Influence of subthalamic deep brain stimulation versus levodopa on motor perseverations in Parkinson's disease
Identifieur interne : 000E53 ( Istex/Checkpoint ); précédent : 000E52; suivant : 000E54Influence of subthalamic deep brain stimulation versus levodopa on motor perseverations in Parkinson's disease
Auteurs : Jan Herzog [Allemagne] ; Bettina Möller [Allemagne] ; Karsten Witt [Allemagne] ; Marcus O. Pinsker [Allemagne] ; Günther Deuschl [Allemagne] ; Jens Volkmann [Allemagne]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-06-15.
English descriptors
Abstract
Patients with Parkinson's disease (PD) show impairment in generating random motor sequences reflecting a higher order motor deficit in set‐shifting and suppression of perseverative behavior. The impact of deep brain stimulation (DBS) of the subthalamic nucleus (STN) on motor perseverations has not yet been elucidated. In 35 patients with PD, we evaluated the effect of STN‐DBS and levodopa on motor perseverations using the Vienna perseveration task. The task was performed 6 months after implantation of stimulation electrodes in the following three conditions: Stimulation off/medication off (Stim OFF/Med OFF), Stim ON/Med OFF, and Stim OFF/Med ON. Perseverations were measured by redundancy of second order (R2) with higher values indicating more severe perseverations. ANCOVA analysis revealed that influence of STN‐DBS on R2 significantly depended on R2 severity during Stim OFF/Med OFF (F = 4.69, P = 0.035). Accordingly, we classified patients with PD into two groups based on the R2 value during off treatment. In patients with mild perseveration (R2 < 35) neither STN‐DBS nor levodopa changed perseverations. By contrast, in patients with severe perseveration (R2 > 35), STN‐DBS significantly reduced R2 by 9.7 ± 2.6 (P < 0.001) whereas levodopa had no impact (R2 reduction 3.7 ± 1.6, P = 0.081). This demonstrates that STN‐DBS, by reducing motor perseveration, influences higher order aspects of motor behavior of patients with PD. © 2009 Movement Disorder Society
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DOI: 10.1002/mds.22568
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Pinsker</name></author><author><name sortKey="Deuschl, Gunther" sort="Deuschl, Gunther" uniqKey="Deuschl G" first="Günther" last="Deuschl">Günther Deuschl</name></author><author><name sortKey="Volkmann, Jens" sort="Volkmann, Jens" uniqKey="Volkmann J" first="Jens" last="Volkmann">Jens Volkmann</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:8F776BB008264FD128CA68FA1591DC54D17B267D</idno><date when="2009" year="2009">2009</date><idno type="doi">10.1002/mds.22568</idno><idno type="url">https://api.istex.fr/document/8F776BB008264FD128CA68FA1591DC54D17B267D/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">001A74</idno><idno type="wicri:Area/Istex/Curation">001A74</idno><idno type="wicri:Area/Istex/Checkpoint">000E53</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Influence of subthalamic deep brain stimulation versus levodopa on motor perseverations in Parkinson's disease</title><author><name sortKey="Herzog, Jan" sort="Herzog, Jan" uniqKey="Herzog J" first="Jan" last="Herzog">Jan Herzog</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, Christian‐Albrechts‐University, Schittenhelmstr. 10, Kiel</wicri:regionArea><placeName><region type="land" nuts="2">Schleswig-Holstein</region><settlement type="city">Kiel</settlement></placeName></affiliation></author><author><name sortKey="Moller, Bettina" sort="Moller, Bettina" uniqKey="Moller B" first="Bettina" last="Möller">Bettina Möller</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, Christian‐Albrechts‐University, Schittenhelmstr. 10, Kiel</wicri:regionArea><placeName><region type="land" nuts="2">Schleswig-Holstein</region><settlement type="city">Kiel</settlement></placeName></affiliation></author><author><name sortKey="Witt, Karsten" sort="Witt, Karsten" uniqKey="Witt K" first="Karsten" last="Witt">Karsten Witt</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, Christian‐Albrechts‐University, Schittenhelmstr. 10, Kiel</wicri:regionArea><placeName><region type="land" nuts="2">Schleswig-Holstein</region><settlement type="city">Kiel</settlement></placeName></affiliation></author><author><name sortKey="Pinsker, Marcus O" sort="Pinsker, Marcus O" uniqKey="Pinsker M" first="Marcus O." last="Pinsker">Marcus O. Pinsker</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurosurgery, Christian‐Albrechts‐University, Schittenhelmstr. 10, Kiel</wicri:regionArea><placeName><region type="land" nuts="2">Schleswig-Holstein</region><settlement type="city">Kiel</settlement></placeName></affiliation></author><author><name sortKey="Deuschl, Gunther" sort="Deuschl, Gunther" uniqKey="Deuschl G" first="Günther" last="Deuschl">Günther Deuschl</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, Christian‐Albrechts‐University, Schittenhelmstr. 10, Kiel</wicri:regionArea><placeName><region type="land" nuts="2">Schleswig-Holstein</region><settlement type="city">Kiel</settlement></placeName></affiliation></author><author><name sortKey="Volkmann, Jens" sort="Volkmann, Jens" uniqKey="Volkmann J" first="Jens" last="Volkmann">Jens Volkmann</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, Christian‐Albrechts‐University, Schittenhelmstr. 10, Kiel</wicri:regionArea><placeName><region type="land" nuts="2">Schleswig-Holstein</region><settlement type="city">Kiel</settlement></placeName></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. 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="2009-06-15">2009-06-15</date><biblScope unit="vol">24</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="1206">1206</biblScope><biblScope unit="page" to="1210">1210</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">8F776BB008264FD128CA68FA1591DC54D17B267D</idno><idno type="DOI">10.1002/mds.22568</idno><idno type="ArticleID">MDS22568</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>STN‐DBS</term><term>Vienna perseveration task</term><term>motor control</term><term>neuropsychology</term><term>random behavior</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Patients with Parkinson's disease (PD) show impairment in generating random motor sequences reflecting a higher order motor deficit in set‐shifting and suppression of perseverative behavior. The impact of deep brain stimulation (DBS) of the subthalamic nucleus (STN) on motor perseverations has not yet been elucidated. In 35 patients with PD, we evaluated the effect of STN‐DBS and levodopa on motor perseverations using the Vienna perseveration task. The task was performed 6 months after implantation of stimulation electrodes in the following three conditions: Stimulation off/medication off (Stim OFF/Med OFF), Stim ON/Med OFF, and Stim OFF/Med ON. Perseverations were measured by redundancy of second order (R2) with higher values indicating more severe perseverations. ANCOVA analysis revealed that influence of STN‐DBS on R2 significantly depended on R2 severity during Stim OFF/Med OFF (F = 4.69, P = 0.035). Accordingly, we classified patients with PD into two groups based on the R2 value during off treatment. In patients with mild perseveration (R2 < 35) neither STN‐DBS nor levodopa changed perseverations. By contrast, in patients with severe perseveration (R2 > 35), STN‐DBS significantly reduced R2 by 9.7 ± 2.6 (P < 0.001) whereas levodopa had no impact (R2 reduction 3.7 ± 1.6, P = 0.081). This demonstrates that STN‐DBS, by reducing motor perseveration, influences higher order aspects of motor behavior of patients with PD. © 2009 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>Schleswig-Holstein</li></region><settlement><li>Kiel</li></settlement></list><tree><country name="Allemagne"><region name="Schleswig-Holstein"><name sortKey="Herzog, Jan" sort="Herzog, Jan" uniqKey="Herzog J" first="Jan" last="Herzog">Jan Herzog</name></region><name sortKey="Deuschl, Gunther" sort="Deuschl, Gunther" uniqKey="Deuschl G" first="Günther" last="Deuschl">Günther Deuschl</name><name sortKey="Moller, Bettina" sort="Moller, Bettina" uniqKey="Moller B" first="Bettina" last="Möller">Bettina Möller</name><name sortKey="Pinsker, Marcus O" sort="Pinsker, Marcus O" uniqKey="Pinsker M" first="Marcus O." last="Pinsker">Marcus O. Pinsker</name><name sortKey="Volkmann, Jens" sort="Volkmann, Jens" uniqKey="Volkmann J" first="Jens" last="Volkmann">Jens Volkmann</name><name sortKey="Witt, Karsten" sort="Witt, Karsten" uniqKey="Witt K" first="Karsten" last="Witt">Karsten Witt</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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