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Treatment of advanced Parkinson's disease by unilateral posterior GPi pallidotomy: 4‐year results of a pilot study

Identifieur interne : 004929 ( Main/Exploration ); précédent : 004928; suivant : 004930

Treatment of advanced Parkinson's disease by unilateral posterior GPi pallidotomy: 4‐year results of a pilot study

Auteurs : Mark S. Baron [États-Unis] ; Jerrold L. Vitek [États-Unis] ; Roy A. E. Bakay [États-Unis] ; Joanne Green [États-Unis] ; William M. Mcdonald [États-Unis] ; Steven A. Cole [États-Unis] ; Mahlon R. Delong [États-Unis]

Source :

Movement Disorders [ 0885-3185 ] ; 2000-03.

RBID : ISTEX:9A3F7C52ED1128BB79D36CA07572C1EA5AF6AC77

Descripteurs français

Pascal (Inist)
- Adulte, Exérèse, Long terme, Pallidotomie, Pallidum, Parkinson maladie, Pronostic, Psychométrie, Réfractaire, Stade avancé, Traitement, Unilatéral.
Wicri :
- topic : Adulte.

English descriptors

KwdEn :
- Adult, Advanced stage, Aged, Dominance, Cerebral (physiology), Exeresis, Female, Follow-Up Studies, Globus Pallidus (physiopathology), Globus Pallidus (surgery), Humans, Long term, Male, Middle Aged, Neurologic Examination, Neuropsychological Tests, Pallidotomy, Pallidum, Parkinson Disease (diagnosis), Parkinson Disease (physiopathology), Parkinson Disease (surgery), Parkinson disease, Parkinson's disease, Pilot Projects, Postoperative Complications (etiology), Postoperative Complications (physiopathology), Prognosis, Psychometrics, Quality of Life, Refractory, Stereotaxic Techniques, Stereotaxic surgery, Treatment, Treatment Outcome, Unilateral.
MESH :
- diagnosis : Parkinson Disease.
- etiology : Postoperative Complications.
- physiology : Dominance, Cerebral.
- physiopathology : Globus Pallidus, Parkinson Disease, Postoperative Complications.
- surgery : Globus Pallidus, Parkinson Disease.
- Adult, Aged, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neurologic Examination, Neuropsychological Tests, Pilot Projects, Quality of Life, Stereotaxic Techniques, Treatment Outcome.

Abstract

To assess the long‐term outcome following unilateral pallidotomy for advanced Parkinson's disease, we performed nonblinded Core Assessment Program for Intracerebral Transplantations protocol assessments in 10 of the original 15 patients in our pilot study for 4 years following surgery. Although Unified Parkinson's Disease Rating Scale motor examination scores returned to baseline levels at 3 and 4 years, most patients continued to show sustained improvements in contralateral tremor, akinesia, and drug‐induced dyskinesias. Contralateral tremor was absent at 4 years in all seven patients with preoperative tremor. Contralateral “off” arm movement times (averaged for three tasks) decreased by 37% at 1 year and by 30% at 4 years. Contralateral dyskinesia scores improved by 82% at 1 year and by 64% at 4 years. In contrast, after reaching speeds equal to the contralateral side at 1 year, ipsilateral “off” movement times increased by 13% over baseline levels at 4 years. Although most gait and postural stability measures showed modest initial improvement followed by a return to baseline values, “on” stand–walk–sit task performance declined significantly at 4 years. Despite the restriction of our surgeries to one side and the expected natural progression of Parkinson's disease, the results of patient self‐assessments suggest that 4 years after unilateral pallidotomy, most patients continue to experience a quality of life above preoperative levels.

Url:

https://api.istex.fr/document/9A3F7C52ED1128BB79D36CA07572C1EA5AF6AC77/fulltext/pdf

DOI: 10.1002/1531-8257(200003)15:2<230::AID-MDS1005>3.0.CO;2-U

Affiliations:

Le document en format XML

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<term>Exeresis</term>
<term>Female</term>
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<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson Disease (surgery)</term>
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<term>Treatment Outcome</term>
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<term>Humans</term>
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<term>Middle Aged</term>
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<term>Neuropsychological Tests</term>
<term>Pilot Projects</term>
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<front><div type="abstract" xml:lang="en">To assess the long‐term outcome following unilateral pallidotomy for advanced Parkinson's disease, we performed nonblinded Core Assessment Program for Intracerebral Transplantations protocol assessments in 10 of the original 15 patients in our pilot study for 4 years following surgery. Although Unified Parkinson's Disease Rating Scale motor examination scores returned to baseline levels at 3 and 4 years, most patients continued to show sustained improvements in contralateral tremor, akinesia, and drug‐induced dyskinesias. Contralateral tremor was absent at 4 years in all seven patients with preoperative tremor. Contralateral “off” arm movement times (averaged for three tasks) decreased by 37% at 1 year and by 30% at 4 years. Contralateral dyskinesia scores improved by 82% at 1 year and by 64% at 4 years. In contrast, after reaching speeds equal to the contralateral side at 1 year, ipsilateral “off” movement times increased by 13% over baseline levels at 4 years. Although most gait and postural stability measures showed modest initial improvement followed by a return to baseline values, “on” stand–walk–sit task performance declined significantly at 4 years. Despite the restriction of our surgeries to one side and the expected natural progression of Parkinson's disease, the results of patient self‐assessments suggest that 4 years after unilateral pallidotomy, most patients continue to experience a quality of life above preoperative levels.</div>
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Movement Disorders (revue)

Treatment of advanced Parkinson's disease by unilateral posterior GPi pallidotomy: 4‐year results of a pilot study

Treatment of advanced Parkinson's disease by unilateral posterior GPi pallidotomy: 4‐year results of a pilot study

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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