[Medial posteroventral pallidotomy for the treatment of Parkinson's disease].
Identifieur interne : 000289 ( PubMed/Corpus ); précédent : 000288; suivant : 000290[Medial posteroventral pallidotomy for the treatment of Parkinson's disease].
Auteurs : J Krauss ; R Grossman ; E Lai ; K. Schwartz ; J. JankovicSource :
- Zentralblatt für Neurochirurgie [ 0044-4251 ] ; 1997.
English descriptors
- KwdEn :
- Adult, Aged, Antiparkinson Agents (adverse effects), Brain (pathology), Electrocoagulation, Follow-Up Studies, Functional Laterality, Globus Pallidus (surgery), Humans, Levodopa (adverse effects), Magnetic Resonance Imaging, Microelectrodes, Middle Aged, Motor Activity, Parkinson Disease (pathology), Parkinson Disease (physiopathology), Parkinson Disease (surgery), Postoperative Complications (epidemiology), Radio Waves, Stereotaxic Techniques.
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- epidemiology : Postoperative Complications.
- pathology : Brain, Parkinson Disease.
- physiopathology : Parkinson Disease.
- surgery : Globus Pallidus, Parkinson Disease.
- Adult, Aged, Electrocoagulation, Follow-Up Studies, Functional Laterality, Humans, Magnetic Resonance Imaging, Microelectrodes, Middle Aged, Motor Activity, Radio Waves, Stereotaxic Techniques.
Abstract
Stereotactic medial posteroventral pallidotomy for treatment of Parkinson's disease attracts increasing attention. We report on the preliminary results of 12 patients at 1 year after microelectrode-guided unilateral pallidotomy. The primary indications were severe bradykinesia and levodopa-induced dyskinesias. After radiofrequency lesioning all patients had immediate improvement of contralateral parkinsonian signs. Postoperative magnetic resonance imaging confirmed the localization of the lesions. At the 1-year follow-up, all patients had sustained benefit. The global improvement was rated as moderate in six cases, and as marked in six other cases. The mean values of various subscores of the Unified Parkinson's Disease Rating Scale (UPDRS) showed highly significant changes in the "off" state (pre/postoperatively): UPDRS Motor score (60.3/31). UPDRS Activities of Daily Living (ADL) score (33.2/18.3), gait/postural stability score (13.8/7.0), and subscores for contralateral rigidity (4.9/2.1), tremor (7.1/1.4) and bradykinesia (11.6/5.3). There was also significant improvement of ipsilateral bradykinesia and rigidity. Furthermore, we found significant changes of the mean values of the UPDRS ADL and motor "on" scores, an increase of the percentage of "on" time with reduced on-off fluctuations, and a decrease of the percentage of levodopa-induced dyskinesias, with marked improvement or complete abolition of contralateral dyskinesias in particular. The preoperative levodopa regimen was maintained, in general, or only slightly modified, if necessary. Two patients had transient complications: one patient suffered postoperative pneumonia and altered mental status; another patient displayed mild Broca's aphasia secondary to a small stroke involving the dorsal thalamus and the adjacent white matter. There were no persistent side effects at the 1-year follow-up. Contemporary unilateral pallidotomy is an effective and promising therapeutical option for surgical treatment of advanced Parkinson's disease.
PubMed: 9487651
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">[Medial posteroventral pallidotomy for the treatment of Parkinson's disease].</title><author><name sortKey="Krauss, J K" sort="Krauss, J K" uniqKey="Krauss J" first="J" last="Krauss">J Krauss</name><affiliation><nlm:affiliation>Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Grossman, R G" sort="Grossman, R G" uniqKey="Grossman R" first="R" last="Grossman">R Grossman</name></author><author><name sortKey="Lai, E C" sort="Lai, E C" uniqKey="Lai E" first="E" last="Lai">E Lai</name></author><author><name sortKey="Schwartz, K" sort="Schwartz, K" uniqKey="Schwartz K" first="K" last="Schwartz">K. Schwartz</name></author><author><name sortKey="Jankovic, J" sort="Jankovic, J" uniqKey="Jankovic J" first="J" last="Jankovic">J. Jankovic</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1997">1997</date><idno type="RBID">pubmed:9487651</idno><idno type="pmid">9487651</idno><idno type="wicri:Area/PubMed/Corpus">000289</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">[Medial posteroventral pallidotomy for the treatment of Parkinson's disease].</title><author><name sortKey="Krauss, J K" sort="Krauss, J K" uniqKey="Krauss J" first="J" last="Krauss">J Krauss</name><affiliation><nlm:affiliation>Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.</nlm:affiliation></affiliation></author><author><name sortKey="Grossman, R G" sort="Grossman, R G" uniqKey="Grossman R" first="R" last="Grossman">R Grossman</name></author><author><name sortKey="Lai, E C" sort="Lai, E C" uniqKey="Lai E" first="E" last="Lai">E Lai</name></author><author><name sortKey="Schwartz, K" sort="Schwartz, K" uniqKey="Schwartz K" first="K" last="Schwartz">K. Schwartz</name></author><author><name sortKey="Jankovic, J" sort="Jankovic, J" uniqKey="Jankovic J" first="J" last="Jankovic">J. Jankovic</name></author></analytic><series><title level="j">Zentralblatt für Neurochirurgie</title><idno type="ISSN">0044-4251</idno><imprint><date when="1997" type="published">1997</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Antiparkinson Agents (adverse effects)</term><term>Brain (pathology)</term><term>Electrocoagulation</term><term>Follow-Up Studies</term><term>Functional Laterality</term><term>Globus Pallidus (surgery)</term><term>Humans</term><term>Levodopa (adverse effects)</term><term>Magnetic Resonance Imaging</term><term>Microelectrodes</term><term>Middle Aged</term><term>Motor Activity</term><term>Parkinson Disease (pathology)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (surgery)</term><term>Postoperative Complications (epidemiology)</term><term>Radio Waves</term><term>Stereotaxic Techniques</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Brain</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Globus Pallidus</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Electrocoagulation</term><term>Follow-Up Studies</term><term>Functional Laterality</term><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Microelectrodes</term><term>Middle Aged</term><term>Motor Activity</term><term>Radio Waves</term><term>Stereotaxic Techniques</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Stereotactic medial posteroventral pallidotomy for treatment of Parkinson's disease attracts increasing attention. We report on the preliminary results of 12 patients at 1 year after microelectrode-guided unilateral pallidotomy. The primary indications were severe bradykinesia and levodopa-induced dyskinesias. After radiofrequency lesioning all patients had immediate improvement of contralateral parkinsonian signs. Postoperative magnetic resonance imaging confirmed the localization of the lesions. At the 1-year follow-up, all patients had sustained benefit. The global improvement was rated as moderate in six cases, and as marked in six other cases. The mean values of various subscores of the Unified Parkinson's Disease Rating Scale (UPDRS) showed highly significant changes in the "off" state (pre/postoperatively): UPDRS Motor score (60.3/31). UPDRS Activities of Daily Living (ADL) score (33.2/18.3), gait/postural stability score (13.8/7.0), and subscores for contralateral rigidity (4.9/2.1), tremor (7.1/1.4) and bradykinesia (11.6/5.3). There was also significant improvement of ipsilateral bradykinesia and rigidity. Furthermore, we found significant changes of the mean values of the UPDRS ADL and motor "on" scores, an increase of the percentage of "on" time with reduced on-off fluctuations, and a decrease of the percentage of levodopa-induced dyskinesias, with marked improvement or complete abolition of contralateral dyskinesias in particular. The preoperative levodopa regimen was maintained, in general, or only slightly modified, if necessary. Two patients had transient complications: one patient suffered postoperative pneumonia and altered mental status; another patient displayed mild Broca's aphasia secondary to a small stroke involving the dorsal thalamus and the adjacent white matter. There were no persistent side effects at the 1-year follow-up. Contemporary unilateral pallidotomy is an effective and promising therapeutical option for surgical treatment of advanced Parkinson's disease.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">9487651</PMID><DateCreated><Year>1998</Year><Month>03</Month><Day>31</Day></DateCreated><DateCompleted><Year>1998</Year><Month>03</Month><Day>31</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0044-4251</ISSN><JournalIssue CitedMedium="Print"><Volume>58</Volume><Issue>4</Issue><PubDate><Year>1997</Year></PubDate></JournalIssue><Title>Zentralblatt für Neurochirurgie</Title><ISOAbbreviation>Zentralbl. Neurochir.</ISOAbbreviation></Journal><ArticleTitle>[Medial posteroventral pallidotomy for the treatment of Parkinson's disease].</ArticleTitle><Pagination><MedlinePgn>153-62</MedlinePgn></Pagination><Abstract><AbstractText>Stereotactic medial posteroventral pallidotomy for treatment of Parkinson's disease attracts increasing attention. We report on the preliminary results of 12 patients at 1 year after microelectrode-guided unilateral pallidotomy. The primary indications were severe bradykinesia and levodopa-induced dyskinesias. After radiofrequency lesioning all patients had immediate improvement of contralateral parkinsonian signs. Postoperative magnetic resonance imaging confirmed the localization of the lesions. At the 1-year follow-up, all patients had sustained benefit. The global improvement was rated as moderate in six cases, and as marked in six other cases. The mean values of various subscores of the Unified Parkinson's Disease Rating Scale (UPDRS) showed highly significant changes in the "off" state (pre/postoperatively): UPDRS Motor score (60.3/31). UPDRS Activities of Daily Living (ADL) score (33.2/18.3), gait/postural stability score (13.8/7.0), and subscores for contralateral rigidity (4.9/2.1), tremor (7.1/1.4) and bradykinesia (11.6/5.3). There was also significant improvement of ipsilateral bradykinesia and rigidity. Furthermore, we found significant changes of the mean values of the UPDRS ADL and motor "on" scores, an increase of the percentage of "on" time with reduced on-off fluctuations, and a decrease of the percentage of levodopa-induced dyskinesias, with marked improvement or complete abolition of contralateral dyskinesias in particular. The preoperative levodopa regimen was maintained, in general, or only slightly modified, if necessary. Two patients had transient complications: one patient suffered postoperative pneumonia and altered mental status; another patient displayed mild Broca's aphasia secondary to a small stroke involving the dorsal thalamus and the adjacent white matter. There were no persistent side effects at the 1-year follow-up. Contemporary unilateral pallidotomy is an effective and promising therapeutical option for surgical treatment of advanced Parkinson's disease.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Krauss</LastName><ForeName>J K</ForeName><Initials>JK</Initials><AffiliationInfo><Affiliation>Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Grossman</LastName><ForeName>R G</ForeName><Initials>RG</Initials></Author><Author ValidYN="Y"><LastName>Lai</LastName><ForeName>E C</ForeName><Initials>EC</Initials></Author><Author ValidYN="Y"><LastName>Schwartz</LastName><ForeName>K</ForeName><Initials>K</Initials></Author><Author ValidYN="Y"><LastName>Jankovic</LastName><ForeName>J</ForeName><Initials>J</Initials></Author></AuthorList><Language>ger</Language><PublicationTypeList><PublicationType UI="D004740">English Abstract</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><VernacularTitle>Die mediale posteroventrale Pallidotomie zur Behandlung des Morbus Parkinson.</VernacularTitle></Article><MedlineJournalInfo><Country>GERMANY</Country><MedlineTA>Zentralbl Neurochir</MedlineTA><NlmUniqueID>0413646</NlmUniqueID><ISSNLinking>0044-4251</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000978">Antiparkinson Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>46627O600J</RegistryNumber><NameOfSubstance UI="D007980">Levodopa</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000328">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000368">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000978">Antiparkinson Agents</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000009">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D001921">Brain</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000473">pathology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D004564">Electrocoagulation</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D005500">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D007839">Functional Laterality</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D005917">Globus Pallidus</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000601">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D007980">Levodopa</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000009">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008279">Magnetic Resonance Imaging</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008839">Microelectrodes</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008875">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D009043">Motor Activity</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D010300">Parkinson Disease</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000473">pathology</QualifierName><QualifierName MajorTopicYN="N" UI="Q000503">physiopathology</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000601">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D011183">Postoperative Complications</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000453">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D011846">Radio Waves</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="Y" UI="D013238">Stereotaxic Techniques</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1997</Year><Month>1</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1998</Year><Month>3</Month><Day>6</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1997</Year><Month>1</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">9487651</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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