Microsubthalamotomy: an immediate predictor of long-term subthalamic stimulation efficacy in Parkinson disease.
Identifieur interne : 000043 ( Hal/Corpus ); précédent : 000042; suivant : 000044Microsubthalamotomy: an immediate predictor of long-term subthalamic stimulation efficacy in Parkinson disease.
Auteurs : David Maltête ; Stéphane Derrey ; Nathalie Chastan ; Bertrand Debono ; Emmanuel Gérardin ; Pierre Fréger ; Bruno Mihout ; Jean François Menard ; Didier HannequinSource :
- Movement Disorders [ 0885-3185 ] ; 2008-05-15.
Abstract
A microsubthalamotomy (mSTN) effect is commonly described after implantation that improves Parkinson's motor disability and is considered to be an obvious sign of good placement of the definitive electrode within the subthalamic nucleus (STN). There has been no formal study, however, demonstrating whether this mSTN effect can predict the long-term efficacy of STN stimulation in Parkinson Disease. The mSTN effect was defined by the percentage improvement of unified parkinson's disease rating scale (UPDRS III) baseline score assessed the third day morning following STN implantation, after at least a 12 hour withdrawal of dopaminergic treatment and before the programmable pulse generator was switched on. It was assessed in 30 consecutive patients with PD submitted for STN stimulation. Multiple stepwise regression analysis showed that mSTN effect (P = 0.005) and global mean intensity of stimulation (P = 0.004) were accurate independent predictors of the 6-month postoperative UPDRS III motor score improvement in the off-drug/on-stimulation condition.
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DOI: 10.1002/mds.22054
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Hal:inserm-00472952Le document en format XML
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<front><div type="abstract" xml:lang="en">A microsubthalamotomy (mSTN) effect is commonly described after implantation that improves Parkinson's motor disability and is considered to be an obvious sign of good placement of the definitive electrode within the subthalamic nucleus (STN). There has been no formal study, however, demonstrating whether this mSTN effect can predict the long-term efficacy of STN stimulation in Parkinson Disease. The mSTN effect was defined by the percentage improvement of unified parkinson's disease rating scale (UPDRS III) baseline score assessed the third day morning following STN implantation, after at least a 12 hour withdrawal of dopaminergic treatment and before the programmable pulse generator was switched on. It was assessed in 30 consecutive patients with PD submitted for STN stimulation. Multiple stepwise regression analysis showed that mSTN effect (P = 0.005) and global mean intensity of stimulation (P = 0.004) were accurate independent predictors of the 6-month postoperative UPDRS III motor score improvement in the off-drug/on-stimulation condition.</div>
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<affiliation ref="#struct-110536"></affiliation>
</author>
<author role="aut"><persName><forename type="first">Didier</forename>
<surname>Hannequin</surname>
</persName>
<idno type="halAuthorId">270912</idno>
<affiliation ref="#struct-43394"></affiliation>
<affiliation ref="#struct-2972"></affiliation>
</author>
</analytic>
<monogr><idno type="halJournalId" status="VALID">17211</idno>
<idno type="issn">0885-3185</idno>
<idno type="eissn">1531-8257</idno>
<title level="j">Movement Disorders</title>
<imprint><publisher>Wiley</publisher>
<biblScope unit="volume">23</biblScope>
<biblScope unit="issue">7</biblScope>
<biblScope unit="pp">1047-50</biblScope>
<date type="datePub">2008-05-15</date>
</imprint>
</monogr>
<idno type="doi">10.1002/mds.22054</idno>
<idno type="pubmed">18412281</idno>
</biblStruct>
</sourceDesc>
<profileDesc><langUsage><language ident="en">English</language>
</langUsage>
<textClass><classCode scheme="mesh">Adult</classCode>
<classCode scheme="mesh">Aged</classCode>
<classCode scheme="mesh">Parkinson Disease</classCode>
<classCode scheme="mesh">Postoperative Care</classCode>
<classCode scheme="mesh">Predictive Value of Tests</classCode>
<classCode scheme="mesh">Subthalamic Nucleus</classCode>
<classCode scheme="mesh">Time Factors</classCode>
<classCode scheme="mesh">Treatment Outcome</classCode>
<classCode scheme="mesh">Aged, 80 and over</classCode>
<classCode scheme="mesh">Deep Brain Stimulation</classCode>
<classCode scheme="mesh">Female</classCode>
<classCode scheme="mesh">Humans</classCode>
<classCode scheme="mesh">Male</classCode>
<classCode scheme="mesh">Microsurgery</classCode>
<classCode scheme="mesh">Middle Aged</classCode>
<classCode scheme="mesh">Neurosurgical Procedures</classCode>
<classCode scheme="halDomain" n="sdv.neu">Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC]</classCode>
<classCode scheme="halTypology" n="ART">Journal articles</classCode>
</textClass>
<abstract xml:lang="en">A microsubthalamotomy (mSTN) effect is commonly described after implantation that improves Parkinson's motor disability and is considered to be an obvious sign of good placement of the definitive electrode within the subthalamic nucleus (STN). There has been no formal study, however, demonstrating whether this mSTN effect can predict the long-term efficacy of STN stimulation in Parkinson Disease. The mSTN effect was defined by the percentage improvement of unified parkinson's disease rating scale (UPDRS III) baseline score assessed the third day morning following STN implantation, after at least a 12 hour withdrawal of dopaminergic treatment and before the programmable pulse generator was switched on. It was assessed in 30 consecutive patients with PD submitted for STN stimulation. Multiple stepwise regression analysis showed that mSTN effect (P = 0.005) and global mean intensity of stimulation (P = 0.004) were accurate independent predictors of the 6-month postoperative UPDRS III motor score improvement in the off-drug/on-stimulation condition.</abstract>
</profileDesc>
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