Inclusion and Exclusion Criteria for DBS in Dystonia
Identifieur interne : 001881 ( Main/Exploration ); précédent : 001880; suivant : 001882Inclusion and Exclusion Criteria for DBS in Dystonia
Auteurs : Helen Bronte-Stewart [États-Unis] ; Takaomi Taira [Japon] ; Francesc Valldeoriola [Espagne] ; Marcello Merello [Argentine] ; William J. Jr Marks [États-Unis] ; Alberto Albanese [Italie] ; Susan Bressman [États-Unis] ; Elena Moro [Canada]Source :
- Movement disorders [ 0885-3185 ] ; 2011.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Chirurgie.
English descriptors
- KwdEn :
Abstract
When considering a patient with dystonia for deep brain stimulation (DBS) surgery several factors need to be considered. Level B evidence has shown that all motor features and associated pain in primary generalized and segmental dystonia are potentially responsive to globus pallidus internus (GPi) DBS. However, improvements in clinical series of ≥90% may reflect methods that need improvement, and larger prospective studies are needed to address these factors. Nevertheless, to date the selection criteria for DBS-specifically in terms of patient features (severity and nature of symptoms, age, time of evolution, or any other demographic or disease aspects)-have not been assessed in a systematic fashion. In general, dystonia patients are not considered for DBS unless medical therapies have been previously and extensively tested. The vast majority of reported patients have had DBS surgery when the disease was provoking important disability, with loss of independence and impaired quality of life. There does not appear to be an upper age limit or a minimum age limit, although there are no published data regarding the outcome of GPi DBS for dystonia in children younger than 7 years of age. There is currently no enough evidence to prove that subjects with primary-generalized dystonia who undergo DBS at an early age and sooner rather than later after disease onset may gain more benefit from DBS than those undergoing DBS after the development of fixed skeletal deformities. There is no enough evidence to refuse or support consideration of DBS in patients with previous ablative procedures.
Affiliations:
- Argentine, Canada, Espagne, Italie, Japon, États-Unis
- Californie, Catalogne, Ontario, État de New York
- Barcelone, Tokyo, Toronto
- Université de Toronto
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Jr" last="Marks">William J. Jr Marks</name><affiliation wicri:level="2"><inist:fA14 i1="05"><s1>Department of Neurology, University of California</s1><s2>San Francisco, California</s2><s3>USA</s3><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Californie</region></placeName></affiliation></author><author><name sortKey="Albanese, Alberto" sort="Albanese, Alberto" uniqKey="Albanese A" first="Alberto" last="Albanese">Alberto Albanese</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Istituto Neurologico Carlo Besta and Università Cattolica</s1><s2>Milano</s2><s3>ITA</s3><sZ>6 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Istituto Neurologico Carlo Besta and Università Cattolica</wicri:noRegion></affiliation></author><author><name sortKey="Bressman, Susan" sort="Bressman, Susan" uniqKey="Bressman S" first="Susan" last="Bressman">Susan Bressman</name><affiliation wicri:level="2"><inist:fA14 i1="07"><s1>Mirken Department of Neurology, Beth Israel Medical Center</s1><s2>New York, New York</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">État de New York</region></placeName></affiliation></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation wicri:level="4"><inist:fA14 i1="08"><s1>Movement Disorders Center, Division of Neurology, TWH, University of Toronto, UHN</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>8 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Dystonia</term><term>Inclusion</term><term>Nervous system diseases</term><term>Surgery</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Dystonie</term><term>Pathologie du système nerveux</term><term>Inclusion</term><term>Chirurgie</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Chirurgie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">When considering a patient with dystonia for deep brain stimulation (DBS) surgery several factors need to be considered. Level B evidence has shown that all motor features and associated pain in primary generalized and segmental dystonia are potentially responsive to globus pallidus internus (GPi) DBS. However, improvements in clinical series of ≥90% may reflect methods that need improvement, and larger prospective studies are needed to address these factors. Nevertheless, to date the selection criteria for DBS-specifically in terms of patient features (severity and nature of symptoms, age, time of evolution, or any other demographic or disease aspects)-have not been assessed in a systematic fashion. In general, dystonia patients are not considered for DBS unless medical therapies have been previously and extensively tested. The vast majority of reported patients have had DBS surgery when the disease was provoking important disability, with loss of independence and impaired quality of life. There does not appear to be an upper age limit or a minimum age limit, although there are no published data regarding the outcome of GPi DBS for dystonia in children younger than 7 years of age. There is currently no enough evidence to prove that subjects with primary-generalized dystonia who undergo DBS at an early age and sooner rather than later after disease onset may gain more benefit from DBS than those undergoing DBS after the development of fixed skeletal deformities. There is no enough evidence to refuse or support consideration of DBS in patients with previous ablative procedures.</div></front></TEI><affiliations><list><country><li>Argentine</li><li>Canada</li><li>Espagne</li><li>Italie</li><li>Japon</li><li>États-Unis</li></country><region><li>Californie</li><li>Catalogne</li><li>Ontario</li><li>État de New York</li></region><settlement><li>Barcelone</li><li>Tokyo</li><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="États-Unis"><region name="Californie"><name sortKey="Bronte Stewart, Helen" sort="Bronte Stewart, Helen" uniqKey="Bronte Stewart H" first="Helen" last="Bronte-Stewart">Helen Bronte-Stewart</name></region><name sortKey="Bressman, Susan" sort="Bressman, Susan" uniqKey="Bressman S" first="Susan" last="Bressman">Susan Bressman</name><name sortKey="Marks, William J Jr" sort="Marks, William J Jr" uniqKey="Marks W" first="William J. Jr" last="Marks">William J. Jr Marks</name></country><country name="Japon"><noRegion><name sortKey="Taira, Takaomi" sort="Taira, Takaomi" uniqKey="Taira T" first="Takaomi" last="Taira">Takaomi Taira</name></noRegion></country><country name="Espagne"><region name="Catalogne"><name sortKey="Valldeoriola, Francesc" sort="Valldeoriola, Francesc" uniqKey="Valldeoriola F" first="Francesc" last="Valldeoriola">Francesc Valldeoriola</name></region></country><country name="Argentine"><noRegion><name sortKey="Merello, Marcello" sort="Merello, Marcello" uniqKey="Merello M" first="Marcello" last="Merello">Marcello Merello</name></noRegion></country><country name="Italie"><noRegion><name sortKey="Albanese, Alberto" sort="Albanese, Alberto" uniqKey="Albanese A" first="Alberto" last="Albanese">Alberto Albanese</name></noRegion></country><country name="Canada"><region name="Ontario"><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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