Long‐term follow‐up of thalamic stimulation versus thalamotomy for tremor suppression
Identifieur interne : 002780 ( Main/Curation ); précédent : 002779; suivant : 002781Long‐term follow‐up of thalamic stimulation versus thalamotomy for tremor suppression
Auteurs : P. Richard Schuurman [Pays-Bas] ; D. Andries Bosch [Pays-Bas] ; Maruschka P. Merkus [Pays-Bas] ; Johannes D. Speelman [Pays-Bas]Source :
- Movement Disorders [ 0885-3185 ] ; 2008-06-15.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Aged, Comparative study, Deep Brain Stimulation, Essential Tremor (therapy), Female, Follow-Up Studies, Humans, Long term, Male, Middle Aged, Multiple Sclerosis (therapy), Multiple sclerosis, Nervous system diseases, Neurologic Examination, Parkinson, Parkinson Disease (therapy), Suppression, Thalamotomy, Thalamus (physiopathology), Thalamus (surgery), Tremor, essential tremor, multiple sclerosis, thalamic stimulation, thalamotomy, tremor.
- MESH :
- physiopathology : Thalamus.
- surgery : Thalamus.
- therapy : Essential Tremor, Multiple Sclerosis, Parkinson Disease.
- Aged, Deep Brain Stimulation, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neurologic Examination.
Abstract
Thalamic stimulation and thalamotomy for treatment of tremor due to Parkinson's disease, essential tremor, and multiple sclerosis were compared in a randomized trial. The symptomatic and functional outcome was studied after 5 years of follow‐up. Sixty‐eight patients were treated (45 Parkinson's disease, 13 essential tremor, 10 multiple sclerosis) by thalamotomy (n = 34) or thalamic stimulation (n = 34). After 5 years, 48 patients were available for follow‐up. The primary outcome measure was change in functional status measured by the Frenchay Activities Index (FAI), scores ranging from 0 to 60. Secondary outcome measures were tremor severity, frequency of complications, and patients' assessment of the outcome. The mean difference in FAI scores between thalamic stimulation and thalamotomy was 4.4 (95% CI: 1.1–7.7) after 6 months, 3.3 (95% CI: −0.03–6.6) after 2 years and 4.0 (95% CI: 0.3–7.7) after 5 years in favor of stimulation. Tremor suppression was equally effective after both procedures, and stable in Parkinson patients. In ET and multiple sclerosis, a diminished effect of stimulation was observed in half of the patients. There were six stimulation equipment‐related complications, but neurological side effects of surgery were higher after thalamotomy. Subjective outcome‐assessment by the patients was more favorable in the stimulation group. © 2008 Movement Disorder Society.
Url:
DOI: 10.1002/mds.22059
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<sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Long‐term follow‐up of thalamic stimulation versus thalamotomy for tremor suppression</title>
<author><name sortKey="Schuurman, P Richard" sort="Schuurman, P Richard" uniqKey="Schuurman P" first="P. Richard" last="Schuurman">P. Richard Schuurman</name>
<affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Neurosurgery, Academic Medical Center, Amsterdam</wicri:regionArea>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Bosch, D Andries" sort="Bosch, D Andries" uniqKey="Bosch D" first="D. Andries" last="Bosch">D. Andries Bosch</name>
<affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Neurosurgery, Academic Medical Center, Amsterdam</wicri:regionArea>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Merkus, Maruschka P" sort="Merkus, Maruschka P" uniqKey="Merkus M" first="Maruschka P." last="Merkus">Maruschka P. Merkus</name>
<affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam</wicri:regionArea>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Speelman, Johannes D" sort="Speelman, Johannes D" uniqKey="Speelman J" first="Johannes D." last="Speelman">Johannes D. Speelman</name>
<affiliation wicri:level="3"><country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Department of Neurology, Academic Medical Center, Amsterdam</wicri:regionArea>
<placeName><settlement type="city">Amsterdam</settlement>
<region nuts="2" type="province">Hollande-Septentrionale</region>
</placeName>
</affiliation>
</author>
</analytic>
<monogr></monogr>
<series><title level="j">Movement Disorders</title>
<title level="j" type="sub">Official Journal of the Movement Disorder Society</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="2008-06-15">2008-06-15</date>
<biblScope unit="vol">23</biblScope>
<biblScope unit="issue">8</biblScope>
<biblScope unit="page" from="1146">1146</biblScope>
<biblScope unit="page" to="1153">1153</biblScope>
</imprint>
<idno type="ISSN">0885-3185</idno>
</series>
<idno type="istex">BEBAD44BDCC45A1BCD703EB8DE8673BA8742C25B</idno>
<idno type="DOI">10.1002/mds.22059</idno>
<idno type="ArticleID">MDS22059</idno>
</biblStruct>
</sourceDesc>
<seriesStmt><idno type="ISSN">0885-3185</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Deep Brain Stimulation</term>
<term>Essential Tremor (therapy)</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Multiple Sclerosis (therapy)</term>
<term>Neurologic Examination</term>
<term>Parkinson</term>
<term>Parkinson Disease (therapy)</term>
<term>Thalamus (physiopathology)</term>
<term>Thalamus (surgery)</term>
<term>essential tremor</term>
<term>multiple sclerosis</term>
<term>thalamic stimulation</term>
<term>thalamotomy</term>
<term>tremor</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Thalamus</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Thalamus</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Essential Tremor</term>
<term>Multiple Sclerosis</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Deep Brain Stimulation</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Neurologic Examination</term>
</keywords>
</textClass>
<langUsage><language ident="en">en</language>
</langUsage>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="fr">Thalamic stimulation and thalamotomy for treatment of tremor due to Parkinson's disease, essential tremor, and multiple sclerosis were compared in a randomized trial. The symptomatic and functional outcome was studied after 5 years of follow‐up. Sixty‐eight patients were treated (45 Parkinson's disease, 13 essential tremor, 10 multiple sclerosis) by thalamotomy (n = 34) or thalamic stimulation (n = 34). After 5 years, 48 patients were available for follow‐up. The primary outcome measure was change in functional status measured by the Frenchay Activities Index (FAI), scores ranging from 0 to 60. Secondary outcome measures were tremor severity, frequency of complications, and patients' assessment of the outcome. The mean difference in FAI scores between thalamic stimulation and thalamotomy was 4.4 (95% CI: 1.1–7.7) after 6 months, 3.3 (95% CI: −0.03–6.6) after 2 years and 4.0 (95% CI: 0.3–7.7) after 5 years in favor of stimulation. Tremor suppression was equally effective after both procedures, and stable in Parkinson patients. In ET and multiple sclerosis, a diminished effect of stimulation was observed in half of the patients. There were six stimulation equipment‐related complications, but neurological side effects of surgery were higher after thalamotomy. Subjective outcome‐assessment by the patients was more favorable in the stimulation group. © 2008 Movement Disorder Society.</div>
</front>
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