MovDisordV3, France, Analysis, bibRecord, 000559

Treatment of tremor in Parkinson's disease by subthalamic nucleus stimulation

Identifieur interne : 000559 ( France/Analysis ); précédent : 000558; suivant : 000560

Treatment of tremor in Parkinson's disease by subthalamic nucleus stimulation

Auteurs : P. Krack [France] ; Abdelhamid Benazzouz [France] ; Pierre Pollak [France] ; Patricia Limousin [France] ; Brigitte Piallat [France] ; Dominique Hoffmann [France] ; Jing Xie [France] ; Alim-Louis Benabid [France]

Source :

Movement Disorders [ 0885-3185 ] ; 1998-11.

RBID : ISTEX:45614D8282909BBA2AB015403049C8BEBABE39BE

Descripteurs français

Pascal (Inist)
- Chirurgie stéréotaxique, Homme, Noyau sousthalamique, Parkinson maladie, Stimulation instrumentale, Traitement, Tremblement.
Wicri :
- topic : Homme.

English descriptors

KwdEn :
- Adult, Aged, Electric Stimulation Therapy, Electrodes, Implanted, Electrophysiology, Female, Human, Humans, Instrumental stimulation, Male, Middle Aged, Parkinson Disease (therapy), Parkinson disease, Parkinson's disease, Statistics, Nonparametric, Stereotaxic Techniques, Stereotaxic surgery, Stereotaxy, Stimulation, Subthalamic nucleus, Thalamic Nuclei, Treatment, Tremor, Tremor (therapy).
MESH :
- therapy : Parkinson Disease, Tremor.
- Adult, Aged, Electric Stimulation Therapy, Electrodes, Implanted, Electrophysiology, Female, Humans, Male, Middle Aged, Statistics, Nonparametric, Stereotaxic Techniques, Thalamic Nuclei.

Abstract

The recent resurgent interest in functional surgery for the treatment of Parkinson's disease (PD) has focused on the effects on akinesia and levodopa‐induced dyskinesia. Stimulation of the subthalamic nucleus (STN) improves akinesia and rigidity but its effects on tremor have not been studied. The objective of this study was to assess the efficacy of STN stimulation on tremor in patients with the complete parkinsonian triad with motor fluctuations. Of 27 consecutive patients with STN stimulation (26 bilateral), 15 exhibited tremor rated at least 2/4 according to item 20 (rest tremor) of the Unified Parkinson's Disease Rating Scale (UPDRS) in at least one limb. The mean preoperative tremor score was 11.3 ± 5.6 in off‐drug and 1.2 ± 2.4 in on‐drug conditions. The postoperative tremor scores at the last follow up (from 1–12 months) were 2.2 ± 2.2 off‐drug/on‐stimulation and 0.2 ± 0.4 on‐drug/on‐stimulation. Both rest and action tremors were improved in all patients. The UPDRS tremor score was reduced by 80%, rigidity score by 65%, and akinesia score by 51% on average. For the three symptoms, the stimulation effect was close to that induced before surgery by a suprathreshold dose of levodopa given in the morning. STN stimulation can be considered an interesting alternative to thalamic or internal pallidal surgery even in PD patients with severe high‐amplitude tremor. In keeping with electrophysiological data in monkeys rendered parkinsonian by MPTP injections, our results emphasize the importance of the oscillation of a neuronal loop involving the STN in the pathophysiology of parkinsonian tremor.

Url:

https://api.istex.fr/document/45614D8282909BBA2AB015403049C8BEBABE39BE/fulltext/pdf

DOI: 10.1002/mds.870130608

Affiliations:

Links to Exploration step

ISTEX:45614D8282909BBA2AB015403049C8BEBABE39BE

Le document en format XML

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<term>Electrodes, Implanted</term>
<term>Electrophysiology</term>
<term>Female</term>
<term>Human</term>
<term>Humans</term>
<term>Instrumental stimulation</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Parkinson Disease (therapy)</term>
<term>Parkinson disease</term>
<term>Parkinson's disease</term>
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<term>Thalamic Nuclei</term>
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<front><div type="abstract" xml:lang="en">The recent resurgent interest in functional surgery for the treatment of Parkinson's disease (PD) has focused on the effects on akinesia and levodopa‐induced dyskinesia. Stimulation of the subthalamic nucleus (STN) improves akinesia and rigidity but its effects on tremor have not been studied. The objective of this study was to assess the efficacy of STN stimulation on tremor in patients with the complete parkinsonian triad with motor fluctuations. Of 27 consecutive patients with STN stimulation (26 bilateral), 15 exhibited tremor rated at least 2/4 according to item 20 (rest tremor) of the Unified Parkinson's Disease Rating Scale (UPDRS) in at least one limb. The mean preoperative tremor score was 11.3 ± 5.6 in off‐drug and 1.2 ± 2.4 in on‐drug conditions. The postoperative tremor scores at the last follow up (from 1–12 months) were 2.2 ± 2.2 off‐drug/on‐stimulation and 0.2 ± 0.4 on‐drug/on‐stimulation. Both rest and action tremors were improved in all patients. The UPDRS tremor score was reduced by 80%, rigidity score by 65%, and akinesia score by 51% on average. For the three symptoms, the stimulation effect was close to that induced before surgery by a suprathreshold dose of levodopa given in the morning. STN stimulation can be considered an interesting alternative to thalamic or internal pallidal surgery even in PD patients with severe high‐amplitude tremor. In keeping with electrophysiological data in monkeys rendered parkinsonian by MPTP injections, our results emphasize the importance of the oscillation of a neuronal loop involving the STN in the pathophysiology of parkinsonian tremor.</div>
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Movement Disorders (revue)

Treatment of tremor in Parkinson's disease by subthalamic nucleus stimulation

Treatment of tremor in Parkinson's disease by subthalamic nucleus stimulation

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Links to Exploration step

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

	Movement Disorders (revue)
	Attention, ce site est en cours de développement ! Attention, site généré par des moyens informatiques à partir de corpus bruts. Les informations ne sont donc pas validées.