Factors predicting improvement in primary generalized dystonia treated by pallidal deep brain stimulation
Identifieur interne : 000253 ( France/Analysis ); précédent : 000252; suivant : 000254Factors predicting improvement in primary generalized dystonia treated by pallidal deep brain stimulation
Auteurs : Xavier Vasques [France] ; Laura Cif [France] ; Victoria Gonzalez [France] ; Claire Nicholson [France] ; Philippe Coubes [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-04-30.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Adolescent, Adult, Analysis of Variance, Child, Child, Preschool, Deep Brain Stimulation (methods), Deep brain stimulation, Dystonia, Dystonic Disorders (therapy), Female, Globus Pallidus (physiology), Humans, Imaging, Three-Dimensional, Improvement, Magnetic Resonance Imaging (methods), Male, Middle Aged, Nervous system diseases, Outcome Assessment (Health Care) (methods), Predictive Value of Tests, Prognosis, Severity of Illness Index, Statistics as Topic, Treatment, Young Adult, clinical outcome predictors, deep brain stimulation, globus pallidus internus, primary generalized dystonia.
- MESH :
- methods : Deep Brain Stimulation, Magnetic Resonance Imaging, Outcome Assessment (Health Care).
- physiology : Globus Pallidus.
- therapy : Dystonic Disorders.
- Adolescent, Adult, Analysis of Variance, Child, Child, Preschool, Female, Humans, Imaging, Three-Dimensional, Male, Middle Aged, Predictive Value of Tests, Severity of Illness Index, Statistics as Topic, Young Adult.
Abstract
Despite the beneficial effects of Globus Pallidus internus (GPi) deep brain stimulation (DBS) in patients with primary generalized dystonia (PGD), the degree of improvement varies from one patient to another. The objective of this study was to examine the effects of clinical, anatomical (volume of the GPi), and electrical variables on the postoperative Burke‐Fahn‐Marsden Dystonia rating scale (BFMDRS) motor score to identify which factors may be predictive of the degree of improvement. We reviewed retrospectively the clinical records of 40 steady‐state patients with PGD who had been treated by bilateral GPi lead implantation. The follow‐up period was 2 to 8 years. The correlation between the electrical parameters (voltage, impedance, and current) and the clinical outcome was studied. An analysis of covariance was performed to identify factors predictive of the magnitude of improvement. The most influential factors according to the model are as follows: the preoperative BFMDRS score (P < 0.0001); age at surgery (P < 0.0001); the right GPi volume (P = 0.002); the left stimulated GPi volume (P = 0.005). No significant correlation was found between the electrical parameters used and the mean motor scores in steady state. © 2009 Movement Disorder Society
Url:
DOI: 10.1002/mds.22433
Affiliations:
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2009-04-30">2009-04-30</date><biblScope unit="vol">24</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="846">846</biblScope><biblScope unit="page" to="853">853</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">C1DC2DE49D6E5A339215E4674BA810BC2B2D5E85</idno><idno type="DOI">10.1002/mds.22433</idno><idno type="ArticleID">MDS22433</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Analysis of Variance</term><term>Child</term><term>Child, Preschool</term><term>Deep Brain Stimulation (methods)</term><term>Deep brain stimulation</term><term>Dystonia</term><term>Dystonic Disorders (therapy)</term><term>Female</term><term>Globus Pallidus (physiology)</term><term>Humans</term><term>Imaging, Three-Dimensional</term><term>Improvement</term><term>Magnetic Resonance Imaging (methods)</term><term>Male</term><term>Middle Aged</term><term>Nervous system diseases</term><term>Outcome Assessment (Health Care) (methods)</term><term>Predictive Value of Tests</term><term>Prognosis</term><term>Severity of Illness Index</term><term>Statistics as Topic</term><term>Treatment</term><term>Young Adult</term><term>clinical outcome predictors</term><term>deep brain stimulation</term><term>globus pallidus internus</term><term>primary generalized dystonia</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term><term>Magnetic Resonance Imaging</term><term>Outcome Assessment (Health Care)</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Globus Pallidus</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Dystonic Disorders</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adolescent</term><term>Adult</term><term>Analysis of Variance</term><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Humans</term><term>Imaging, Three-Dimensional</term><term>Male</term><term>Middle Aged</term><term>Predictive Value of Tests</term><term>Severity of Illness Index</term><term>Statistics as Topic</term><term>Young Adult</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Amélioration</term><term>Dystonie</term><term>Pathologie du système nerveux</term><term>Pronostic</term><term>Stimulation cérébrale profonde</term><term>Traitement</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Despite the beneficial effects of Globus Pallidus internus (GPi) deep brain stimulation (DBS) in patients with primary generalized dystonia (PGD), the degree of improvement varies from one patient to another. The objective of this study was to examine the effects of clinical, anatomical (volume of the GPi), and electrical variables on the postoperative Burke‐Fahn‐Marsden Dystonia rating scale (BFMDRS) motor score to identify which factors may be predictive of the degree of improvement. We reviewed retrospectively the clinical records of 40 steady‐state patients with PGD who had been treated by bilateral GPi lead implantation. The follow‐up period was 2 to 8 years. The correlation between the electrical parameters (voltage, impedance, and current) and the clinical outcome was studied. An analysis of covariance was performed to identify factors predictive of the magnitude of improvement. The most influential factors according to the model are as follows: the preoperative BFMDRS score (P < 0.0001); age at surgery (P < 0.0001); the right GPi volume (P = 0.002); the left stimulated GPi volume (P = 0.005). No significant correlation was found between the electrical parameters used and the mean motor scores in steady state. © 2009 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>France</li></country><settlement><li>Montpellier</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Vasques, Xavier" sort="Vasques, Xavier" uniqKey="Vasques X" first="Xavier" last="Vasques">Xavier Vasques</name></noRegion><name sortKey="Cif, Laura" sort="Cif, Laura" uniqKey="Cif L" first="Laura" last="Cif">Laura Cif</name><name sortKey="Cif, Laura" sort="Cif, Laura" uniqKey="Cif L" first="Laura" last="Cif">Laura Cif</name><name sortKey="Cif, Laura" sort="Cif, Laura" uniqKey="Cif L" first="Laura" last="Cif">Laura Cif</name><name sortKey="Cif, Laura" sort="Cif, Laura" uniqKey="Cif L" first="Laura" last="Cif">Laura Cif</name><name sortKey="Cif, Laura" sort="Cif, Laura" uniqKey="Cif L" first="Laura" last="Cif">Laura Cif</name><name sortKey="Coubes, Philippe" sort="Coubes, Philippe" uniqKey="Coubes P" first="Philippe" last="Coubes">Philippe Coubes</name><name sortKey="Coubes, Philippe" sort="Coubes, Philippe" uniqKey="Coubes P" first="Philippe" last="Coubes">Philippe Coubes</name><name sortKey="Coubes, Philippe" sort="Coubes, Philippe" uniqKey="Coubes P" first="Philippe" last="Coubes">Philippe Coubes</name><name sortKey="Coubes, Philippe" sort="Coubes, Philippe" uniqKey="Coubes P" first="Philippe" last="Coubes">Philippe Coubes</name><name sortKey="Coubes, Philippe" sort="Coubes, Philippe" uniqKey="Coubes P" first="Philippe" last="Coubes">Philippe Coubes</name><name sortKey="Gonzalez, Victoria" sort="Gonzalez, Victoria" uniqKey="Gonzalez V" first="Victoria" last="Gonzalez">Victoria Gonzalez</name><name sortKey="Gonzalez, Victoria" sort="Gonzalez, Victoria" uniqKey="Gonzalez V" first="Victoria" last="Gonzalez">Victoria Gonzalez</name><name sortKey="Gonzalez, Victoria" sort="Gonzalez, Victoria" uniqKey="Gonzalez V" first="Victoria" last="Gonzalez">Victoria Gonzalez</name><name sortKey="Gonzalez, Victoria" sort="Gonzalez, Victoria" uniqKey="Gonzalez V" first="Victoria" last="Gonzalez">Victoria Gonzalez</name><name sortKey="Gonzalez, Victoria" sort="Gonzalez, Victoria" uniqKey="Gonzalez V" first="Victoria" last="Gonzalez">Victoria Gonzalez</name><name sortKey="Nicholson, Claire" sort="Nicholson, Claire" uniqKey="Nicholson C" first="Claire" last="Nicholson">Claire Nicholson</name><name sortKey="Nicholson, Claire" sort="Nicholson, Claire" uniqKey="Nicholson C" first="Claire" last="Nicholson">Claire Nicholson</name><name sortKey="Nicholson, Claire" sort="Nicholson, Claire" uniqKey="Nicholson C" first="Claire" last="Nicholson">Claire Nicholson</name><name sortKey="Nicholson, Claire" sort="Nicholson, Claire" uniqKey="Nicholson C" first="Claire" last="Nicholson">Claire Nicholson</name><name sortKey="Nicholson, Claire" sort="Nicholson, Claire" uniqKey="Nicholson C" first="Claire" last="Nicholson">Claire Nicholson</name><name sortKey="Vasques, Xavier" sort="Vasques, Xavier" uniqKey="Vasques X" first="Xavier" last="Vasques">Xavier Vasques</name><name sortKey="Vasques, Xavier" sort="Vasques, Xavier" uniqKey="Vasques X" first="Xavier" last="Vasques">Xavier Vasques</name><name sortKey="Vasques, Xavier" sort="Vasques, Xavier" uniqKey="Vasques X" first="Xavier" last="Vasques">Xavier Vasques</name><name sortKey="Vasques, Xavier" sort="Vasques, Xavier" uniqKey="Vasques X" first="Xavier" last="Vasques">Xavier Vasques</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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