Treatment of advanced Parkinson's disease by unilateral posterior GPi pallidotomy: 4-year results of a pilot study.
Identifieur interne : 000220 ( Ncbi/Checkpoint ); précédent : 000219; suivant : 000221Treatment of advanced Parkinson's disease by unilateral posterior GPi pallidotomy: 4-year results of a pilot study.
Auteurs : M S Baron [États-Unis] ; J L Vitek ; R A Bakay ; J. Green ; W M Mcdonald ; S A Cole ; M R DelongSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2000.
English descriptors
- KwdEn :
- Adult, Aged, Dominance, Cerebral (physiology), Female, Follow-Up Studies, Globus Pallidus (physiopathology), Globus Pallidus (surgery), Humans, Male, Middle Aged, Neurologic Examination, Neuropsychological Tests, Parkinson Disease (diagnosis), Parkinson Disease (physiopathology), Parkinson Disease (surgery), Pilot Projects, Postoperative Complications (etiology), Postoperative Complications (physiopathology), Quality of Life, Stereotaxic Techniques, Treatment Outcome.
- MESH :
- diagnosis : Parkinson Disease.
- etiology : Postoperative Complications.
- physiology : Dominance, Cerebral.
- physiopathology : Globus Pallidus, Parkinson Disease, Postoperative Complications.
- surgery : Globus Pallidus, Parkinson Disease.
- Adult, Aged, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neurologic Examination, Neuropsychological Tests, Pilot Projects, Quality of Life, Stereotaxic Techniques, Treatment Outcome.
Abstract
To assess the long-term outcome following unilateral pallidotomy for advanced Parkinson's disease, we performed nonblinded Core Assessment Program for Intracerebral Transplantations protocol assessments in 10 of the original 15 patients in our pilot study for 4 years following surgery. Although Unified Parkinson's Disease Rating Scale motor examination scores returned to baseline levels at 3 and 4 years, most patients continued to show sustained improvements in contralateral tremor, akinesia, and drug-induced dyskinesias. Contralateral tremor was absent at 4 years in all seven patients with preoperative tremor. Contralateral "off" arm movement times (averaged for three tasks) decreased by 37% at 1 year and by 30% at 4 years. Contralateral dyskinesia scores improved by 82% at 1 year and by 64% at 4 years. In contrast, after reaching speeds equal to the contralateral side at 1 year, ipsilateral "off" movement times increased by 13% over baseline levels at 4 years. Although most gait and postural stability measures showed modest initial improvement followed by a return to baseline values, "on" stand-walk-sit task performance declined significantly at 4 years. Despite the restriction of our surgeries to one side and the expected natural progression of Parkinson's disease, the results of patient self-assessments suggest that 4 years after unilateral pallidotomy, most patients continue to experience a quality of life above preoperative levels.
PubMed: 10752571
Affiliations:
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Green</name></author><author><name sortKey="Mcdonald, W M" sort="Mcdonald, W M" uniqKey="Mcdonald W" first="W M" last="Mcdonald">W M Mcdonald</name></author><author><name sortKey="Cole, S A" sort="Cole, S A" uniqKey="Cole S" first="S A" last="Cole">S A Cole</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></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2000">2000</date><idno type="RBID">pubmed:10752571</idno><idno type="pmid">10752571</idno><idno type="wicri:Area/PubMed/Corpus">004031</idno><idno type="wicri:Area/PubMed/Curation">004031</idno><idno type="wicri:Area/PubMed/Checkpoint">003E43</idno><idno type="wicri:Area/Ncbi/Merge">000220</idno><idno type="wicri:Area/Ncbi/Curation">000220</idno><idno type="wicri:Area/Ncbi/Checkpoint">000220</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Treatment of advanced Parkinson's disease by unilateral posterior GPi pallidotomy: 4-year results of a pilot study.</title><author><name sortKey="Baron, M S" sort="Baron, M S" uniqKey="Baron M" first="M S" last="Baron">M S Baron</name><affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurology, Emory University School of Medicine, Atlanta, Georgia</wicri:regionArea><placeName><region type="state">Géorgie (États-Unis)</region></placeName></affiliation></author><author><name sortKey="Vitek, J L" sort="Vitek, J L" uniqKey="Vitek J" first="J L" last="Vitek">J L Vitek</name></author><author><name sortKey="Bakay, R A" sort="Bakay, R A" uniqKey="Bakay R" first="R A" last="Bakay">R A Bakay</name></author><author><name sortKey="Green, J" sort="Green, J" uniqKey="Green J" first="J" last="Green">J. Green</name></author><author><name sortKey="Mcdonald, W M" sort="Mcdonald, W M" uniqKey="Mcdonald W" first="W M" last="Mcdonald">W M Mcdonald</name></author><author><name sortKey="Cole, S A" sort="Cole, S A" uniqKey="Cole S" first="S A" last="Cole">S A Cole</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></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="2000" type="published">2000</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Dominance, Cerebral (physiology)</term><term>Female</term><term>Follow-Up Studies</term><term>Globus Pallidus (physiopathology)</term><term>Globus Pallidus (surgery)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Neurologic Examination</term><term>Neuropsychological Tests</term><term>Parkinson Disease (diagnosis)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (surgery)</term><term>Pilot Projects</term><term>Postoperative Complications (etiology)</term><term>Postoperative Complications (physiopathology)</term><term>Quality of Life</term><term>Stereotaxic Techniques</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Dominance, Cerebral</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Globus Pallidus</term><term>Parkinson Disease</term><term>Postoperative Complications</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Globus Pallidus</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Neurologic Examination</term><term>Neuropsychological Tests</term><term>Pilot Projects</term><term>Quality of Life</term><term>Stereotaxic Techniques</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">To assess the long-term outcome following unilateral pallidotomy for advanced Parkinson's disease, we performed nonblinded Core Assessment Program for Intracerebral Transplantations protocol assessments in 10 of the original 15 patients in our pilot study for 4 years following surgery. Although Unified Parkinson's Disease Rating Scale motor examination scores returned to baseline levels at 3 and 4 years, most patients continued to show sustained improvements in contralateral tremor, akinesia, and drug-induced dyskinesias. Contralateral tremor was absent at 4 years in all seven patients with preoperative tremor. Contralateral "off" arm movement times (averaged for three tasks) decreased by 37% at 1 year and by 30% at 4 years. Contralateral dyskinesia scores improved by 82% at 1 year and by 64% at 4 years. In contrast, after reaching speeds equal to the contralateral side at 1 year, ipsilateral "off" movement times increased by 13% over baseline levels at 4 years. Although most gait and postural stability measures showed modest initial improvement followed by a return to baseline values, "on" stand-walk-sit task performance declined significantly at 4 years. Despite the restriction of our surgeries to one side and the expected natural progression of Parkinson's disease, the results of patient self-assessments suggest that 4 years after unilateral pallidotomy, most patients continue to experience a quality of life above preoperative levels.</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Géorgie (États-Unis)</li></region></list><tree><noCountry><name sortKey="Bakay, R A" sort="Bakay, R A" uniqKey="Bakay R" first="R A" last="Bakay">R A Bakay</name><name sortKey="Cole, S A" sort="Cole, S A" uniqKey="Cole S" first="S A" last="Cole">S A Cole</name><name sortKey="Delong, M R" sort="Delong, M R" uniqKey="Delong M" first="M R" last="Delong">M R Delong</name><name sortKey="Green, J" sort="Green, J" uniqKey="Green J" first="J" last="Green">J. Green</name><name sortKey="Mcdonald, W M" sort="Mcdonald, W M" uniqKey="Mcdonald W" first="W M" last="Mcdonald">W M Mcdonald</name><name sortKey="Vitek, J L" sort="Vitek, J L" uniqKey="Vitek J" first="J L" last="Vitek">J L Vitek</name></noCountry><country name="États-Unis"><region name="Géorgie (États-Unis)"><name sortKey="Baron, M S" sort="Baron, M S" uniqKey="Baron M" first="M S" last="Baron">M S Baron</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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