Bilateral subthalamic stimulation monotherapy in advanced Parkinson's disease: long-term follow-up of patients.
Identifieur interne : 006230 ( Main/Merge ); précédent : 006229; suivant : 006231Bilateral subthalamic stimulation monotherapy in advanced Parkinson's disease: long-term follow-up of patients.
Auteurs : Francesc Valldeoriola [Espagne] ; Manuela Pilleri ; Eduardo Tolosa ; José L. Molinuevo ; Jordi Rumià ; Enric FerrerSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2002.
English descriptors
- KwdEn :
- Antiparkinson Agents (therapeutic use), Combined Modality Therapy, Electric Stimulation Therapy (methods), Electrodes, Implanted, Female, Follow-Up Studies, Functional Laterality (physiology), Humans, Levodopa (therapeutic use), Male, Middle Aged, Parkinson Disease (diagnosis), Parkinson Disease (drug therapy), Parkinson Disease (therapy), Severity of Illness Index, Subthalamic Nucleus (physiology), Subthalamic Nucleus (surgery), Time.
- 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 We analyzed clinical outcome of ten patients with PD in which all ApMed was withdrawn after bilateral subthalamic stimulation and 16 parkinsonian patients still taking antiparkinsonian medication after surgery.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.
PubMed: 11835449
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Molinuevo</name></author><author><name sortKey="Rumia, Jordi" sort="Rumia, Jordi" uniqKey="Rumia J" first="Jordi" last="Rumià">Jordi Rumià</name></author><author><name sortKey="Ferrer, Enric" sort="Ferrer, Enric" uniqKey="Ferrer E" first="Enric" last="Ferrer">Enric Ferrer</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2002">2002</date><idno type="RBID">pubmed:11835449</idno><idno type="pmid">11835449</idno><idno type="wicri:Area/PubMed/Corpus">003B89</idno><idno type="wicri:Area/PubMed/Curation">003B89</idno><idno type="wicri:Area/PubMed/Checkpoint">003B81</idno><idno type="wicri:Area/Ncbi/Merge">000662</idno><idno type="wicri:Area/Ncbi/Curation">000662</idno><idno type="wicri:Area/Ncbi/Checkpoint">000662</idno><idno type="wicri:doubleKey">0885-3185:2002:Valldeoriola F:bilateral:subthalamic:stimulation</idno><idno type="wicri:Area/Main/Merge">006230</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Bilateral subthalamic stimulation monotherapy in advanced Parkinson's disease: long-term follow-up of patients.</title><author><name sortKey="Valldeoriola, Francesc" sort="Valldeoriola, Francesc" uniqKey="Valldeoriola F" first="Francesc" last="Valldeoriola">Francesc Valldeoriola</name><affiliation wicri:level="3"><nlm:affiliation>Unitat de Parkinson i Moviments Anormals, Service of Neurology, Institut Clínic de Malalties del Sistema Nerviós, Institut d'Investigacions Biomèdiques August Pi i Suñer, Hospital Clínic Universitari, Barcelona, Spain. fvallde@clinic.ub.es</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Unitat de Parkinson i Moviments Anormals, Service of Neurology, Institut Clínic de Malalties del Sistema Nerviós, Institut d'Investigacions Biomèdiques August Pi i Suñer, Hospital Clínic Universitari, Barcelona</wicri:regionArea><placeName><settlement type="city">Barcelone</settlement><region nuts="2" type="region">Catalogne</region></placeName></affiliation></author><author><name sortKey="Pilleri, Manuela" sort="Pilleri, Manuela" uniqKey="Pilleri M" first="Manuela" last="Pilleri">Manuela Pilleri</name></author><author><name sortKey="Tolosa, Eduardo" sort="Tolosa, Eduardo" uniqKey="Tolosa E" first="Eduardo" last="Tolosa">Eduardo Tolosa</name></author><author><name sortKey="Molinuevo, Jose L" sort="Molinuevo, Jose L" uniqKey="Molinuevo J" first="José L" last="Molinuevo">José L. Molinuevo</name></author><author><name sortKey="Rumia, Jordi" sort="Rumia, Jordi" uniqKey="Rumia J" first="Jordi" last="Rumià">Jordi Rumià</name></author><author><name sortKey="Ferrer, Enric" sort="Ferrer, Enric" uniqKey="Ferrer E" first="Enric" last="Ferrer">Enric Ferrer</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="2002" type="published">2002</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antiparkinson Agents (therapeutic use)</term><term>Combined Modality Therapy</term><term>Electric Stimulation Therapy (methods)</term><term>Electrodes, Implanted</term><term>Female</term><term>Follow-Up Studies</term><term>Functional Laterality (physiology)</term><term>Humans</term><term>Levodopa (therapeutic use)</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>Severity of Illness Index</term><term>Subthalamic Nucleus (physiology)</term><term>Subthalamic Nucleus (surgery)</term><term>Time</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></textClass></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.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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