Effects of bilateral stimulation of the subthalamic nucleus in patients with severe Parkinson's disease and motor fluctuations
Identifieur interne : 006485 ( Main/Merge ); précédent : 006484; suivant : 006486Effects of bilateral stimulation of the subthalamic nucleus in patients with severe Parkinson's disease and motor fluctuations
Auteurs : Karen Stergaard [Danemark] ; Niels Sunde [Danemark] ; Erik Dupont [Danemark]Source :
- Movement Disorders [ 0885-3185 ] ; 2002-07.
English descriptors
- KwdEn :
- Activities of Daily Living (classification), Adult, Aged, Antiparkinson Agents (administration & dosage), Antiparkinson Agents (adverse effects), Dominance, Cerebral (physiology), Double-Blind Method, Electric Stimulation Therapy, Electrodes, Implanted, Female, Follow-Up Studies, Humans, Levodopa (administration & dosage), Levodopa (adverse effects), Male, Middle Aged, Neurologic Examination (drug effects), Parkinson Disease (physiopathology), Parkinson Disease (therapy), Parkinson's disease, Subthalamic Nucleus (physiopathology), activities of daily living (ADL), deep brain stimulation, dyskinesias, motor score, nucleus subthalamicus, on–off phenomenon.
- MESH :
- chemical , administration & dosage : Antiparkinson Agents, Levodopa.
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- classification : Activities of Daily Living.
- drug effects : Neurologic Examination.
- physiology : Dominance, Cerebral.
- physiopathology : Parkinson Disease, Subthalamic Nucleus.
- therapy : Parkinson Disease.
- Adult, Aged, Double-Blind Method, Electric Stimulation Therapy, Electrodes, Implanted, Female, Follow-Up Studies, Humans, Male, Middle Aged.
Abstract
We present the efficacy and side effects of bilateral deep brain stimulation (DBS) of the subthalamic nuclei (STN) performed with a more simplified surgical procedure than described by the Grenoble group. A consecutive series of 26 patients with advanced and levodopa‐responsive Parkinson's disease and motor complications was evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) part I–VI, timed tests, and a patient diary for 2 days concerning on–off phenomenon and dyskinesias. At 3 months, evaluation of stimulation by the UPDRS motor score was performed in a double‐blind manner and a significant improvement of 57% was found. The results 12 months after surgery off medication showed significant improvement in both UPDRS motor score and activities of daily living of 64% and, on medication, a significant reduction of 86% in duration of dyskinesias and 83% in duration of off‐periods. Reduction in medication was less than for other groups, probably because we used smaller doses of levodopa before the operation. No serious side effects were encountered. When the patients are carefully selected and followed up, bilateral DBS of STN is a significant progress in treatment of advanced idiopathic Parkinson's disease with levodopa‐induced motor complications. © 2002 Movement Disorder Society
Url:
DOI: 10.1002/mds.10188
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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>New York</pubPlace><date type="published" when="2002-07">2002-07</date><biblScope unit="vol">17</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="693">693</biblScope><biblScope unit="page" to="700">700</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">A4D5BCD874D884861ADBC402F5E70113F8B7533F</idno><idno type="DOI">10.1002/mds.10188</idno><idno type="ArticleID">MDS10188</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activities of Daily Living (classification)</term><term>Adult</term><term>Aged</term><term>Antiparkinson Agents (administration & dosage)</term><term>Antiparkinson Agents (adverse effects)</term><term>Dominance, Cerebral (physiology)</term><term>Double-Blind Method</term><term>Electric Stimulation Therapy</term><term>Electrodes, Implanted</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Levodopa (administration & dosage)</term><term>Levodopa (adverse effects)</term><term>Male</term><term>Middle Aged</term><term>Neurologic Examination (drug effects)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (therapy)</term><term>Parkinson's disease</term><term>Subthalamic Nucleus (physiopathology)</term><term>activities of daily living (ADL)</term><term>deep brain stimulation</term><term>dyskinesias</term><term>motor score</term><term>nucleus subthalamicus</term><term>on–off phenomenon</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="classification" xml:lang="en"><term>Activities of Daily Living</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Neurologic Examination</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Dominance, Cerebral</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term><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>Adult</term><term>Aged</term><term>Double-Blind Method</term><term>Electric Stimulation Therapy</term><term>Electrodes, Implanted</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We present the efficacy and side effects of bilateral deep brain stimulation (DBS) of the subthalamic nuclei (STN) performed with a more simplified surgical procedure than described by the Grenoble group. A consecutive series of 26 patients with advanced and levodopa‐responsive Parkinson's disease and motor complications was evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) part I–VI, timed tests, and a patient diary for 2 days concerning on–off phenomenon and dyskinesias. At 3 months, evaluation of stimulation by the UPDRS motor score was performed in a double‐blind manner and a significant improvement of 57% was found. The results 12 months after surgery off medication showed significant improvement in both UPDRS motor score and activities of daily living of 64% and, on medication, a significant reduction of 86% in duration of dyskinesias and 83% in duration of off‐periods. Reduction in medication was less than for other groups, probably because we used smaller doses of levodopa before the operation. No serious side effects were encountered. When the patients are carefully selected and followed up, bilateral DBS of STN is a significant progress in treatment of advanced idiopathic Parkinson's disease with levodopa‐induced motor complications. © 2002 Movement Disorder Society</div></front></TEI><double doi="10.1002/mds.10188"><ISTEX><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Effects of bilateral stimulation of the subthalamic nucleus in patients with severe Parkinson's disease and motor fluctuations</title><author><name sortKey=" Stergaard, Karen" sort=" Stergaard, Karen" uniqKey=" Stergaard K" first="Karen" last=" Stergaard">Karen Stergaard</name></author><author><name sortKey="Sunde, Niels" sort="Sunde, Niels" uniqKey="Sunde N" first="Niels" last="Sunde">Niels Sunde</name></author><author><name sortKey="Dupont, Erik" sort="Dupont, Erik" uniqKey="Dupont E" first="Erik" last="Dupont">Erik Dupont</name></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:A4D5BCD874D884861ADBC402F5E70113F8B7533F</idno><date when="2002" year="2002">2002</date><idno type="doi">10.1002/mds.10188</idno><idno type="url">https://api.istex.fr/document/A4D5BCD874D884861ADBC402F5E70113F8B7533F/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">000274</idno><idno type="wicri:Area/Istex/Curation">000274</idno><idno type="wicri:Area/Istex/Checkpoint">002D71</idno><idno type="wicri:doubleKey">0885-3185:2002: Stergaard K:effects:of:bilateral</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Effects of bilateral stimulation of the subthalamic nucleus in patients with severe Parkinson's disease and motor fluctuations</title><author><name sortKey=" Stergaard, Karen" sort=" Stergaard, Karen" uniqKey=" Stergaard K" first="Karen" last=" Stergaard">Karen Stergaard</name><affiliation wicri:level="1"><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Neurology, Aarhus University Hospital, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Sunde, Niels" sort="Sunde, Niels" uniqKey="Sunde N" first="Niels" last="Sunde">Niels Sunde</name><affiliation wicri:level="1"><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Neurosurgery, Aarhus University Hospital, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Dupont, Erik" sort="Dupont, Erik" uniqKey="Dupont E" first="Erik" last="Dupont">Erik Dupont</name><affiliation wicri:level="1"><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Neurology, Aarhus University Hospital, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>New York</pubPlace><date type="published" when="2002-07">2002-07</date><biblScope unit="vol">17</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="693">693</biblScope><biblScope unit="page" to="700">700</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">A4D5BCD874D884861ADBC402F5E70113F8B7533F</idno><idno type="DOI">10.1002/mds.10188</idno><idno type="ArticleID">MDS10188</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>activities of daily living (ADL)</term><term>deep brain stimulation</term><term>dyskinesias</term><term>motor score</term><term>nucleus subthalamicus</term><term>on–off phenomenon</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We present the efficacy and side effects of bilateral deep brain stimulation (DBS) of the subthalamic nuclei (STN) performed with a more simplified surgical procedure than described by the Grenoble group. A consecutive series of 26 patients with advanced and levodopa‐responsive Parkinson's disease and motor complications was evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) part I–VI, timed tests, and a patient diary for 2 days concerning on–off phenomenon and dyskinesias. At 3 months, evaluation of stimulation by the UPDRS motor score was performed in a double‐blind manner and a significant improvement of 57% was found. The results 12 months after surgery off medication showed significant improvement in both UPDRS motor score and activities of daily living of 64% and, on medication, a significant reduction of 86% in duration of dyskinesias and 83% in duration of off‐periods. Reduction in medication was less than for other groups, probably because we used smaller doses of levodopa before the operation. No serious side effects were encountered. When the patients are carefully selected and followed up, bilateral DBS of STN is a significant progress in treatment of advanced idiopathic Parkinson's disease with levodopa‐induced motor complications. © 2002 Movement Disorder Society</div></front></TEI></ISTEX><PubMed><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Effects of bilateral stimulation of the subthalamic nucleus in patients with severe Parkinson's disease and motor fluctuations.</title><author><name sortKey=" Stergaard, Karen" sort=" Stergaard, Karen" uniqKey=" Stergaard K" first="Karen" last=" Stergaard">Karen Stergaard</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Aarhus University Hospital, Aarhus, Denmark. karen.ostergaard@oncable.dk</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Neurology, Aarhus University Hospital, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Sunde, Niels" sort="Sunde, Niels" uniqKey="Sunde N" first="Niels" last="Sunde">Niels Sunde</name></author><author><name sortKey="Dupont, Erik" sort="Dupont, Erik" uniqKey="Dupont E" first="Erik" last="Dupont">Erik Dupont</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2002">2002</date><idno type="RBID">pubmed:12210858</idno><idno type="pmid">12210858</idno><idno type="doi">10.1002/mds.10188</idno><idno type="wicri:Area/PubMed/Corpus">003A23</idno><idno type="wicri:Area/PubMed/Curation">003A23</idno><idno type="wicri:Area/PubMed/Checkpoint">003B06</idno><idno type="wicri:Area/Ncbi/Merge">000828</idno><idno type="wicri:Area/Ncbi/Curation">000828</idno><idno type="wicri:Area/Ncbi/Checkpoint">000828</idno><idno type="wicri:doubleKey">0885-3185:2002: Stergaard K:effects:of:bilateral</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Effects of bilateral stimulation of the subthalamic nucleus in patients with severe Parkinson's disease and motor fluctuations.</title><author><name sortKey=" Stergaard, Karen" sort=" Stergaard, Karen" uniqKey=" Stergaard K" first="Karen" last=" Stergaard">Karen Stergaard</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Aarhus University Hospital, Aarhus, Denmark. karen.ostergaard@oncable.dk</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Neurology, Aarhus University Hospital, Aarhus</wicri:regionArea><wicri:noRegion>Aarhus</wicri:noRegion></affiliation></author><author><name sortKey="Sunde, Niels" sort="Sunde, Niels" uniqKey="Sunde N" first="Niels" last="Sunde">Niels Sunde</name></author><author><name sortKey="Dupont, Erik" sort="Dupont, Erik" uniqKey="Dupont E" first="Erik" last="Dupont">Erik Dupont</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>Activities of Daily Living (classification)</term><term>Adult</term><term>Aged</term><term>Antiparkinson Agents (administration & dosage)</term><term>Antiparkinson Agents (adverse effects)</term><term>Dominance, Cerebral (physiology)</term><term>Double-Blind Method</term><term>Electric Stimulation Therapy</term><term>Electrodes, Implanted</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Levodopa (administration & dosage)</term><term>Levodopa (adverse effects)</term><term>Male</term><term>Middle Aged</term><term>Neurologic Examination (drug effects)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (therapy)</term><term>Subthalamic Nucleus (physiopathology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="classification" xml:lang="en"><term>Activities of Daily Living</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Neurologic Examination</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Dominance, Cerebral</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term><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>Adult</term><term>Aged</term><term>Double-Blind Method</term><term>Electric Stimulation Therapy</term><term>Electrodes, Implanted</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We present the efficacy and side effects of bilateral deep brain stimulation (DBS) of the subthalamic nuclei (STN) performed with a more simplified surgical procedure than described by the Grenoble group. A consecutive series of 26 patients with advanced and levodopa-responsive Parkinson's disease and motor complications was evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) part I-VI, timed tests, and a patient diary for 2 days concerning on-off phenomenon and dyskinesias. At 3 months, evaluation of stimulation by the UPDRS motor score was performed in a double-blind manner and a significant improvement of 57% was found. The results 12 months after surgery off medication showed significant improvement in both UPDRS motor score and activities of daily living of 64% and, on medication, a significant reduction of 86% in duration of dyskinesias and 83% in duration of off-periods. Reduction in medication was less than for other groups, probably because we used smaller doses of levodopa before the operation. No serious side effects were encountered. When the patients are carefully selected and followed up, bilateral DBS of STN is a significant progress in treatment of advanced idiopathic Parkinson's disease with levodopa-induced motor complications.</div></front></TEI></PubMed></double></record>Pour manipuler ce document sous Unix (Dilib)
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