Bilateral subthalamic nucleus stimulation in a parkinsonian patient with preoperative deficits in speech and cognition: Persistent improvement in mobility but increased dependency: A case study
Identifieur interne : 003273 ( Istex/Corpus ); précédent : 003272; suivant : 003274Bilateral subthalamic nucleus stimulation in a parkinsonian patient with preoperative deficits in speech and cognition: Persistent improvement in mobility but increased dependency: A case study
Auteurs : Marwan I. Hariz ; Folke Johansson ; Parvis Shamsgovara ; Eva Johansson ; Gun-Marie Hariz ; Markku FagerlundSource :
- Movement Disorders [ 0885-3185 ] ; 2000-01.
English descriptors
Abstract
We report a patient with advanced Parkinson's disease, including severe and frequent off periods with freezing of gait, moderate dysphonia, and some cognitive impairment, who underwent bilateral subthalamic nucleus (STN) stimulation. The patient was followed for 1 year after surgery, showing persistent good mobility without off periods and without freezing, which reverted completely when stopping the stimulation. There was deterioration of cognition as well as increased aphonia and drooling, all of which remained when the stimulation was turned off. The striking improvement in motor symptoms following STN stimulation was not paralleled by improvement in disability, probably as a result of a cognitive decline, suggesting a diagnosis of Parkinson's disease with dementia. We conclude that chronic STN stimulation is efficient in alleviating akinetic motor symptoms including gait freezing; this surgery should be offered before patients start to exhibit speech or cognitive disturbances.
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DOI: 10.1002/1531-8257(200001)15:1<136::AID-MDS1021>3.0.CO;2-5
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<!--Version 0.6 générée le 3-12-2015--><mods version="3.6"><titleInfo lang="en"><title>Bilateral subthalamic nucleus stimulation in a parkinsonian patient with preoperative deficits in speech and cognition: Persistent improvement in mobility but increased dependency: A case study</title>
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<titleInfo type="abbreviated" lang="en"><title>STN Stimulation in a Cognitively Declined Patient</title>
</titleInfo>
<titleInfo type="alternative" contentType="CDATA" lang="en"><title>Bilateral subthalamic nucleus stimulation in a parkinsonian patient with preoperative deficits in speech and cognition: Persistent improvement in mobility but increased dependency: A case study</title>
</titleInfo>
<name type="personal"><namePart type="given">Marwan I.</namePart>
<namePart type="family">Hariz</namePart>
<namePart type="termsOfAddress">MD, PhD</namePart>
<affiliation>Department of Neurosurgery, University Hospital, Umeéa, Sweden</affiliation>
<description>Correspondence: Department of Neurosurgery, University Hospital S‐901 85 Umeéa, Sweden</description>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Folke</namePart>
<namePart type="family">Johansson</namePart>
<namePart type="termsOfAddress">MD, PhD</namePart>
<affiliation>Department of Neurology, University Hospital, Umeéa, Sweden</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Parvis</namePart>
<namePart type="family">Shamsgovara</namePart>
<namePart type="termsOfAddress">MD</namePart>
<affiliation>Department of Neurosurgery, University Hospital, Umeéa, Sweden</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Eva</namePart>
<namePart type="family">Johansson</namePart>
<affiliation>Department of Neurology, University Hospital, Umeéa, Sweden</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Gun‐Marie</namePart>
<namePart type="family">Hariz</namePart>
<namePart type="termsOfAddress">MS</namePart>
<affiliation>Department of Rehabilitation Medicine, University Hospital, Umeéa, Sweden</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Markku</namePart>
<namePart type="family">Fagerlund</namePart>
<namePart type="termsOfAddress">MD, PhD</namePart>
<affiliation>Department of Neuroradiology, University Hospital, Umeéa, Sweden</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<typeOfResource>text</typeOfResource>
<genre authority="originalCategForm">shortCommunication</genre>
<originInfo><publisher>John Wiley & Sons, Inc.</publisher>
<place><placeTerm type="text">New York</placeTerm>
</place>
<dateIssued encoding="w3cdtf">2000-01</dateIssued>
<dateCaptured encoding="w3cdtf">1999-01-22</dateCaptured>
<dateValid encoding="w3cdtf">1999-07-23</dateValid>
<copyrightDate encoding="w3cdtf">2000</copyrightDate>
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<language><languageTerm type="code" authority="rfc3066">en</languageTerm>
<languageTerm type="code" authority="iso639-2b">eng</languageTerm>
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<extent unit="tables">1</extent>
<extent unit="references">6</extent>
<extent unit="words">1827</extent>
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<abstract lang="en">We report a patient with advanced Parkinson's disease, including severe and frequent off periods with freezing of gait, moderate dysphonia, and some cognitive impairment, who underwent bilateral subthalamic nucleus (STN) stimulation. The patient was followed for 1 year after surgery, showing persistent good mobility without off periods and without freezing, which reverted completely when stopping the stimulation. There was deterioration of cognition as well as increased aphonia and drooling, all of which remained when the stimulation was turned off. The striking improvement in motor symptoms following STN stimulation was not paralleled by improvement in disability, probably as a result of a cognitive decline, suggesting a diagnosis of Parkinson's disease with dementia. We conclude that chronic STN stimulation is efficient in alleviating akinetic motor symptoms including gait freezing; this surgery should be offered before patients start to exhibit speech or cognitive disturbances.</abstract>
<subject lang="en"><genre>Keywords</genre>
<topic>Deep brain stimulation</topic>
<topic>Subthalamic nucleus</topic>
<topic>Disability</topic>
<topic>Parkinson's disease</topic>
</subject>
<relatedItem type="host"><titleInfo><title>Movement Disorders</title>
<subTitle>Official Journal of the Movement Disorder Society</subTitle>
</titleInfo>
<titleInfo type="abbreviated"><title>Mov. Disord.</title>
</titleInfo>
<subject><genre>article category</genre>
<topic>Brief Report</topic>
</subject>
<identifier type="ISSN">0885-3185</identifier>
<identifier type="eISSN">1531-8257</identifier>
<identifier type="DOI">10.1002/(ISSN)1531-8257</identifier>
<identifier type="PublisherID">MDS</identifier>
<part><date>2000</date>
<detail type="volume"><caption>vol.</caption>
<number>15</number>
</detail>
<detail type="issue"><caption>no.</caption>
<number>1</number>
</detail>
<extent unit="pages"><start>136</start>
<end>139</end>
<total>4</total>
</extent>
</part>
</relatedItem>
<identifier type="istex">DCCCED9930270C4BE7443CE7F93CA3FE81FCDCE8</identifier>
<identifier type="DOI">10.1002/1531-8257(200001)15:1<136::AID-MDS1021>3.0.CO;2-5</identifier>
<identifier type="ArticleID">MDS1021</identifier>
<accessCondition type="use and reproduction" contentType="copyright">Copyright © 2000 Movement Disorder Society</accessCondition>
<recordInfo><recordOrigin>John Wiley & Sons, Inc.</recordOrigin>
<recordContentSource>WILEY</recordContentSource>
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<serie></serie>
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