Beyond nine years of continuous subthalamic nucleus deep brain stimulation in Parkinson's disease
Identifieur interne : 001789 ( Main/Exploration ); précédent : 001788; suivant : 001790Beyond nine years of continuous subthalamic nucleus deep brain stimulation in Parkinson's disease
Auteurs : Maurizio Zibetti [Italie] ; Aristide Merola [Italie] ; Laura Rizzi [Italie] ; Valeria Ricchi [Italie] ; Serena Angrisano [Italie] ; Corrado Azzaro [Italie] ; Carlo Alberto Artusi [Italie] ; Nichy Arduino [Italie] ; Alice Marchisio [Italie] ; Michele Lanotte [Italie] ; Mario Rizzone [Italie] ; Leonardo Lopiano [Italie]Source :
- Movement Disorders [ 0885-3185 ] ; 2011-11.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Activities of Daily Living, Aged, Deep Brain Stimulation (instrumentation), Deep Brain Stimulation (methods), Deep brain stimulation, Disease Progression, Dopamine Agents (administration & dosage), Dopamine Agents (adverse effects), Female, Follow-Up Studies, Humans, Long term, Male, Middle Aged, Nervous system diseases, Neuropsychological Tests, Parkinson Disease (diagnosis), Parkinson Disease (drug therapy), Parkinson Disease (therapy), Parkinson disease, Parkinson's disease, Prospective Studies, Severity of Illness Index, Subthalamic Nucleus (physiology), Subthalamic Nucleus (surgery), Subthalamic nucleus, Time Factors, Treatment Outcome, deep brain stimulation, long‐term follow‐up, subthalamic nucleus.
- MESH :
- chemical , administration & dosage : Dopamine Agents.
- chemical , adverse effects : Dopamine Agents.
- diagnosis : Parkinson Disease.
- drug therapy : Parkinson Disease.
- instrumentation : Deep Brain Stimulation.
- methods : Deep Brain Stimulation.
- physiology : Subthalamic Nucleus.
- surgery : Subthalamic Nucleus.
- therapy : Parkinson Disease.
- Activities of Daily Living, Aged, Disease Progression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neuropsychological Tests, Prospective Studies, Severity of Illness Index, Time Factors, Treatment Outcome.
Abstract
Deep brain stimulation of the subthalamic nucleus is an effective treatment for advanced Parkinson's disease. The benefits of bilateral subthalamic stimulation are well documented, and some studies reported outcomes with a follow‐up of 5 to 6 years; nevertheless, few data are available beyond 5 years. We report a long‐term prospective evaluation of 14 consecutive parkinsonian patients, treated by bilateral subthalamic stimulation for at least 9 years. Motor symptoms, activity of daily living, and motor complications were evaluated by means of the Unified Parkinson's Disease Rating Scale, while cognition and mood were assessed with a specific neuropsychological test battery; medication intake, stimulation parameters, comorbidity, and adverse events were also recorded. Patients were evaluated before surgery and at 1, 5, and ≥9 years after surgery. At last follow‐up, deep brain stimulation significantly improved the motor score by 42% compared to baseline, whereas activities of daily living were no longer improved; there was a 39% reduction in the dosage of dopaminergic drugs and a 59% improvement of L‐dopa–related motor complications. The neuropsychological assessment showed that 4 patients (29%) developed a significant cognitive decline over the follow‐up period. These results indicate a persistent effect of deep brain stimulation of the subthalamic nucleus on the cardinal motor symptoms in advanced Parkinson's disease patients in the long‐term; however, a worsening of patients' disability, mainly due to disease progression, was observed. © 2011 Movement Disorder Society
Url:
DOI: 10.1002/mds.23903
Affiliations:
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nuts="2">Piémont</region></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="2011-11">2011-11</date><biblScope unit="vol">26</biblScope><biblScope unit="issue">13</biblScope><biblScope unit="page" from="2327">2327</biblScope><biblScope unit="page" to="2334">2334</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">86BC223EC673155C439086073CC3FAB44D244F98</idno><idno type="DOI">10.1002/mds.23903</idno><idno type="ArticleID">MDS23903</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activities of Daily Living</term><term>Aged</term><term>Deep Brain Stimulation (instrumentation)</term><term>Deep Brain Stimulation (methods)</term><term>Deep brain stimulation</term><term>Disease Progression</term><term>Dopamine Agents (administration & dosage)</term><term>Dopamine Agents (adverse effects)</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Long term</term><term>Male</term><term>Middle Aged</term><term>Nervous system diseases</term><term>Neuropsychological Tests</term><term>Parkinson Disease (diagnosis)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (therapy)</term><term>Parkinson disease</term><term>Parkinson's disease</term><term>Prospective Studies</term><term>Severity of Illness Index</term><term>Subthalamic Nucleus (physiology)</term><term>Subthalamic Nucleus (surgery)</term><term>Subthalamic nucleus</term><term>Time Factors</term><term>Treatment Outcome</term><term>deep brain stimulation</term><term>long‐term follow‐up</term><term>subthalamic nucleus</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Dopamine Agents</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Dopamine Agents</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="instrumentation" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Activities of Daily Living</term><term>Aged</term><term>Disease Progression</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Neuropsychological Tests</term><term>Prospective Studies</term><term>Severity of Illness Index</term><term>Time Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Long terme</term><term>Maladie de Parkinson</term><term>Noyau sousthalamique</term><term>Pathologie du système nerveux</term><term>Stimulation cérébrale profonde</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Deep brain stimulation of the subthalamic nucleus is an effective treatment for advanced Parkinson's disease. The benefits of bilateral subthalamic stimulation are well documented, and some studies reported outcomes with a follow‐up of 5 to 6 years; nevertheless, few data are available beyond 5 years. We report a long‐term prospective evaluation of 14 consecutive parkinsonian patients, treated by bilateral subthalamic stimulation for at least 9 years. Motor symptoms, activity of daily living, and motor complications were evaluated by means of the Unified Parkinson's Disease Rating Scale, while cognition and mood were assessed with a specific neuropsychological test battery; medication intake, stimulation parameters, comorbidity, and adverse events were also recorded. Patients were evaluated before surgery and at 1, 5, and ≥9 years after surgery. At last follow‐up, deep brain stimulation significantly improved the motor score by 42% compared to baseline, whereas activities of daily living were no longer improved; there was a 39% reduction in the dosage of dopaminergic drugs and a 59% improvement of L‐dopa–related motor complications. The neuropsychological assessment showed that 4 patients (29%) developed a significant cognitive decline over the follow‐up period. These results indicate a persistent effect of deep brain stimulation of the subthalamic nucleus on the cardinal motor symptoms in advanced Parkinson's disease patients in the long‐term; however, a worsening of patients' disability, mainly due to disease progression, was observed. © 2011 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Italie</li></country><region><li>Piémont</li></region><settlement><li>Turin</li></settlement></list><tree><country name="Italie"><region name="Piémont"><name sortKey="Zibetti, Maurizio" sort="Zibetti, Maurizio" uniqKey="Zibetti M" first="Maurizio" last="Zibetti">Maurizio Zibetti</name></region><name sortKey="Angrisano, Serena" sort="Angrisano, Serena" uniqKey="Angrisano S" first="Serena" last="Angrisano">Serena Angrisano</name><name sortKey="Arduino, Nichy" sort="Arduino, Nichy" uniqKey="Arduino N" first="Nichy" last="Arduino">Nichy Arduino</name><name sortKey="Artusi, Carlo Alberto" sort="Artusi, Carlo Alberto" uniqKey="Artusi C" first="Carlo Alberto" last="Artusi">Carlo Alberto Artusi</name><name sortKey="Azzaro, Corrado" sort="Azzaro, Corrado" uniqKey="Azzaro C" first="Corrado" last="Azzaro">Corrado Azzaro</name><name sortKey="Lanotte, Michele" sort="Lanotte, Michele" uniqKey="Lanotte M" first="Michele" last="Lanotte">Michele Lanotte</name><name sortKey="Lopiano, Leonardo" sort="Lopiano, Leonardo" uniqKey="Lopiano L" first="Leonardo" last="Lopiano">Leonardo Lopiano</name><name sortKey="Marchisio, Alice" sort="Marchisio, Alice" uniqKey="Marchisio A" first="Alice" last="Marchisio">Alice Marchisio</name><name sortKey="Merola, Aristide" sort="Merola, Aristide" uniqKey="Merola A" first="Aristide" last="Merola">Aristide Merola</name><name sortKey="Ricchi, Valeria" sort="Ricchi, Valeria" uniqKey="Ricchi V" first="Valeria" last="Ricchi">Valeria Ricchi</name><name sortKey="Rizzi, Laura" sort="Rizzi, Laura" uniqKey="Rizzi L" first="Laura" last="Rizzi">Laura Rizzi</name><name sortKey="Rizzone, Mario" sort="Rizzone, Mario" uniqKey="Rizzone M" first="Mario" last="Rizzone">Mario Rizzone</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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