Inhibition of levodopa effects by internal pallidal stimulation
Identifieur interne : 000567 ( France/Analysis ); précédent : 000566; suivant : 000568Inhibition of levodopa effects by internal pallidal stimulation
Auteurs : Paul Krack [France] ; Pierre Pollak [France] ; Patricia Limousin [France] ; Dominique Hoffmann [France] ; Abdelhamid Benazzouz [France] ; Alim-Louis Benabid [France]Source :
- Movement Disorders [ 0885-3185 ] ; 1998-07.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Adulte.
English descriptors
- KwdEn :
- Adult, Antiparkinson Agents (administration & dosage), Antiparkinson Agents (adverse effects), Antiparkinson agent, Case study, Chemotherapy, Combined Modality Therapy, Dominance, Cerebral (drug effects), Dominance, Cerebral (physiology), Dyskinesia, Dyskinesia, Drug-Induced (diagnosis), Dyskinesia, Drug-Induced (physiopathology), Dyskinesia, Drug-Induced (therapy), Electric Stimulation Therapy, Electrical stimulation, Electrical stimulus, Electrodes, Implanted, Globus Pallidus (drug effects), Globus Pallidus (physiopathology), High frequency, Humans, Indication, Instrumentation therapy, Internal, Internal pallidum, Levodopa, Levodopa (administration & dosage), Levodopa (adverse effects), Male, Middle Aged, Motricity, On effect, Pallidum, Parkinson Disease (physiopathology), Parkinson Disease (therapy), Parkinson disease, Parkinson's disease, Toxicity.
- MESH :
- chemical , administration & dosage : Antiparkinson Agents, Levodopa.
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- diagnosis : Dyskinesia, Drug-Induced.
- drug effects : Dominance, Cerebral, Globus Pallidus.
- physiology : Dominance, Cerebral.
- physiopathology : Dyskinesia, Drug-Induced, Globus Pallidus, Parkinson Disease.
- therapy : Dyskinesia, Drug-Induced, Parkinson Disease.
- Combined Modality Therapy, Electric Stimulation Therapy, Electrodes, Implanted, Humans, Male, Middle Aged.
Abstract
We report three patients with bilateral GPi stimulation for stage 4 Parkinson's disease (PD) with severe levodopa‐induced dyskinesias (LID). In all three it was possible to completely inhibit LID using high‐stimulation parameters. Parallel to complete inhibition of LID, an inhibition of the anti‐akinetic effect of levodopa was observed, whereas, at the same time, rigidity was markedly improved. GPi stimulation is adaptable over time, and stimulation parameters have to be programmed according to off‐and on‐period motor symptoms. The main interest of stimulation is the possibility of finding a compromise between LID alleviation in on‐phase without loss of the beneficial motor effects and improvement in parkinsonism in off‐phase. In some patients, residual dyskinesias have to be accepted so as not to aggravate on‐period motor symptoms by a presumed overinhibition of basal ganglia outflow.
Url:
DOI: 10.1002/mds.870130407
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="1998-07">1998-07</date><biblScope unit="vol">13</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="648">648</biblScope><biblScope unit="page" to="652">652</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">A3E18445A389F4FC66F38749E041592C1C5AE95A</idno><idno type="DOI">10.1002/mds.870130407</idno><idno type="ArticleID">MDS870130407</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Antiparkinson Agents (administration & dosage)</term><term>Antiparkinson Agents (adverse effects)</term><term>Antiparkinson agent</term><term>Case study</term><term>Chemotherapy</term><term>Combined Modality Therapy</term><term>Dominance, Cerebral (drug effects)</term><term>Dominance, Cerebral (physiology)</term><term>Dyskinesia</term><term>Dyskinesia, Drug-Induced (diagnosis)</term><term>Dyskinesia, Drug-Induced (physiopathology)</term><term>Dyskinesia, Drug-Induced (therapy)</term><term>Electric Stimulation Therapy</term><term>Electrical stimulation</term><term>Electrical stimulus</term><term>Electrodes, Implanted</term><term>Globus Pallidus (drug effects)</term><term>Globus Pallidus (physiopathology)</term><term>High frequency</term><term>Humans</term><term>Indication</term><term>Instrumentation therapy</term><term>Internal</term><term>Internal pallidum</term><term>Levodopa</term><term>Levodopa (administration & dosage)</term><term>Levodopa (adverse effects)</term><term>Male</term><term>Middle Aged</term><term>Motricity</term><term>On effect</term><term>Pallidum</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (therapy)</term><term>Parkinson disease</term><term>Parkinson's disease</term><term>Toxicity</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</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="diagnosis" xml:lang="en"><term>Dyskinesia, Drug-Induced</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Dominance, Cerebral</term><term>Globus Pallidus</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Dominance, Cerebral</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Dyskinesia, Drug-Induced</term><term>Globus Pallidus</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Dyskinesia, Drug-Induced</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Combined Modality Therapy</term><term>Electric Stimulation Therapy</term><term>Electrodes, Implanted</term><term>Humans</term><term>Male</term><term>Middle Aged</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Adulte</term><term>Antiparkinsonien</term><term>Chimiothérapie</term><term>Dyskinésie</term><term>Effet on</term><term>Etude cas</term><term>Haute fréquence</term><term>Indication</term><term>Interne</term><term>Lévodopa</term><term>Motricité</term><term>Mâle</term><term>Pallidum</term><term>Parkinson maladie</term><term>Stimulus électrique</term><term>Toxicité</term><term>Traitement instrumental</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Adulte</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We report three patients with bilateral GPi stimulation for stage 4 Parkinson's disease (PD) with severe levodopa‐induced dyskinesias (LID). In all three it was possible to completely inhibit LID using high‐stimulation parameters. Parallel to complete inhibition of LID, an inhibition of the anti‐akinetic effect of levodopa was observed, whereas, at the same time, rigidity was markedly improved. GPi stimulation is adaptable over time, and stimulation parameters have to be programmed according to off‐and on‐period motor symptoms. The main interest of stimulation is the possibility of finding a compromise between LID alleviation in on‐phase without loss of the beneficial motor effects and improvement in parkinsonism in off‐phase. In some patients, residual dyskinesias have to be accepted so as not to aggravate on‐period motor symptoms by a presumed overinhibition of basal ganglia outflow.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Auvergne-Rhône-Alpes</li><li>Rhône-Alpes</li></region><settlement><li>Grenoble</li></settlement><orgName><li>Centre hospitalier universitaire Grenoble Alpes</li></orgName></list><tree><country name="France"><noRegion><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name></noRegion><name sortKey="Benabid, Alim Ouis" sort="Benabid, Alim Ouis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name><name sortKey="Benazzouz, Abdelhamid" sort="Benazzouz, Abdelhamid" uniqKey="Benazzouz A" first="Abdelhamid" last="Benazzouz">Abdelhamid Benazzouz</name><name sortKey="Hoffmann, Dominique" sort="Hoffmann, Dominique" uniqKey="Hoffmann D" first="Dominique" last="Hoffmann">Dominique Hoffmann</name><name sortKey="Limousin, Patricia" sort="Limousin, Patricia" uniqKey="Limousin P" first="Patricia" last="Limousin">Patricia Limousin</name><name sortKey="Pollak, Pierre" sort="Pollak, Pierre" uniqKey="Pollak P" first="Pierre" last="Pollak">Pierre Pollak</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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