Clinical pattern and risk factors for dyskinesias following fetal nigral transplantation in Parkinson's disease: a double blind video-based analysis.
Identifieur interne : 002429 ( Ncbi/Checkpoint ); précédent : 002428; suivant : 002430Clinical pattern and risk factors for dyskinesias following fetal nigral transplantation in Parkinson's disease: a double blind video-based analysis.
Auteurs : C Warren Olanow [États-Unis] ; Jean-Michel Gracies ; Christopher G. Goetz ; A Jon Stoessl ; Thomas Freeman ; Jeffrey H. Kordower ; James Godbold ; Jose A. ObesoSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2009.
English descriptors
- KwdEn :
- Antiparkinson Agents (adverse effects), Cell Transplantation (methods), Double-Blind Method, Dyskinesia, Drug-Induced (diagnosis), Dyskinesia, Drug-Induced (etiology), Dyskinesias (diagnosis), Dyskinesias (etiology), Female, Humans, Levodopa (adverse effects), Male, Middle Aged, Parkinson Disease (complications), Parkinson Disease (drug therapy), Parkinson Disease (surgery), Risk Factors, Severity of Illness Index, Substantia Nigra (cytology), Substantia Nigra (embryology), Substantia Nigra (transplantation), Videotape Recording.
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- complications : Parkinson Disease.
- cytology : Substantia Nigra.
- diagnosis : Dyskinesia, Drug-Induced, Dyskinesias.
- drug therapy : Parkinson Disease.
- embryology : Substantia Nigra.
- etiology : Dyskinesia, Drug-Induced, Dyskinesias.
- methods : Cell Transplantation.
- surgery : Parkinson Disease.
- transplantation : Substantia Nigra.
- Double-Blind Method, Female, Humans, Male, Middle Aged, Risk Factors, Severity of Illness Index, Videotape Recording.
Abstract
The objective of this study is to assess dyskinesias in 34 Parkinson's disease patients randomized to receive bilateral fetal nigral transplantation with 4 donors per side (12), 1 donor per side (11), or placebo (11). Videotape recordings were performed at the baseline, 3, 6, 12, 18, and 24 month visits during the "practically defined off" (12 hours after last evening dopaminergic therapy) and "best on" (best response following morning dopaminergic therapy) states. Videotapes were analyzed in random order by a blinded investigator. Dyskinesias during "best on" (on-medication dyskinesia) were observed in all, but 1 patient at baseline, and in all patients at each subsequent visit. There were no differences between groups. No patient had dyskinesia at baseline in "practically-defined off" ("off-medication" dyskinesia). Following transplantation, off-medication dyskinesia was observed in 13 of 23 patients, but not in any patient in the placebo group (P = 0.019). There was no difference in dyskinesia score between patients in the 1 and 4 donor groups. On-medication dyskinesias were typically generalized and choreiform, whereas off-medication dyskinesias were usually repetitive, stereotypic movements in the lower extremities with residual Parkinsonism in other body regions. Off-medication dyskinesias are common following transplantation and may represent a prolonged form of diphasic dyskinesias.
DOI: 10.1002/mds.22208
PubMed: 19006186
Affiliations:
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pubmed:19006186Le document en format XML
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<author><name sortKey="Olanow, C Warren" sort="Olanow, C Warren" uniqKey="Olanow C" first="C Warren" last="Olanow">C Warren Olanow</name>
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<term>Double-Blind Method</term>
<term>Dyskinesia, Drug-Induced (diagnosis)</term>
<term>Dyskinesia, Drug-Induced (etiology)</term>
<term>Dyskinesias (diagnosis)</term>
<term>Dyskinesias (etiology)</term>
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<term>Parkinson Disease (surgery)</term>
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<term>Substantia Nigra (transplantation)</term>
<term>Videotape Recording</term>
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<front><div type="abstract" xml:lang="en">The objective of this study is to assess dyskinesias in 34 Parkinson's disease patients randomized to receive bilateral fetal nigral transplantation with 4 donors per side (12), 1 donor per side (11), or placebo (11). Videotape recordings were performed at the baseline, 3, 6, 12, 18, and 24 month visits during the "practically defined off" (12 hours after last evening dopaminergic therapy) and "best on" (best response following morning dopaminergic therapy) states. Videotapes were analyzed in random order by a blinded investigator. Dyskinesias during "best on" (on-medication dyskinesia) were observed in all, but 1 patient at baseline, and in all patients at each subsequent visit. There were no differences between groups. No patient had dyskinesia at baseline in "practically-defined off" ("off-medication" dyskinesia). Following transplantation, off-medication dyskinesia was observed in 13 of 23 patients, but not in any patient in the placebo group (P = 0.019). There was no difference in dyskinesia score between patients in the 1 and 4 donor groups. On-medication dyskinesias were typically generalized and choreiform, whereas off-medication dyskinesias were usually repetitive, stereotypic movements in the lower extremities with residual Parkinsonism in other body regions. Off-medication dyskinesias are common following transplantation and may represent a prolonged form of diphasic dyskinesias.</div>
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<name sortKey="Godbold, James" sort="Godbold, James" uniqKey="Godbold J" first="James" last="Godbold">James Godbold</name>
<name sortKey="Goetz, Christopher G" sort="Goetz, Christopher G" uniqKey="Goetz C" first="Christopher G" last="Goetz">Christopher G. Goetz</name>
<name sortKey="Gracies, Jean Michel" sort="Gracies, Jean Michel" uniqKey="Gracies J" first="Jean-Michel" last="Gracies">Jean-Michel Gracies</name>
<name sortKey="Kordower, Jeffrey H" sort="Kordower, Jeffrey H" uniqKey="Kordower J" first="Jeffrey H" last="Kordower">Jeffrey H. Kordower</name>
<name sortKey="Obeso, Jose A" sort="Obeso, Jose A" uniqKey="Obeso J" first="Jose A" last="Obeso">Jose A. Obeso</name>
<name sortKey="Stoessl, A Jon" sort="Stoessl, A Jon" uniqKey="Stoessl A" first="A Jon" last="Stoessl">A Jon Stoessl</name>
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