Long-Term Stability of Effects of Subthalamic Stimulation in Parkinson's Disease: Indian Experience
Identifieur interne : 002565 ( Main/Merge ); précédent : 002564; suivant : 002566Long-Term Stability of Effects of Subthalamic Stimulation in Parkinson's Disease: Indian Experience
Auteurs : Asha Kishore [Inde] ; Ravimohan Rao [Inde] ; Syam Krishnan [Inde] ; Dilip Panikar [Inde] ; Gangadhara Sarma [Inde] ; MATHURANATH PAVAGADA SIVASANAKARAN [Inde] ; Sankara Sarma [Inde]Source :
- Movement disorders [ 0885-3185 ] ; 2010.
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Abstract
Reports of long-term effects of subthalamic (STN) stimulation for Parkinson's disease (PD) are few, mostly open-label evaluations and from Western centers. We used single-blind and open-label motor, cognitive and quality of life (QOL) evaluations to study the effects of bilateral STN stimulation in 45 patients over 5 years. Our patients showed a stable and substantial reduction in the cardinal signs of PD, motor fluctuations, and dyskinesias but less so for axial signs. The reduction in medications and the intensity of electrical stimulation needed also remained stable during follow up. Although the total QOL and its parkinsonism and social components showed sustained benefits till 5 years, the gains in emotional and systemic subsets were short lasting. Global scores for mood and cognition did not show significant worsening. Benefits of STN stimulation on the cardinal signs, motor complications, and QOL of advanced PD were substantial and sustained till 5 years. The initial benefits in axial motor signs and emotional and psychological aspects of QOL did not show similar stability. In general, the procedure had insignificant impact on cognition and mood. This is the first report of STN stimulation in Asian patients with PD.
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aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Trivandrum, Kerala</wicri:noRegion></affiliation></author><author><name sortKey="Rao, Ravimohan" sort="Rao, Ravimohan" uniqKey="Rao R" first="Ravimohan" last="Rao">Ravimohan Rao</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology</s1><s2>Trivandrum, Kerala</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Trivandrum, Kerala</wicri:noRegion></affiliation></author><author><name sortKey="Krishnan, Syam" sort="Krishnan, Syam" uniqKey="Krishnan S" first="Syam" last="Krishnan">Syam Krishnan</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology</s1><s2>Trivandrum, Kerala</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Trivandrum, Kerala</wicri:noRegion></affiliation></author><author><name sortKey="Panikar, Dilip" sort="Panikar, Dilip" uniqKey="Panikar D" first="Dilip" last="Panikar">Dilip Panikar</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology</s1><s2>Trivandrum, Kerala</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Trivandrum, Kerala</wicri:noRegion></affiliation></author><author><name sortKey="Sarma, Gangadhara" sort="Sarma, Gangadhara" uniqKey="Sarma G" first="Gangadhara" last="Sarma">Gangadhara Sarma</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology</s1><s2>Trivandrum, Kerala</s2><s3>IND</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Trivandrum, Kerala</wicri:noRegion></affiliation></author><author><name sortKey="Mathuranath Pavagada Sivasanakaran" sort="Mathuranath Pavagada Sivasanakaran" uniqKey="Mathuranath Pavagada Sivasanakaran" last="Mathuranath Pavagada Sivasanakaran">MATHURANATH PAVAGADA SIVASANAKARAN</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Cognition and Behavioral Neurology Centre, Sree Chitra Tirunal Institute for Medical Sciences and Technology</s1><s2>Trivandrum, Kerala</s2><s3>IND</s3><sZ>6 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Trivandrum, Kerala</wicri:noRegion></affiliation></author><author><name sortKey="Sarma, Sankara" sort="Sarma, Sankara" uniqKey="Sarma S" first="Sankara" last="Sarma">Sankara Sarma</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Achutha Menon Centre for Health Sciences Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology</s1><s2>Trivandrum, Kerala</s2><s3>IND</s3><sZ>7 aut.</sZ></inist:fA14><country>Inde</country><wicri:noRegion>Trivandrum, Kerala</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2010">2010</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Deep brain stimulation</term><term>Experience</term><term>Fluctuations</term><term>Indian</term><term>Long term</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Stability</term><term>Subthalamic nucleus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Long terme</term><term>Stabilité</term><term>Indien</term><term>Expérience</term><term>Noyau sousthalamique</term><term>Fluctuation</term><term>Stimulation cérébrale profonde</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Reports of long-term effects of subthalamic (STN) stimulation for Parkinson's disease (PD) are few, mostly open-label evaluations and from Western centers. We used single-blind and open-label motor, cognitive and quality of life (QOL) evaluations to study the effects of bilateral STN stimulation in 45 patients over 5 years. Our patients showed a stable and substantial reduction in the cardinal signs of PD, motor fluctuations, and dyskinesias but less so for axial signs. The reduction in medications and the intensity of electrical stimulation needed also remained stable during follow up. Although the total QOL and its parkinsonism and social components showed sustained benefits till 5 years, the gains in emotional and systemic subsets were short lasting. Global scores for mood and cognition did not show significant worsening. Benefits of STN stimulation on the cardinal signs, motor complications, and QOL of advanced PD were substantial and sustained till 5 years. The initial benefits in axial motor signs and emotional and psychological aspects of QOL did not show similar stability. In general, the procedure had insignificant impact on cognition and mood. This is the first report of STN stimulation in Asian patients with PD.</div></front></TEI><affiliations><list><country><li>Inde</li></country></list><tree><country name="Inde"><noRegion><name sortKey="Kishore, Asha" sort="Kishore, Asha" uniqKey="Kishore A" first="Asha" last="Kishore">Asha Kishore</name></noRegion><name sortKey="Krishnan, Syam" sort="Krishnan, Syam" uniqKey="Krishnan S" first="Syam" last="Krishnan">Syam Krishnan</name><name sortKey="Mathuranath Pavagada Sivasanakaran" sort="Mathuranath Pavagada Sivasanakaran" uniqKey="Mathuranath Pavagada Sivasanakaran" last="Mathuranath Pavagada Sivasanakaran">MATHURANATH PAVAGADA SIVASANAKARAN</name><name sortKey="Panikar, Dilip" sort="Panikar, Dilip" uniqKey="Panikar D" first="Dilip" last="Panikar">Dilip Panikar</name><name sortKey="Rao, Ravimohan" sort="Rao, Ravimohan" uniqKey="Rao R" first="Ravimohan" last="Rao">Ravimohan Rao</name><name sortKey="Sarma, Gangadhara" sort="Sarma, Gangadhara" uniqKey="Sarma G" first="Gangadhara" last="Sarma">Gangadhara Sarma</name><name sortKey="Sarma, Sankara" sort="Sarma, Sankara" uniqKey="Sarma S" first="Sankara" last="Sarma">Sankara Sarma</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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