Movement Disorders (revue)

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Inhibition of levodopa effects by internal pallidal stimulation

Identifieur interne : 004F76 ( Main/Curation ); précédent : 004F75; suivant : 004F77

Inhibition of levodopa effects by internal pallidal stimulation

Auteurs : Paul Krack [France] ; Pierre Pollak [France] ; Patricia Limousin [France] ; Dominique Hoffmann [France] ; Abdelhamid Benazzouz [France] ; Alim-Louis Benabid [France]

Source :

RBID : ISTEX:A3E18445A389F4FC66F38749E041592C1C5AE95A

Descripteurs français

English descriptors

Abstract

We report three patients with bilateral GPi stimulation for stage 4 Parkinson's disease (PD) with severe levodopa‐induced dyskinesias (LID). In all three it was possible to completely inhibit LID using high‐stimulation parameters. Parallel to complete inhibition of LID, an inhibition of the anti‐akinetic effect of levodopa was observed, whereas, at the same time, rigidity was markedly improved. GPi stimulation is adaptable over time, and stimulation parameters have to be programmed according to off‐and on‐period motor symptoms. The main interest of stimulation is the possibility of finding a compromise between LID alleviation in on‐phase without loss of the beneficial motor effects and improvement in parkinsonism in off‐phase. In some patients, residual dyskinesias have to be accepted so as not to aggravate on‐period motor symptoms by a presumed overinhibition of basal ganglia outflow.

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DOI: 10.1002/mds.870130407

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ISTEX:A3E18445A389F4FC66F38749E041592C1C5AE95A

Le document en format XML

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<term>Antiparkinson agent</term>
<term>Case study</term>
<term>Chemotherapy</term>
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<term>Etude cas</term>
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<term>Antiparkinson Agents (adverse effects)</term>
<term>Combined Modality Therapy</term>
<term>Dominance, Cerebral (drug effects)</term>
<term>Dominance, Cerebral (physiology)</term>
<term>Dyskinesia, Drug-Induced (diagnosis)</term>
<term>Dyskinesia, Drug-Induced (physiopathology)</term>
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<term>Globus Pallidus (physiopathology)</term>
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<term>Internal pallidum</term>
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<term>Levodopa (adverse effects)</term>
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<term>Parkinson Disease (therapy)</term>
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<term>Antiparkinson Agents</term>
<term>Levodopa</term>
</keywords>
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<term>Antiparkinson Agents</term>
<term>Levodopa</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en">
<term>Dyskinesia, Drug-Induced</term>
</keywords>
<keywords scheme="MESH" qualifier="drug effects" xml:lang="en">
<term>Dominance, Cerebral</term>
<term>Globus Pallidus</term>
</keywords>
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<term>Dominance, Cerebral</term>
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<term>Parkinson Disease</term>
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<term>Combined Modality Therapy</term>
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<term>Electrodes, Implanted</term>
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<front>
<div type="abstract" xml:lang="en">We report three patients with bilateral GPi stimulation for stage 4 Parkinson's disease (PD) with severe levodopa‐induced dyskinesias (LID). In all three it was possible to completely inhibit LID using high‐stimulation parameters. Parallel to complete inhibition of LID, an inhibition of the anti‐akinetic effect of levodopa was observed, whereas, at the same time, rigidity was markedly improved. GPi stimulation is adaptable over time, and stimulation parameters have to be programmed according to off‐and on‐period motor symptoms. The main interest of stimulation is the possibility of finding a compromise between LID alleviation in on‐phase without loss of the beneficial motor effects and improvement in parkinsonism in off‐phase. In some patients, residual dyskinesias have to be accepted so as not to aggravate on‐period motor symptoms by a presumed overinhibition of basal ganglia outflow.</div>
</front>
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