Long‐term safety and efficacy of unilateral deep brain stimulation of the thalamus in essential tremor
Identifieur interne : 004758 ( Main/Exploration ); précédent : 004757; suivant : 004759Long‐term safety and efficacy of unilateral deep brain stimulation of the thalamus in essential tremor
Auteurs : William C. Koller [États-Unis] ; Kelly E. Lyons [États-Unis] ; Steven B. Wilkinson [États-Unis] ; Alexander I. Troster [États-Unis] ; Rajesh Pahwa [États-Unis]Source :
- Movement Disorders [ 0885-3185 ] ; 2001-05.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Electric Stimulation Therapy (adverse effects), Electric Stimulation Therapy (methods), Electrodes, Implanted, Essential, Essential Tremor (therapy), Female, Follow-Up Studies, Human, Humans, Instrumental stimulation, Long term, Male, Middle Aged, Prospective Studies, Survival Analysis, Thalamus, Time Factors, Tolerance, Treatment Outcome, Treatment efficiency, Tremor, Unilateral, Ventromedial nucleus.
- MESH :
- adverse effects : Electric Stimulation Therapy.
- methods : Electric Stimulation Therapy.
- therapy : Essential Tremor.
- Adult, Aged, Aged, 80 and over, Electrodes, Implanted, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prospective Studies, Survival Analysis, Thalamus, Time Factors, Treatment Outcome.
Abstract
Our objective was to investigate the long‐term safety and efficacy of unilateral deep brain stimulation (DBS) of the VIM nucleus of the thalamus in essential tremor. Forty‐nine patients were evaluated for DBS between December 1993 and March 1998. Tremor was assessed by a clinical rating scale at 3 and 12 months and then yearly. Three patients were not implanted, seven were explanted prior to 24 months, 11 were lost to long‐term follow‐up, and three died from unrelated causes. Twenty‐five patients were evaluated with follow‐up greater than or equal to 2 years. The last postsurgical follow‐up occurred on average 40.2 ± 14.7 months after surgery. Tremor scores were significantly improved with stimulation on at the long‐term follow‐up as compared to baseline. There was no change in tremor scores from baseline to long‐term follow‐up with stimulation off. There was no significant change in any stimulus parameters from 3 months to the long‐term follow‐up. Three patients had asymptomatic intracerebral hemorrhages and one patient had postoperative seizures. Stimulus‐related adverse reactions were mild and easily controlled with changes in stimulus parameters. Device‐related complications were common and required repeated surgical procedures. Unilateral DBS of the thalamus has long‐term efficacy in some patients for treatment of essential tremor. However, this therapy is compromised by loss of efficacy in some patients and device complications which increase the risk of additional surgical procedures. © 2001 Movement Disorder Society.
Url:
DOI: 10.1002/mds.1089
Affiliations:
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Le document en format XML
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Wilkinson</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurosurgery, University of Kansas Medical Center, Kansas</wicri:regionArea><placeName><region type="state">Kansas</region></placeName></affiliation></author><author><name sortKey="Troster, Alexander I" sort="Troster, Alexander I" uniqKey="Troster A" first="Alexander I." last="Troster">Alexander I. 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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="2001-05">2001-05</date><biblScope unit="vol">16</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="464">464</biblScope><biblScope unit="page" to="468">468</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">4BAC512F70533534ABC87564D2687C925220E9A0</idno><idno type="DOI">10.1002/mds.1089</idno><idno type="ArticleID">MDS1089</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Electric Stimulation Therapy (adverse effects)</term><term>Electric Stimulation Therapy (methods)</term><term>Electrodes, Implanted</term><term>Essential</term><term>Essential Tremor (therapy)</term><term>Female</term><term>Follow-Up Studies</term><term>Human</term><term>Humans</term><term>Instrumental stimulation</term><term>Long term</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Survival Analysis</term><term>Thalamus</term><term>Time Factors</term><term>Tolerance</term><term>Treatment Outcome</term><term>Treatment efficiency</term><term>Tremor</term><term>Unilateral</term><term>Ventromedial nucleus</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Electric Stimulation Therapy</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Electric Stimulation Therapy</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Essential Tremor</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Electrodes, Implanted</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Prospective Studies</term><term>Survival Analysis</term><term>Thalamus</term><term>Time Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Efficacité traitement</term><term>Essentiel</term><term>Homme</term><term>Long terme</term><term>Noyau ventromédial</term><term>Stimulation instrumentale</term><term>Thalamus</term><term>Tolérance</term><term>Tremblement</term><term>Unilatéral</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Our objective was to investigate the long‐term safety and efficacy of unilateral deep brain stimulation (DBS) of the VIM nucleus of the thalamus in essential tremor. Forty‐nine patients were evaluated for DBS between December 1993 and March 1998. Tremor was assessed by a clinical rating scale at 3 and 12 months and then yearly. Three patients were not implanted, seven were explanted prior to 24 months, 11 were lost to long‐term follow‐up, and three died from unrelated causes. Twenty‐five patients were evaluated with follow‐up greater than or equal to 2 years. The last postsurgical follow‐up occurred on average 40.2 ± 14.7 months after surgery. Tremor scores were significantly improved with stimulation on at the long‐term follow‐up as compared to baseline. There was no change in tremor scores from baseline to long‐term follow‐up with stimulation off. There was no significant change in any stimulus parameters from 3 months to the long‐term follow‐up. Three patients had asymptomatic intracerebral hemorrhages and one patient had postoperative seizures. Stimulus‐related adverse reactions were mild and easily controlled with changes in stimulus parameters. Device‐related complications were common and required repeated surgical procedures. Unilateral DBS of the thalamus has long‐term efficacy in some patients for treatment of essential tremor. However, this therapy is compromised by loss of efficacy in some patients and device complications which increase the risk of additional surgical procedures. © 2001 Movement Disorder Society.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Floride</li><li>Kansas</li><li>Washington (État)</li></region></list><tree><country name="États-Unis"><region name="Floride"><name sortKey="Koller, William C" sort="Koller, William C" uniqKey="Koller W" first="William C." last="Koller">William C. Koller</name></region><name sortKey="Lyons, Kelly E" sort="Lyons, Kelly E" uniqKey="Lyons K" first="Kelly E." last="Lyons">Kelly E. Lyons</name><name sortKey="Pahwa, Rajesh" sort="Pahwa, Rajesh" uniqKey="Pahwa R" first="Rajesh" last="Pahwa">Rajesh Pahwa</name><name sortKey="Troster, Alexander I" sort="Troster, Alexander I" uniqKey="Troster A" first="Alexander I." last="Troster">Alexander I. Troster</name><name sortKey="Troster, Alexander I" sort="Troster, Alexander I" uniqKey="Troster A" first="Alexander I." last="Troster">Alexander I. Troster</name><name sortKey="Wilkinson, Steven B" sort="Wilkinson, Steven B" uniqKey="Wilkinson S" first="Steven B." last="Wilkinson">Steven B. Wilkinson</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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