sortKey="Desaloms, J M" sort="Desaloms, J M" uniqKey="Desaloms J" first="J" last="Desaloms">J Desaloms</name>
<affiliation><nlm:affiliation>Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.</nlm:affiliation>
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<author><name sortKey="Krauss, J K" sort="Krauss, J K" uniqKey="Krauss J" first="J" last="Krauss">J Krauss</name>
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<author><name sortKey="Lai, E C" sort="Lai, E C" uniqKey="Lai E" first="E" last="Lai">E Lai</name>
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<author><name sortKey="Jankovic, J" sort="Jankovic, J" uniqKey="Jankovic J" first="J" last="Jankovic">J. Jankovic</name>
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<author><name sortKey="Grossman, R G" sort="Grossman, R G" uniqKey="Grossman R" first="R" last="Grossman">R Grossman</name>
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<series><title level="j">Journal of neurosurgery</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activities of Daily Living</term>
<term>Adult</term>
<term>Aged</term>
<term>Atrophy</term>
<term>Brain Ischemia (pathology)</term>
<term>Brain Ischemia (surgery)</term>
<term>Cerebral Cortex (pathology)</term>
<term>Cerebral Ventricles (pathology)</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Forecasting</term>
<term>Globus Pallidus (pathology)</term>
<term>Globus Pallidus (surgery)</term>
<term>Humans</term>
<term>Magnetic Resonance Imaging</term>
<term>Male</term>
<term>Mental Processes (physiology)</term>
<term>Middle Aged</term>
<term>Motor Skills (physiology)</term>
<term>Movement Disorders (physiopathology)</term>
<term>Nerve Degeneration (pathology)</term>
<term>Nerve Degeneration (surgery)</term>
<term>Parkinson Disease (pathology)</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson Disease (surgery)</term>
<term>Preoperative Care</term>
<term>Prospective Studies</term>
<term>Risk Factors</term>
<term>Stereotaxic Techniques</term>
<term>Treatment Outcome</term>
<term>Wakefulness (physiology)</term>
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<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Brain Ischemia</term>
<term>Cerebral Cortex</term>
<term>Cerebral Ventricles</term>
<term>Globus Pallidus</term>
<term>Nerve Degeneration</term>
<term>Parkinson Disease</term>
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<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Mental Processes</term>
<term>Motor Skills</term>
<term>Wakefulness</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Movement Disorders</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Brain Ischemia</term>
<term>Globus Pallidus</term>
<term>Nerve Degeneration</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Activities of Daily Living</term>
<term>Adult</term>
<term>Aged</term>
<term>Atrophy</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Forecasting</term>
<term>Humans</term>
<term>Magnetic Resonance Imaging</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Preoperative Care</term>
<term>Prospective Studies</term>
<term>Risk Factors</term>
<term>Stereotaxic Techniques</term>
<term>Treatment Outcome</term>
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<front><div type="abstract" xml:lang="en">The goal of this study was to investigate the impact of mild or moderate degrees of degenerative or ischemic encephalopathy on predicting clinical outcome following unilateral posteroventral medial pallidotomy for treatment of advanced Parkinson's disease (PD).</div>
</front>
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<pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">9688112</PMID>
<DateCreated><Year>1998</Year>
<Month>08</Month>
<Day>18</Day>
</DateCreated>
<DateCompleted><Year>1998</Year>
<Month>08</Month>
<Day>18</Day>
</DateCompleted>
<DateRevised><Year>2006</Year>
<Month>11</Month>
<Day>15</Day>
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<JournalIssue CitedMedium="Print"><Volume>89</Volume>
<Issue>2</Issue>
<PubDate><Year>1998</Year>
<Month>Aug</Month>
</PubDate>
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<Title>Journal of neurosurgery</Title>
<ISOAbbreviation>J. Neurosurg.</ISOAbbreviation>
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<ArticleTitle>Posteroventral medial pallidotomy for treatment of Parkinson's disease: preoperative magnetic resonance imaging features and clinical outcome.</ArticleTitle>
<Pagination><MedlinePgn>194-9</MedlinePgn>
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<Abstract><AbstractText Label="OBJECT" NlmCategory="OBJECTIVE">The goal of this study was to investigate the impact of mild or moderate degrees of degenerative or ischemic encephalopathy on predicting clinical outcome following unilateral posteroventral medial pallidotomy for treatment of advanced Parkinson's disease (PD).</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Thirty-five patients with PD were studied prospectively. The presence and degree of cortical atrophy, ventriculomegaly, deep white matter lesions (DWML), periventricular lucencies (PVL), and the presence of lacunes and status cribriformis (multiple and bilateral enlarged Virchow-Robin spaces) were determined by magnetic resonance (MR) imaging before the patients underwent stereotactic pallidotomy performed according to a standard protocol. Clinical outcome was measured using a standard battery of tests including application of the Unified Parkinson's Disease Rating Scale (UPDRS). The preoperative MR imaging features were correlated with UPDRS subscores such as motor "off' score, the activities of daily living (ADL) off score, the off subscore for bradykinesia, the percentage of "on" time dyskinesias, and a global outcome rating. The MR findings were also correlated with the occurrence of side effects. Global outcome was rated as markedly improved in 22 patients (63%) and as moderately improved in 12 patients (34%) 6 months postoperatively. At the 1-year follow-up examination, global outcome in 31 patients was rated as markedly improved in 14 patients (45%), as moderately improved in another 14 (45%), as slightly improved in two (6%), and as worse in one patient (3%). The mean UPDRS motor off score changed from 58.7 preoperatively to 33.2 at 6 months and 33.4 at 1 year (p < 0.0001), the ADL off score from 31.8 to 18.2 at 6 months and 18.6 at 1 year (p < 0.0001), the off score from contralateral bradykinesia from 11.6 to 5.6 at 6 months and 4.1 at 1 year (p < 0.0001), and the percentage of awake time with dyskinesias from 37.4 to 17.4% at 6 months and 21.1% at 1 year (p < 0.0001). The presence of mild or moderate degrees of cortical atrophy, PVL, and DWML had no effect on clinical outcome. Patients with status cribriformis and those with lacunes tended to show comparatively less improvement in the UPDRS ADL off score (p = 0.014 and p = 0.016, respectively) at 6 months. This tendency was also present in patients with status cribriformis 1 year postoperatively (p = 0.046). Patients with both status cribriformis and lacunes had a higher incidence of transient altered mental status immediately postoperatively (p = 0.05).</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Mild-to-moderate degrees of cortical atrophy, ventriculomegaly, and ischemic encephalopathy do not predispose patients to less favorable outcomes following unilateral pallidotomy. Patients with both status cribriformis and lacunes have a higher risk of transient side effects; however, with regard to clinical outcome, these patients should not be denied surgical treatment.</AbstractText>
</Abstract>
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<ForeName>J M</ForeName>
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<AffiliationInfo><Affiliation>Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.</Affiliation>
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<Author ValidYN="Y"><LastName>Jankovic</LastName>
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<Author ValidYN="Y"><LastName>Grossman</LastName>
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<Language>eng</Language>
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