The subthalamic nucleus and tremor in Parkinson's disease.
Identifieur interne : 007D41 ( Main/Merge ); précédent : 007D40; suivant : 007D42The subthalamic nucleus and tremor in Parkinson's disease.
Auteurs : M C Rodriguez [Espagne] ; O J Guridi ; L. Alvarez ; K. Mewes ; R. Macias ; J. Vitek ; M R Delong ; J A ObesoSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1998.
English descriptors
- KwdEn :
- MESH :
- complications : Parkinson Disease.
- etiology : Tremor.
- methods : Electric Stimulation.
- surgery : Thalamic Nuclei.
- therapy : Tremor.
- Adult, Aged, Female, Humans, Male, Middle Aged, Monitoring, Intraoperative, Postoperative Period, Preoperative Care.
Abstract
The role of the subthalamic nucleus (STN) in the origin of parkinsonian tremor is discussed. Previous studies in monkeys made parkinsonian by MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) administration suggested a direct participation of the STN in the pathophysiology of tremor. We recorded tremor-related activity in the STN in 12 patients with Parkinson's disease (PD) and found that microstimulation of the sensorimotor region of the nucleus, where these neurons are present, stopped the tremor with a very short latency. Long-term treatment by means of bilateral deep-brain stimulation (DBS) in the same 12 patients led to a significant reduction of tremor as well as other cardinal features of PD. This effect was blindly assessed at 3 months after implantation. In another group of seven patients, a unilateral lesion of the STN was performed. Both postural and resting tremor were significantly improved on the limbs contralateral to the lesion side. In three patients, tremor disappeared completely after 12 months of follow up. The electrophysiologic data and therapeutic effect of inactivating the STN strongly indicated that this structure is directly involved in the origin of parkinsonian tremor, as suggested by the MPTP model.
PubMed: 9827606
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The subthalamic nucleus and tremor in Parkinson's disease.</title><author><name sortKey="Rodriguez, M C" sort="Rodriguez, M C" uniqKey="Rodriguez M" first="M C" last="Rodriguez">M C Rodriguez</name><affiliation wicri:level="1"><nlm:affiliation>Centro de Neurologia y Neurocirugia Funcional, Clinica Quiron, University of La Laguna, Tenerife, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Centro de Neurologia y Neurocirugia Funcional, Clinica Quiron, University of La Laguna, Tenerife</wicri:regionArea><wicri:noRegion>Tenerife</wicri:noRegion></affiliation></author><author><name sortKey="Guridi, O J" sort="Guridi, O J" uniqKey="Guridi O" first="O J" last="Guridi">O J Guridi</name></author><author><name sortKey="Alvarez, L" sort="Alvarez, L" uniqKey="Alvarez L" first="L" last="Alvarez">L. Alvarez</name></author><author><name sortKey="Mewes, K" sort="Mewes, K" uniqKey="Mewes K" first="K" last="Mewes">K. Mewes</name></author><author><name sortKey="Macias, R" sort="Macias, R" uniqKey="Macias R" first="R" last="Macias">R. Macias</name></author><author><name sortKey="Vitek, J" sort="Vitek, J" uniqKey="Vitek J" first="J" last="Vitek">J. Vitek</name></author><author><name sortKey="Delong, M R" sort="Delong, M R" uniqKey="Delong M" first="M R" last="Delong">M R Delong</name></author><author><name sortKey="Obeso, J A" sort="Obeso, J A" uniqKey="Obeso J" first="J A" last="Obeso">J A Obeso</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1998">1998</date><idno type="RBID">pubmed:9827606</idno><idno type="pmid">9827606</idno><idno type="wicri:Area/PubMed/Corpus">004320</idno><idno type="wicri:Area/PubMed/Curation">004320</idno><idno type="wicri:Area/PubMed/Checkpoint">004315</idno><idno type="wicri:Area/Ncbi/Merge">005063</idno><idno type="wicri:Area/Ncbi/Curation">005063</idno><idno type="wicri:Area/Ncbi/Checkpoint">005063</idno><idno type="wicri:doubleKey">0885-3185:1998:Rodriguez M:the:subthalamic:nucleus</idno><idno type="wicri:Area/Main/Merge">007D41</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">The subthalamic nucleus and tremor in Parkinson's disease.</title><author><name sortKey="Rodriguez, M C" sort="Rodriguez, M C" uniqKey="Rodriguez M" first="M C" last="Rodriguez">M C Rodriguez</name><affiliation wicri:level="1"><nlm:affiliation>Centro de Neurologia y Neurocirugia Funcional, Clinica Quiron, University of La Laguna, Tenerife, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Centro de Neurologia y Neurocirugia Funcional, Clinica Quiron, University of La Laguna, Tenerife</wicri:regionArea><wicri:noRegion>Tenerife</wicri:noRegion></affiliation></author><author><name sortKey="Guridi, O J" sort="Guridi, O J" uniqKey="Guridi O" first="O J" last="Guridi">O J Guridi</name></author><author><name sortKey="Alvarez, L" sort="Alvarez, L" uniqKey="Alvarez L" first="L" last="Alvarez">L. Alvarez</name></author><author><name sortKey="Mewes, K" sort="Mewes, K" uniqKey="Mewes K" first="K" last="Mewes">K. Mewes</name></author><author><name sortKey="Macias, R" sort="Macias, R" uniqKey="Macias R" first="R" last="Macias">R. Macias</name></author><author><name sortKey="Vitek, J" sort="Vitek, J" uniqKey="Vitek J" first="J" last="Vitek">J. Vitek</name></author><author><name sortKey="Delong, M R" sort="Delong, M R" uniqKey="Delong M" first="M R" last="Delong">M R Delong</name></author><author><name sortKey="Obeso, J A" sort="Obeso, J A" uniqKey="Obeso J" first="J A" last="Obeso">J A Obeso</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="1998" type="published">1998</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Electric Stimulation (methods)</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Monitoring, Intraoperative</term><term>Parkinson Disease (complications)</term><term>Postoperative Period</term><term>Preoperative Care</term><term>Thalamic Nuclei (surgery)</term><term>Tremor (etiology)</term><term>Tremor (therapy)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Electric Stimulation</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Thalamic Nuclei</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Tremor</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Monitoring, Intraoperative</term><term>Postoperative Period</term><term>Preoperative Care</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The role of the subthalamic nucleus (STN) in the origin of parkinsonian tremor is discussed. Previous studies in monkeys made parkinsonian by MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine) administration suggested a direct participation of the STN in the pathophysiology of tremor. We recorded tremor-related activity in the STN in 12 patients with Parkinson's disease (PD) and found that microstimulation of the sensorimotor region of the nucleus, where these neurons are present, stopped the tremor with a very short latency. Long-term treatment by means of bilateral deep-brain stimulation (DBS) in the same 12 patients led to a significant reduction of tremor as well as other cardinal features of PD. This effect was blindly assessed at 3 months after implantation. In another group of seven patients, a unilateral lesion of the STN was performed. Both postural and resting tremor were significantly improved on the limbs contralateral to the lesion side. In three patients, tremor disappeared completely after 12 months of follow up. The electrophysiologic data and therapeutic effect of inactivating the STN strongly indicated that this structure is directly involved in the origin of parkinsonian tremor, as suggested by the MPTP model.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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