MovDisordV3, Main, Exploration, bibRecord, 003170

Subthalamic deep brain stimulation in patients with a previous pallidotomy

Identifieur interne : 003170 ( Main/Exploration ); précédent : 003169; suivant : 003171

Subthalamic deep brain stimulation in patients with a previous pallidotomy

Auteurs : William G. Ondo [États-Unis] ; Yavuz Silay [États-Unis] ; Mike Almaguer [États-Unis] ; Joseph Jankovic [États-Unis]

Source :

Movement Disorders [ 0885-3185 ] ; 2006-08.

RBID : ISTEX:023530E96474E4C01F318E7CD98D34895545E3EE

Descripteurs français

Pascal (Inist)
- Homme, Parkinson maladie, Stimulation cérébrale profonde, Système nerveux pathologie.
Wicri :
- topic : Homme.

English descriptors

KwdEn :
- Adult, Aged, Antiparkinson Agents (therapeutic use), Deep Brain Stimulation, Deep brain stimulation, Functional Laterality, Human, Humans, Levodopa (therapeutic use), Middle Aged, Motor Cortex (physiopathology), Nervous system diseases, Pallidotomy, Parkinson Disease (drug therapy), Parkinson Disease (physiopathology), Parkinson Disease (surgery), Parkinson Disease (therapy), Parkinson disease, Parkinson's disease, Thalamus, deep brain stimulation, pallidotomy.
MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- drug therapy : Parkinson Disease.
- physiopathology : Motor Cortex, Parkinson Disease.
- surgery : Parkinson Disease.
- therapy : Parkinson Disease.
- Adult, Aged, Deep Brain Stimulation, Functional Laterality, Humans, Middle Aged, Pallidotomy, Thalamus.

Abstract

The safety and efficacy of subthalamic nucleus (STN) deep brain stimulation (DBS) in patients who have had a previous unilateral pallidotomy is not clear. We identified 10 patients (9 male) at the Baylor College of Medicine Parkinson's Disease Center who underwent STN DBS after prior unilateral pallidotomy. Demographics, efficacy as determined by off Unified Parkinson's Disease Rating Scale (UPDRS) part III scores, and levodopa equivalent dosing were analyzed. We then compared these to an age‐ and sex‐matched group of 25 DBS patients who had no prior pallidotomy. After their initial pallidotomy (mean age, 51.8 ± 10.8 years), the mean UPDRS motor off medicine scores improved from 51.3 ± 14.3 to 34.9 ± 12.8, and the UPDRS dyskinesia score improved from 1.8 ± 1.0 to 0.8 ± 0.7. Their STN DBS off UPDRS motor scores (mean age, 56.0 ± 10.2 years) improved by 16.0% from 53.1 ± 9.7 (range, 42–68) to 44.6 ± 11.1 (range, 25–67). In contrast, the UPDRS off motor scores in a control group of 25 DBS patients improved by 49.9%, from 49.7 ± 11.1 to 25.7 ± 18.9, (16.0% vs. 49.9%; P < 0.001). Changes in UPDRS dyskinesia scores were similar in both groups. AE thought to be related to the STN DBS following pallidotomy included worse dysarthria (three) and worse balance (two). STN DBS patients with prior pallidotomy had less improvement in UPDRS off motor score compared to other STN DBS patients, despite relatively good outcomes immediately after their pallidotomy. This may be partially due to a selection bias, but it may also indicate that prior pallidotomy is a negative predictor of outcome of STN DBS and should be considered in patient selection. © 2006 Movement Disorder Society

Url:

https://api.istex.fr/document/023530E96474E4C01F318E7CD98D34895545E3EE/fulltext/pdf

DOI: 10.1002/mds.20920

Affiliations:

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<front><div type="abstract" xml:lang="en">The safety and efficacy of subthalamic nucleus (STN) deep brain stimulation (DBS) in patients who have had a previous unilateral pallidotomy is not clear. We identified 10 patients (9 male) at the Baylor College of Medicine Parkinson's Disease Center who underwent STN DBS after prior unilateral pallidotomy. Demographics, efficacy as determined by off Unified Parkinson's Disease Rating Scale (UPDRS) part III scores, and levodopa equivalent dosing were analyzed. We then compared these to an age‐ and sex‐matched group of 25 DBS patients who had no prior pallidotomy. After their initial pallidotomy (mean age, 51.8 ± 10.8 years), the mean UPDRS motor off medicine scores improved from 51.3 ± 14.3 to 34.9 ± 12.8, and the UPDRS dyskinesia score improved from 1.8 ± 1.0 to 0.8 ± 0.7. Their STN DBS off UPDRS motor scores (mean age, 56.0 ± 10.2 years) improved by 16.0% from 53.1 ± 9.7 (range, 42–68) to 44.6 ± 11.1 (range, 25–67). In contrast, the UPDRS off motor scores in a control group of 25 DBS patients improved by 49.9%, from 49.7 ± 11.1 to 25.7 ± 18.9, (16.0% vs. 49.9%; P < 0.001). Changes in UPDRS dyskinesia scores were similar in both groups. AE thought to be related to the STN DBS following pallidotomy included worse dysarthria (three) and worse balance (two). STN DBS patients with prior pallidotomy had less improvement in UPDRS off motor score compared to other STN DBS patients, despite relatively good outcomes immediately after their pallidotomy. This may be partially due to a selection bias, but it may also indicate that prior pallidotomy is a negative predictor of outcome of STN DBS and should be considered in patient selection. © 2006 Movement Disorder Society</div>
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Movement Disorders (revue)

Subthalamic deep brain stimulation in patients with a previous pallidotomy

Subthalamic deep brain stimulation in patients with a previous pallidotomy

Source :

Descripteurs français

English descriptors

Abstract

Links toward previous steps (curation, corpus...)

Le document en format XML

Pour manipuler ce document sous Unix (Dilib)

Pour mettre un lien sur cette page dans le réseau Wicri

	Movement Disorders (revue)
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