Subthalamic nucleus deep brain stimulation for parkinson's disease after successful pallidotomy: Clinical and electrophysiological observations
Identifieur interne : 001A06 ( Istex/Curation ); précédent : 001A05; suivant : 001A07Subthalamic nucleus deep brain stimulation for parkinson's disease after successful pallidotomy: Clinical and electrophysiological observations
Auteurs : Galit Kleiner-Fisman [Canada] ; David N. Fisman [Canada] ; Orit Zamir [Canada] ; Jonathan O. Dostrovsky [Canada] ; Elspeth Sime [Canada] ; Jean A. Saint-Cyr [Canada] ; Andres M. Lozano [Canada] ; Anthony E. Lang [Canada]Source :
- Movement Disorders [ 0885-3185 ] ; 2004-10.
English descriptors
Abstract
Unilateral pallidotomy is an effective treatment for contralateral parkinsonism and dyskinesia, yet symptoms progress in many patients. Little is known about whether such patients obtain a useful response to subsequent bilateral subthalamic nucleus deep brain stimulation (STN DBS). Changes in Unified Parkinson's Disease Rating Scale (UPDRS) Motor and Activities of Daily Living (ADL) scores, medication requirements, and dyskinesias were measured. Clinical outcomes were compared to patients with de novo STN DBS. Neuronal recordings were performed. STN DBS resulted in a significant reduction in UPDRS Motor scores (42.1%; 95% confidence interval [CI], 26.9–57.4; P = 0.03), comparable with de novo STN DBS surgery (41%; 95% CI, 26–46%; P < 0.001). There was also less change in dyskinesia duration and disability scores (P = 0.017, 0.005). There were no side‐to‐side differences clinically or in the STN neuronal firing rates and patterns. Bilateral STN DBS is safe and efficacious in improving motor symptoms in patients with prior pallidotomy. © 2004 Movement Disorder Society
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DOI: 10.1002/mds.20151
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Fisman</name><affiliation wicri:level="1"><mods:affiliation>Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario</wicri:regionArea></affiliation></author><author><name sortKey="Zamir, Orit" sort="Zamir, Orit" uniqKey="Zamir O" first="Orit" last="Zamir">Orit Zamir</name><affiliation wicri:level="1"><mods:affiliation>Department of Physiology, University of Toronto, Toronto, Ontario, Canada</mods:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Department of Physiology, University of Toronto, Toronto, Ontario</wicri:regionArea></affiliation></author><author><name sortKey="Dostrovsky, Jonathan O" sort="Dostrovsky, Jonathan O" uniqKey="Dostrovsky J" first="Jonathan O." last="Dostrovsky">Jonathan O. 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Little is known about whether such patients obtain a useful response to subsequent bilateral subthalamic nucleus deep brain stimulation (STN DBS). Changes in Unified Parkinson's Disease Rating Scale (UPDRS) Motor and Activities of Daily Living (ADL) scores, medication requirements, and dyskinesias were measured. Clinical outcomes were compared to patients with de novo STN DBS. Neuronal recordings were performed. STN DBS resulted in a significant reduction in UPDRS Motor scores (42.1%; 95% confidence interval [CI], 26.9–57.4; P = 0.03), comparable with de novo STN DBS surgery (41%; 95% CI, 26–46%; P < 0.001). There was also less change in dyskinesia duration and disability scores (P = 0.017, 0.005). There were no side‐to‐side differences clinically or in the STN neuronal firing rates and patterns. Bilateral STN DBS is safe and efficacious in improving motor symptoms in patients with prior pallidotomy. © 2004 Movement Disorder Society</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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