Effects of chronic subthalamic stimulation on nonmotor fluctuations in Parkinson's disease
Identifieur interne : 000338 ( France/Analysis ); précédent : 000337; suivant : 000339Effects of chronic subthalamic stimulation on nonmotor fluctuations in Parkinson's disease
Auteurs : Tatiana Witjas [France] ; Elsa Kaphan [France] ; Jean Régis [France] ; Elisabeth Jouve [France] ; André Ali Chérif [France] ; Jean-Claude Péragut [France] ; Jean Philippe Azulay [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2007-09-15.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Aged, Autonomic Nervous System Diseases (etiology), Autonomic Nervous System Diseases (therapy), Chronic, Deep Brain Stimulation (methods), Female, Fluctuations, Humans, Male, Mental Disorders (etiology), Mental Disorders (therapy), Middle Aged, Nervous system diseases, Pain (etiology), Pain Management, Parkinson Disease (complications), Parkinson Disease (psychology), Parkinson Disease (therapy), Parkinson disease, Parkinson's disease, Retrospective Studies, STN stimulation, Subthalamic Nucleus (physiopathology), Subthalamic Nucleus (radiation effects), nonmotor fluctuations, nonmotor symptoms.
- MESH :
- complications : Parkinson Disease.
- etiology : Autonomic Nervous System Diseases, Mental Disorders, Pain.
- methods : Deep Brain Stimulation.
- physiopathology : Subthalamic Nucleus.
- psychology : Parkinson Disease.
- radiation effects : Subthalamic Nucleus.
- therapy : Autonomic Nervous System Diseases, Mental Disorders, Parkinson Disease.
- Aged, Female, Humans, Male, Middle Aged, Pain Management, Retrospective Studies.
Abstract
The aim of this study was to assess the outcome of nonmotor fluctuations (NMF) after chronic Subthalamic nucleus (STN) Deep Brain Stimulation (DBS) in Parkinson's disease(PD). Chronic stimulation of the STN has proved to be an effective treatment for advanced PD with motor complications. The outcome of NMF, which are also disabling, remains unknown. Forty‐patients underwent bilateral STN stimulation. Each patient was interviewed before and after 1 yr of STN DBS with a structured questionnaire about their NMF. After 1 yr of chronic stimulation, the improvement in the motor score (UPDRS III) and dyskinesia amounted respectively to 67.4 and 76.3%. The decrease in motor fluctuations (MF) was 59% and 13 patients reported that their MF had disappeared. Comparatively, a reduction of the total number of NMF was also observed (mean number preoperatively: 15.6 per patient, postoperatively: 6.6). Most of the nonmotor fluctuating symptoms occurred in the “off” state preoperatively and no longer depended on the patient's motor state after surgery. The improvement in NMF was not identical for the different categories: pain/sensory fluctuations showed the best response to STN DBS (84.2%). Dysautonomic and cognitive fluctuations were also markedly improved (>60%) while psychic fluctuations remained the most frequent postoperative NMF observed. Some incapacitating manifestations such as drenching sweats and akathisia showed a remarkably good response to STN stimulation. In conclusion STN DBS alleviates NMF. It has strikingly successful effects on sensory, dysautonomic and cognitive fluctuations. However, psychic fluctuations respond less consistently to this treatment. © 2007 Movement Disorder Society
Url:
DOI: 10.1002/mds.21602
Affiliations:
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ISTEX:34C2DE0F7A7373A662DCA63A39538A2133543528Le document en format XML
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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="2007-09-15">2007-09-15</date><biblScope unit="vol">22</biblScope><biblScope unit="issue">12</biblScope><biblScope unit="page" from="1729">1729</biblScope><biblScope unit="page" to="1734">1734</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">34C2DE0F7A7373A662DCA63A39538A2133543528</idno><idno type="DOI">10.1002/mds.21602</idno><idno type="ArticleID">MDS21602</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Autonomic Nervous System Diseases (etiology)</term><term>Autonomic Nervous System Diseases (therapy)</term><term>Chronic</term><term>Deep Brain Stimulation (methods)</term><term>Female</term><term>Fluctuations</term><term>Humans</term><term>Male</term><term>Mental Disorders (etiology)</term><term>Mental Disorders (therapy)</term><term>Middle Aged</term><term>Nervous system diseases</term><term>Pain (etiology)</term><term>Pain Management</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (psychology)</term><term>Parkinson Disease (therapy)</term><term>Parkinson disease</term><term>Parkinson's disease</term><term>Retrospective Studies</term><term>STN stimulation</term><term>Subthalamic Nucleus (physiopathology)</term><term>Subthalamic Nucleus (radiation effects)</term><term>nonmotor fluctuations</term><term>nonmotor symptoms</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Autonomic Nervous System Diseases</term><term>Mental Disorders</term><term>Pain</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="radiation effects" xml:lang="en"><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Autonomic Nervous System Diseases</term><term>Mental Disorders</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pain Management</term><term>Retrospective Studies</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Chronique</term><term>Fluctuation</term><term>Parkinson maladie</term><term>Système nerveux pathologie</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aim of this study was to assess the outcome of nonmotor fluctuations (NMF) after chronic Subthalamic nucleus (STN) Deep Brain Stimulation (DBS) in Parkinson's disease(PD). Chronic stimulation of the STN has proved to be an effective treatment for advanced PD with motor complications. The outcome of NMF, which are also disabling, remains unknown. Forty‐patients underwent bilateral STN stimulation. Each patient was interviewed before and after 1 yr of STN DBS with a structured questionnaire about their NMF. After 1 yr of chronic stimulation, the improvement in the motor score (UPDRS III) and dyskinesia amounted respectively to 67.4 and 76.3%. The decrease in motor fluctuations (MF) was 59% and 13 patients reported that their MF had disappeared. Comparatively, a reduction of the total number of NMF was also observed (mean number preoperatively: 15.6 per patient, postoperatively: 6.6). Most of the nonmotor fluctuating symptoms occurred in the “off” state preoperatively and no longer depended on the patient's motor state after surgery. The improvement in NMF was not identical for the different categories: pain/sensory fluctuations showed the best response to STN DBS (84.2%). Dysautonomic and cognitive fluctuations were also markedly improved (>60%) while psychic fluctuations remained the most frequent postoperative NMF observed. Some incapacitating manifestations such as drenching sweats and akathisia showed a remarkably good response to STN stimulation. In conclusion STN DBS alleviates NMF. It has strikingly successful effects on sensory, dysautonomic and cognitive fluctuations. However, psychic fluctuations respond less consistently to this treatment. © 2007 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>France</li></country><settlement><li>Marseille</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Witjas, Tatiana" sort="Witjas, Tatiana" uniqKey="Witjas T" first="Tatiana" last="Witjas">Tatiana Witjas</name></noRegion><name sortKey="Azulay, Jean Philippe" sort="Azulay, Jean Philippe" uniqKey="Azulay J" first="Jean Philippe" last="Azulay">Jean Philippe Azulay</name><name sortKey="Cherif, Andre Ali" sort="Cherif, Andre Ali" uniqKey="Cherif A" first="André Ali" last="Chérif">André Ali Chérif</name><name sortKey="Jouve, Elisabeth" sort="Jouve, Elisabeth" uniqKey="Jouve E" first="Elisabeth" last="Jouve">Elisabeth Jouve</name><name sortKey="Kaphan, Elsa" sort="Kaphan, Elsa" uniqKey="Kaphan E" first="Elsa" last="Kaphan">Elsa Kaphan</name><name sortKey="Peragut, Jean Laude" sort="Peragut, Jean Laude" uniqKey="Peragut J" first="Jean-Claude" last="Péragut">Jean-Claude Péragut</name><name sortKey="Regis, Jean" sort="Regis, Jean" uniqKey="Regis J" first="Jean" last="Régis">Jean Régis</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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