Factors Predicting Improvement in Primary Generalized Dystonia Treated by Pallidal Deep Brain Stimulation
Identifieur interne : 002F74 ( Main/Merge ); précédent : 002F73; suivant : 002F75Factors Predicting Improvement in Primary Generalized Dystonia Treated by Pallidal Deep Brain Stimulation
Auteurs : Xavier Vasques [France] ; Laura Cif [France] ; Victoria Gonzalez [France] ; Claire Nicholson [France] ; Philippe Coubes [France]Source :
- Movement disorders [ 0885-3185 ] ; 2009.
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Abstract
Despite the beneficial effects of Globus Pallidus intemus (GPi) deep brain stimulation (DBS) in patients with primary generalized dystonia (PGD), the degree of improvement varies from one patient to another. The objective of this study was to examine the effects of clinical, anatomical (volume of the GPi), and electrical variables on the postoperative Burke-Fahn-Marsden Dystonia rating scale (BFMDRS) motor score to identify which factors may be predictive of the degree of improvement. We reviewed retrospectively the clinical records of 40 steady-state patients with PGD who had been treated by bilateral GPi lead implantation. The follow-up period was 2 to 8 years. The correlation between the electrical parameters (voltage, impedance, and current) and the clinical outcome was studied. An analysis of covariance was performed to identify factors predictive of the magnitude of improvement. The most influential factors according to the model are as follows: the preoperative BFMDRS score (P < 0.0001); age at surgery (P < 0.0001); the right GPi volume (P = 0.002); the left stimulated GPi volume (P = 0.005). No significant correlation was found between the electrical parameters used and the mean motor scores in steady state.
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i1="05"><s1>Univ Montpellier I</s1><s2>Montpellier</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Montpellier</settlement></placeName></affiliation></author><author><name sortKey="Coubes, Philippe" sort="Coubes, Philippe" uniqKey="Coubes P" first="Philippe" last="Coubes">Philippe Coubes</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>CHRU Montpellier, Service de Neurochirurgie</s1><s2>Montpellier</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Montpellier</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>IGF</s1><s2>Montpellier</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Montpellier</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>CNRS, UMRS203</s1><s2>Montpellier</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Montpellier</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>INSERM, U06-1</s1><s2>Montpellier</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Montpellier</settlement></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Univ Montpellier I</s1><s2>Montpellier</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>France</country><placeName><settlement type="city">Montpellier</settlement></placeName></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="2009">2009</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>Dystonia</term><term>Improvement</term><term>Nervous system diseases</term><term>Prognosis</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Dystonie</term><term>Pathologie du système nerveux</term><term>Amélioration</term><term>Traitement</term><term>Pronostic</term><term>Stimulation cérébrale profonde</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Despite the beneficial effects of Globus Pallidus intemus (GPi) deep brain stimulation (DBS) in patients with primary generalized dystonia (PGD), the degree of improvement varies from one patient to another. The objective of this study was to examine the effects of clinical, anatomical (volume of the GPi), and electrical variables on the postoperative Burke-Fahn-Marsden Dystonia rating scale (BFMDRS) motor score to identify which factors may be predictive of the degree of improvement. We reviewed retrospectively the clinical records of 40 steady-state patients with PGD who had been treated by bilateral GPi lead implantation. The follow-up period was 2 to 8 years. The correlation between the electrical parameters (voltage, impedance, and current) and the clinical outcome was studied. An analysis of covariance was performed to identify factors predictive of the magnitude of improvement. The most influential factors according to the model are as follows: the preoperative BFMDRS score (P < 0.0001); age at surgery (P < 0.0001); the right GPi volume (P = 0.002); the left stimulated GPi volume (P = 0.005). No significant correlation was found between the electrical parameters used and the mean motor scores in steady state.</div></front></TEI><affiliations><list><country><li>France</li></country><settlement><li>Montpellier</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Vasques, Xavier" sort="Vasques, Xavier" uniqKey="Vasques X" first="Xavier" last="Vasques">Xavier Vasques</name></noRegion><name sortKey="Cif, Laura" sort="Cif, Laura" uniqKey="Cif L" first="Laura" last="Cif">Laura Cif</name><name sortKey="Cif, Laura" sort="Cif, Laura" uniqKey="Cif L" first="Laura" last="Cif">Laura Cif</name><name sortKey="Cif, Laura" sort="Cif, Laura" uniqKey="Cif L" first="Laura" last="Cif">Laura Cif</name><name sortKey="Cif, Laura" sort="Cif, Laura" uniqKey="Cif L" first="Laura" last="Cif">Laura Cif</name><name sortKey="Cif, Laura" sort="Cif, Laura" uniqKey="Cif L" first="Laura" last="Cif">Laura Cif</name><name sortKey="Coubes, Philippe" sort="Coubes, Philippe" uniqKey="Coubes P" first="Philippe" last="Coubes">Philippe Coubes</name><name sortKey="Coubes, Philippe" sort="Coubes, Philippe" uniqKey="Coubes P" first="Philippe" last="Coubes">Philippe Coubes</name><name sortKey="Coubes, Philippe" sort="Coubes, Philippe" uniqKey="Coubes P" first="Philippe" last="Coubes">Philippe Coubes</name><name sortKey="Coubes, Philippe" sort="Coubes, Philippe" uniqKey="Coubes P" first="Philippe" last="Coubes">Philippe Coubes</name><name sortKey="Coubes, Philippe" sort="Coubes, Philippe" uniqKey="Coubes P" first="Philippe" last="Coubes">Philippe Coubes</name><name sortKey="Gonzalez, Victoria" sort="Gonzalez, Victoria" uniqKey="Gonzalez V" first="Victoria" last="Gonzalez">Victoria Gonzalez</name><name sortKey="Gonzalez, Victoria" sort="Gonzalez, Victoria" uniqKey="Gonzalez V" first="Victoria" last="Gonzalez">Victoria Gonzalez</name><name sortKey="Gonzalez, Victoria" sort="Gonzalez, Victoria" uniqKey="Gonzalez V" first="Victoria" last="Gonzalez">Victoria Gonzalez</name><name sortKey="Gonzalez, Victoria" sort="Gonzalez, Victoria" uniqKey="Gonzalez V" first="Victoria" last="Gonzalez">Victoria Gonzalez</name><name sortKey="Gonzalez, Victoria" sort="Gonzalez, Victoria" uniqKey="Gonzalez V" first="Victoria" last="Gonzalez">Victoria Gonzalez</name><name sortKey="Nicholson, Claire" sort="Nicholson, Claire" uniqKey="Nicholson C" first="Claire" last="Nicholson">Claire Nicholson</name><name sortKey="Nicholson, Claire" sort="Nicholson, Claire" uniqKey="Nicholson C" first="Claire" last="Nicholson">Claire Nicholson</name><name sortKey="Nicholson, Claire" sort="Nicholson, Claire" uniqKey="Nicholson C" first="Claire" last="Nicholson">Claire Nicholson</name><name sortKey="Nicholson, Claire" sort="Nicholson, Claire" uniqKey="Nicholson C" first="Claire" last="Nicholson">Claire Nicholson</name><name sortKey="Nicholson, Claire" sort="Nicholson, Claire" uniqKey="Nicholson C" first="Claire" last="Nicholson">Claire Nicholson</name><name sortKey="Vasques, Xavier" sort="Vasques, Xavier" uniqKey="Vasques X" first="Xavier" last="Vasques">Xavier Vasques</name><name sortKey="Vasques, Xavier" sort="Vasques, Xavier" uniqKey="Vasques X" first="Xavier" last="Vasques">Xavier Vasques</name><name sortKey="Vasques, Xavier" sort="Vasques, Xavier" uniqKey="Vasques X" first="Xavier" last="Vasques">Xavier Vasques</name><name sortKey="Vasques, Xavier" sort="Vasques, Xavier" uniqKey="Vasques X" first="Xavier" last="Vasques">Xavier Vasques</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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