Influence of subthalamic deep brain stimulation versus levodopa on motor perseverations in Parkinson's disease
Identifieur interne : 002251 ( Main/Exploration ); précédent : 002250; suivant : 002252Influence of subthalamic deep brain stimulation versus levodopa on motor perseverations in Parkinson's disease
Auteurs : Jan Herzog [Allemagne] ; Bettina Möller [Allemagne] ; Karsten Witt [Allemagne] ; Marcus O. Pinsker [Allemagne] ; Günther Deuschl [Allemagne] ; Jens Volkmann [Allemagne]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-06-15.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Aged, Antiparkinson Agents (pharmacology), Antiparkinson Agents (therapeutic use), Behavior, Comparative study, Deep Brain Stimulation, Deep brain stimulation, Female, Follow-Up Studies, Humans, Levodopa, Levodopa (pharmacology), Levodopa (therapeutic use), Male, Middle Aged, Motor Activity (drug effects), Motor Activity (physiology), Motor control, Nervous system diseases, Parkinson Disease (drug therapy), Parkinson Disease (physiopathology), Parkinson Disease (therapy), Parkinson disease, Perseveration, STN‐DBS, Severity of Illness Index, Subthalamic Nucleus (physiology), Vienna perseveration task, motor control, neuropsychology, random behavior.
- MESH :
- chemical , pharmacology : Antiparkinson Agents, Levodopa.
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- drug effects : Motor Activity.
- drug therapy : Parkinson Disease.
- physiology : Motor Activity, Subthalamic Nucleus.
- physiopathology : Parkinson Disease.
- therapy : Parkinson Disease.
- Aged, Deep Brain Stimulation, Female, Follow-Up Studies, Humans, Male, Middle Aged, Severity of Illness Index.
Abstract
Patients with Parkinson's disease (PD) show impairment in generating random motor sequences reflecting a higher order motor deficit in set‐shifting and suppression of perseverative behavior. The impact of deep brain stimulation (DBS) of the subthalamic nucleus (STN) on motor perseverations has not yet been elucidated. In 35 patients with PD, we evaluated the effect of STN‐DBS and levodopa on motor perseverations using the Vienna perseveration task. The task was performed 6 months after implantation of stimulation electrodes in the following three conditions: Stimulation off/medication off (Stim OFF/Med OFF), Stim ON/Med OFF, and Stim OFF/Med ON. Perseverations were measured by redundancy of second order (R2) with higher values indicating more severe perseverations. ANCOVA analysis revealed that influence of STN‐DBS on R2 significantly depended on R2 severity during Stim OFF/Med OFF (F = 4.69, P = 0.035). Accordingly, we classified patients with PD into two groups based on the R2 value during off treatment. In patients with mild perseveration (R2 < 35) neither STN‐DBS nor levodopa changed perseverations. By contrast, in patients with severe perseveration (R2 > 35), STN‐DBS significantly reduced R2 by 9.7 ± 2.6 (P < 0.001) whereas levodopa had no impact (R2 reduction 3.7 ± 1.6, P = 0.081). This demonstrates that STN‐DBS, by reducing motor perseveration, influences higher order aspects of motor behavior of patients with PD. © 2009 Movement Disorder Society
Url:
DOI: 10.1002/mds.22568
Affiliations:
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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="2009-06-15">2009-06-15</date><biblScope unit="vol">24</biblScope><biblScope unit="issue">8</biblScope><biblScope unit="page" from="1206">1206</biblScope><biblScope unit="page" to="1210">1210</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">8F776BB008264FD128CA68FA1591DC54D17B267D</idno><idno type="DOI">10.1002/mds.22568</idno><idno type="ArticleID">MDS22568</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Antiparkinson Agents (pharmacology)</term><term>Antiparkinson Agents (therapeutic use)</term><term>Behavior</term><term>Comparative study</term><term>Deep Brain Stimulation</term><term>Deep brain stimulation</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Levodopa</term><term>Levodopa (pharmacology)</term><term>Levodopa (therapeutic use)</term><term>Male</term><term>Middle Aged</term><term>Motor Activity (drug effects)</term><term>Motor Activity (physiology)</term><term>Motor control</term><term>Nervous system diseases</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (therapy)</term><term>Parkinson disease</term><term>Perseveration</term><term>STN‐DBS</term><term>Severity of Illness Index</term><term>Subthalamic Nucleus (physiology)</term><term>Vienna perseveration task</term><term>motor control</term><term>neuropsychology</term><term>random behavior</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacology" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Motor Activity</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Motor Activity</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><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>Severity of Illness Index</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Comportement</term><term>Contrôle moteur</term><term>Etude comparative</term><term>Lévodopa</term><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Persévération</term><term>Stimulation cérébrale profonde</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Patients with Parkinson's disease (PD) show impairment in generating random motor sequences reflecting a higher order motor deficit in set‐shifting and suppression of perseverative behavior. The impact of deep brain stimulation (DBS) of the subthalamic nucleus (STN) on motor perseverations has not yet been elucidated. In 35 patients with PD, we evaluated the effect of STN‐DBS and levodopa on motor perseverations using the Vienna perseveration task. The task was performed 6 months after implantation of stimulation electrodes in the following three conditions: Stimulation off/medication off (Stim OFF/Med OFF), Stim ON/Med OFF, and Stim OFF/Med ON. Perseverations were measured by redundancy of second order (R2) with higher values indicating more severe perseverations. ANCOVA analysis revealed that influence of STN‐DBS on R2 significantly depended on R2 severity during Stim OFF/Med OFF (F = 4.69, P = 0.035). Accordingly, we classified patients with PD into two groups based on the R2 value during off treatment. In patients with mild perseveration (R2 < 35) neither STN‐DBS nor levodopa changed perseverations. By contrast, in patients with severe perseveration (R2 > 35), STN‐DBS significantly reduced R2 by 9.7 ± 2.6 (P < 0.001) whereas levodopa had no impact (R2 reduction 3.7 ± 1.6, P = 0.081). This demonstrates that STN‐DBS, by reducing motor perseveration, influences higher order aspects of motor behavior of patients with PD. © 2009 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>Schleswig-Holstein</li></region><settlement><li>Kiel</li></settlement></list><tree><country name="Allemagne"><region name="Schleswig-Holstein"><name sortKey="Herzog, Jan" sort="Herzog, Jan" uniqKey="Herzog J" first="Jan" last="Herzog">Jan Herzog</name></region><name sortKey="Deuschl, Gunther" sort="Deuschl, Gunther" uniqKey="Deuschl G" first="Günther" last="Deuschl">Günther Deuschl</name><name sortKey="Moller, Bettina" sort="Moller, Bettina" uniqKey="Moller B" first="Bettina" last="Möller">Bettina Möller</name><name sortKey="Pinsker, Marcus O" sort="Pinsker, Marcus O" uniqKey="Pinsker M" first="Marcus O." last="Pinsker">Marcus O. Pinsker</name><name sortKey="Volkmann, Jens" sort="Volkmann, Jens" uniqKey="Volkmann J" first="Jens" last="Volkmann">Jens Volkmann</name><name sortKey="Witt, Karsten" sort="Witt, Karsten" uniqKey="Witt K" first="Karsten" last="Witt">Karsten Witt</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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