Bilateral subthalamic stimulation monotherapy in advanced Parkinson's disease: Long‐term follow‐up of patients
Identifieur interne : 004559 ( Main/Exploration ); précédent : 004558; suivant : 004560Bilateral subthalamic stimulation monotherapy in advanced Parkinson's disease: Long‐term follow‐up of patients
Auteurs : Francesc Valldeoriola [Espagne] ; Manuela Pilleri [Espagne] ; Eduardo Tolosa [Espagne] ; José L. Molinuevo [Espagne] ; Jordi Rumià [Espagne] ; Enric Ferrer [Espagne]Source :
- Movement Disorders [ 0885-3185 ] ; 2002-01.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Adulte.
English descriptors
- KwdEn :
- Adult, Advanced stage, Antiparkinson Agents (therapeutic use), Antiparkinson agent, Bilateral, Chemotherapy, Combined Modality Therapy, Combined treatment, Comparative study, Electric Stimulation Therapy (methods), Electrical stimulus, Electrodes, Implanted, Female, Follow-Up Studies, Functional Laterality (physiology), Humans, Instrumentation therapy, Levodopa, Levodopa (therapeutic use), Long term, Male, Middle Aged, Parkinson Disease (diagnosis), Parkinson Disease (drug therapy), Parkinson Disease (therapy), Parkinson disease, Parkinson's disease, Prognosis, Severity of Illness Index, Subthalamic Nucleus (physiology), Subthalamic Nucleus (surgery), Subthalamic nucleus, Time, functional neurosurgery, levodopa, subthalamic stimulation.
- MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- diagnosis : Parkinson Disease.
- drug therapy : Parkinson Disease.
- methods : Electric Stimulation Therapy.
- physiology : Functional Laterality, Subthalamic Nucleus.
- surgery : Subthalamic Nucleus.
- therapy : Parkinson Disease.
- Combined Modality Therapy, Electrodes, Implanted, Female, Follow-Up Studies, Humans, Male, Middle Aged, Severity of Illness Index, Time.
Abstract
Bilateral subthalamic nucleus stimulation (STN‐DBS) is used to improve parkinsonian symptoms and attenuate levodopa‐induced motor complications. In some patients, such clinical improvement allows antiparkinsonian medication (ApMed) withdrawal. We show the clinical outcome at the long‐term follow‐up of patients with advanced Parkinson's disease (PD) in which STN‐DBS was used in monotherapy, and compare the clinical results of patients without medication with those obtained in parkinsonian patients in which ApMed were reduced but could not be totally displaced after surgery. We analyzed clinical outcome of ten patients with PD in which all ApMed was withdrawn after bilateral subthalamic stimulation and 16 parkinsonian patients still taking antiparkinsonian medication after surgery. After 1.5 years, STN‐DBS monotherapy produced UPDRS motor scores similar to those observed in the on‐drug condition before surgery without the inconvenience of motor fluctuations and dyskinesias. No significant differences were seen in most of clinical outcome measures when comparing patients still taking ApMed with patients in STN‐DBS monotherapy but a few patients still taking ApMed presented mild dyskinesias and motor fluctuations and patients with STN‐DBS monotherapy did not. STN‐DBS is useful in the treatment of advanced PD and in some patients it is possible to maintain this therapy alone in the long term. The therapeutic effect of STN‐DBS on motor signs can be equipotent to that of levodopa with the additional benefit of avoiding motor fluctuations and dyskinesias. © 2001 Movement Disorder Society.
Url:
DOI: 10.1002/mds.1278
Affiliations:
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Le document en format XML
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>John Wiley & Sons, Inc.</publisher><pubPlace>New York</pubPlace><date type="published" when="2002-01">2002-01</date><biblScope unit="vol">17</biblScope><biblScope unit="issue">1</biblScope><biblScope unit="page" from="125">125</biblScope><biblScope unit="page" to="132">132</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">19F578E937E00B6A01576ED6508B8AAD5DBE8A77</idno><idno type="DOI">10.1002/mds.1278</idno><idno type="ArticleID">MDS1278</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Advanced stage</term><term>Antiparkinson Agents (therapeutic use)</term><term>Antiparkinson agent</term><term>Bilateral</term><term>Chemotherapy</term><term>Combined Modality Therapy</term><term>Combined treatment</term><term>Comparative study</term><term>Electric Stimulation Therapy (methods)</term><term>Electrical stimulus</term><term>Electrodes, Implanted</term><term>Female</term><term>Follow-Up Studies</term><term>Functional Laterality (physiology)</term><term>Humans</term><term>Instrumentation therapy</term><term>Levodopa</term><term>Levodopa (therapeutic use)</term><term>Long term</term><term>Male</term><term>Middle Aged</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>Prognosis</term><term>Severity of Illness Index</term><term>Subthalamic Nucleus (physiology)</term><term>Subthalamic Nucleus (surgery)</term><term>Subthalamic nucleus</term><term>Time</term><term>functional neurosurgery</term><term>levodopa</term><term>subthalamic stimulation</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="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="methods" xml:lang="en"><term>Electric Stimulation Therapy</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Functional Laterality</term><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>Combined Modality Therapy</term><term>Electrodes, Implanted</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><term>Time</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Adulte</term><term>Antiparkinsonien</term><term>Bilatéral</term><term>Chimiothérapie</term><term>Etude comparative</term><term>Long terme</term><term>Lévodopa</term><term>Noyau sousthalamique</term><term>Parkinson maladie</term><term>Pronostic</term><term>Stade avancé</term><term>Stimulus électrique</term><term>Traitement associé</term><term>Traitement instrumental</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Adulte</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Bilateral subthalamic nucleus stimulation (STN‐DBS) is used to improve parkinsonian symptoms and attenuate levodopa‐induced motor complications. In some patients, such clinical improvement allows antiparkinsonian medication (ApMed) withdrawal. We show the clinical outcome at the long‐term follow‐up of patients with advanced Parkinson's disease (PD) in which STN‐DBS was used in monotherapy, and compare the clinical results of patients without medication with those obtained in parkinsonian patients in which ApMed were reduced but could not be totally displaced after surgery. We analyzed clinical outcome of ten patients with PD in which all ApMed was withdrawn after bilateral subthalamic stimulation and 16 parkinsonian patients still taking antiparkinsonian medication after surgery. After 1.5 years, STN‐DBS monotherapy produced UPDRS motor scores similar to those observed in the on‐drug condition before surgery without the inconvenience of motor fluctuations and dyskinesias. No significant differences were seen in most of clinical outcome measures when comparing patients still taking ApMed with patients in STN‐DBS monotherapy but a few patients still taking ApMed presented mild dyskinesias and motor fluctuations and patients with STN‐DBS monotherapy did not. STN‐DBS is useful in the treatment of advanced PD and in some patients it is possible to maintain this therapy alone in the long term. The therapeutic effect of STN‐DBS on motor signs can be equipotent to that of levodopa with the additional benefit of avoiding motor fluctuations and dyskinesias. © 2001 Movement Disorder Society.</div></front></TEI><affiliations><list><country><li>Espagne</li></country><region><li>Catalogne</li></region><settlement><li>Barcelone</li></settlement></list><tree><country name="Espagne"><region name="Catalogne"><name sortKey="Valldeoriola, Francesc" sort="Valldeoriola, Francesc" uniqKey="Valldeoriola F" first="Francesc" last="Valldeoriola">Francesc Valldeoriola</name></region><name sortKey="Ferrer, Enric" sort="Ferrer, Enric" uniqKey="Ferrer E" first="Enric" last="Ferrer">Enric Ferrer</name><name sortKey="Molinuevo, Jose L" sort="Molinuevo, Jose L" uniqKey="Molinuevo J" first="José L." last="Molinuevo">José L. Molinuevo</name><name sortKey="Pilleri, Manuela" sort="Pilleri, Manuela" uniqKey="Pilleri M" first="Manuela" last="Pilleri">Manuela Pilleri</name><name sortKey="Rumia, Jordi" sort="Rumia, Jordi" uniqKey="Rumia J" first="Jordi" last="Rumià">Jordi Rumià</name><name sortKey="Tolosa, Eduardo" sort="Tolosa, Eduardo" uniqKey="Tolosa E" first="Eduardo" last="Tolosa">Eduardo Tolosa</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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