Two-year follow-up on the effect of unilateral subthalamic deep brain stimulation in highly asymmetric Parkinson's disease.
Identifieur interne : 002430 ( Ncbi/Checkpoint ); précédent : 002429; suivant : 002431Two-year follow-up on the effect of unilateral subthalamic deep brain stimulation in highly asymmetric Parkinson's disease.
Auteurs : Han-Joon Kim [Corée du Sud] ; Sun Ha Paek ; Ji-Young Kim ; Jee-Young Lee ; Yong Hoon Lim ; Dong Gyu Kim ; Beom S. JeonSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2009.
English descriptors
- KwdEn :
- Aged, Antiparkinson Agents (therapeutic use), Cognition Disorders (diagnosis), Cognition Disorders (epidemiology), Combined Modality Therapy, Deep Brain Stimulation (methods), Drug Resistance, Female, Follow-Up Studies, Functional Laterality (physiology), Humans, Hypokinesia (diagnosis), Hypokinesia (epidemiology), Levodopa (therapeutic use), Male, Middle Aged, Neuropsychological Tests, Parkinson Disease (physiopathology), Parkinson Disease (surgery), Parkinson Disease (therapy), Postoperative Care, Posture, Preoperative Care, Questionnaires, Severity of Illness Index, Subthalamic Nucleus (physiopathology), Time Factors, Tremor (diagnosis), Tremor (epidemiology).
- MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- diagnosis : Cognition Disorders, Hypokinesia, Tremor.
- epidemiology : Cognition Disorders, Hypokinesia, Tremor.
- methods : Deep Brain Stimulation.
- physiology : Functional Laterality.
- physiopathology : Parkinson Disease, Subthalamic Nucleus.
- surgery : Parkinson Disease.
- therapy : Parkinson Disease.
- Aged, Combined Modality Therapy, Drug Resistance, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neuropsychological Tests, Postoperative Care, Posture, Preoperative Care, Questionnaires, Severity of Illness Index, Time Factors.
Abstract
Although bilateral subthalamic deep brain stimulation (STN DBS) provides greater relief from the symptoms of Parkinson's disease (PD) than unilateral STN DBS, it has been suggested that unilateral STN DBS may be a reasonable treatment option in selected patients, especially those with highly asymmetric PD. In previous studies on the effect of unilateral STN DBS, the asymmetry of PD symptoms was not prominent and the mean follow-up durations were only 3 to 12 months. In this study, we report our findings in a series of 8 patients with highly asymmetric PD who were treated with unilateral STN DBS and were followed for 24 months. Serial changes in Unified Parkinson's Disease Rating Scale (UPDRS) motor score and subscores in the ipsilateral, contralateral, and axial body parts were analyzed. Unilateral STN DBS improved the UPDRS motor score and the contralateral subscore in the on-medication state for 5 nonfluctuating patients and in the off-medication state for 3 fluctuating patients. However, the ipsilateral subscore progressively worsened and reversed asymmetry became difficult to manage, which led to compromised medication and stimulator adjustment. At 24 months, all the patients were considering the second-side surgery. Our results suggest that bilateral STN DBS should be considered even in highly asymmetric PD.
DOI: 10.1002/mds.22211
PubMed: 19006187
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Two-year follow-up on the effect of unilateral subthalamic deep brain stimulation in highly asymmetric Parkinson's disease.</title><author><name sortKey="Kim, Han Joon" sort="Kim, Han Joon" uniqKey="Kim H" first="Han-Joon" last="Kim">Han-Joon Kim</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-Si, Gyeonggi-Do, Korea.</nlm:affiliation><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-Si, Gyeonggi-Do</wicri:regionArea><wicri:noRegion>Gyeonggi-Do</wicri:noRegion></affiliation></author><author><name sortKey="Paek, Sun Ha" sort="Paek, Sun Ha" uniqKey="Paek S" first="Sun Ha" last="Paek">Sun Ha Paek</name></author><author><name sortKey="Kim, Ji Young" sort="Kim, Ji Young" uniqKey="Kim J" first="Ji-Young" last="Kim">Ji-Young Kim</name></author><author><name sortKey="Lee, Jee Young" sort="Lee, Jee Young" uniqKey="Lee J" first="Jee-Young" last="Lee">Jee-Young Lee</name></author><author><name sortKey="Lim, Yong Hoon" sort="Lim, Yong Hoon" uniqKey="Lim Y" first="Yong Hoon" last="Lim">Yong Hoon Lim</name></author><author><name sortKey="Kim, Dong Gyu" sort="Kim, Dong Gyu" uniqKey="Kim D" first="Dong Gyu" last="Kim">Dong Gyu Kim</name></author><author><name sortKey="Jeon, Beom S" sort="Jeon, Beom S" uniqKey="Jeon B" first="Beom S" last="Jeon">Beom S. Jeon</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2009">2009</date><idno type="doi">10.1002/mds.22211</idno><idno type="RBID">pubmed:19006187</idno><idno type="pmid">19006187</idno><idno type="wicri:Area/PubMed/Corpus">001F34</idno><idno type="wicri:Area/PubMed/Curation">001F34</idno><idno type="wicri:Area/PubMed/Checkpoint">001B17</idno><idno type="wicri:Area/Ncbi/Merge">002430</idno><idno type="wicri:Area/Ncbi/Curation">002430</idno><idno type="wicri:Area/Ncbi/Checkpoint">002430</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Two-year follow-up on the effect of unilateral subthalamic deep brain stimulation in highly asymmetric Parkinson's disease.</title><author><name sortKey="Kim, Han Joon" sort="Kim, Han Joon" uniqKey="Kim H" first="Han-Joon" last="Kim">Han-Joon Kim</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-Si, Gyeonggi-Do, Korea.</nlm:affiliation><country xml:lang="fr">Corée du Sud</country><wicri:regionArea>Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-Si, Gyeonggi-Do</wicri:regionArea><wicri:noRegion>Gyeonggi-Do</wicri:noRegion></affiliation></author><author><name sortKey="Paek, Sun Ha" sort="Paek, Sun Ha" uniqKey="Paek S" first="Sun Ha" last="Paek">Sun Ha Paek</name></author><author><name sortKey="Kim, Ji Young" sort="Kim, Ji Young" uniqKey="Kim J" first="Ji-Young" last="Kim">Ji-Young Kim</name></author><author><name sortKey="Lee, Jee Young" sort="Lee, Jee Young" uniqKey="Lee J" first="Jee-Young" last="Lee">Jee-Young Lee</name></author><author><name sortKey="Lim, Yong Hoon" sort="Lim, Yong Hoon" uniqKey="Lim Y" first="Yong Hoon" last="Lim">Yong Hoon Lim</name></author><author><name sortKey="Kim, Dong Gyu" sort="Kim, Dong Gyu" uniqKey="Kim D" first="Dong Gyu" last="Kim">Dong Gyu Kim</name></author><author><name sortKey="Jeon, Beom S" sort="Jeon, Beom S" uniqKey="Jeon B" first="Beom S" last="Jeon">Beom S. Jeon</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2009" type="published">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Antiparkinson Agents (therapeutic use)</term><term>Cognition Disorders (diagnosis)</term><term>Cognition Disorders (epidemiology)</term><term>Combined Modality Therapy</term><term>Deep Brain Stimulation (methods)</term><term>Drug Resistance</term><term>Female</term><term>Follow-Up Studies</term><term>Functional Laterality (physiology)</term><term>Humans</term><term>Hypokinesia (diagnosis)</term><term>Hypokinesia (epidemiology)</term><term>Levodopa (therapeutic use)</term><term>Male</term><term>Middle Aged</term><term>Neuropsychological Tests</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (surgery)</term><term>Parkinson Disease (therapy)</term><term>Postoperative Care</term><term>Posture</term><term>Preoperative Care</term><term>Questionnaires</term><term>Severity of Illness Index</term><term>Subthalamic Nucleus (physiopathology)</term><term>Time Factors</term><term>Tremor (diagnosis)</term><term>Tremor (epidemiology)</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>Cognition Disorders</term><term>Hypokinesia</term><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Cognition Disorders</term><term>Hypokinesia</term><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Functional Laterality</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Combined Modality Therapy</term><term>Drug Resistance</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Neuropsychological Tests</term><term>Postoperative Care</term><term>Posture</term><term>Preoperative Care</term><term>Questionnaires</term><term>Severity of Illness Index</term><term>Time Factors</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Although bilateral subthalamic deep brain stimulation (STN DBS) provides greater relief from the symptoms of Parkinson's disease (PD) than unilateral STN DBS, it has been suggested that unilateral STN DBS may be a reasonable treatment option in selected patients, especially those with highly asymmetric PD. In previous studies on the effect of unilateral STN DBS, the asymmetry of PD symptoms was not prominent and the mean follow-up durations were only 3 to 12 months. In this study, we report our findings in a series of 8 patients with highly asymmetric PD who were treated with unilateral STN DBS and were followed for 24 months. Serial changes in Unified Parkinson's Disease Rating Scale (UPDRS) motor score and subscores in the ipsilateral, contralateral, and axial body parts were analyzed. Unilateral STN DBS improved the UPDRS motor score and the contralateral subscore in the on-medication state for 5 nonfluctuating patients and in the off-medication state for 3 fluctuating patients. However, the ipsilateral subscore progressively worsened and reversed asymmetry became difficult to manage, which led to compromised medication and stimulator adjustment. At 24 months, all the patients were considering the second-side surgery. Our results suggest that bilateral STN DBS should be considered even in highly asymmetric PD.</div></front></TEI><affiliations><list><country><li>Corée du Sud</li></country></list><tree><noCountry><name sortKey="Jeon, Beom S" sort="Jeon, Beom S" uniqKey="Jeon B" first="Beom S" last="Jeon">Beom S. Jeon</name><name sortKey="Kim, Dong Gyu" sort="Kim, Dong Gyu" uniqKey="Kim D" first="Dong Gyu" last="Kim">Dong Gyu Kim</name><name sortKey="Kim, Ji Young" sort="Kim, Ji Young" uniqKey="Kim J" first="Ji-Young" last="Kim">Ji-Young Kim</name><name sortKey="Lee, Jee Young" sort="Lee, Jee Young" uniqKey="Lee J" first="Jee-Young" last="Lee">Jee-Young Lee</name><name sortKey="Lim, Yong Hoon" sort="Lim, Yong Hoon" uniqKey="Lim Y" first="Yong Hoon" last="Lim">Yong Hoon Lim</name><name sortKey="Paek, Sun Ha" sort="Paek, Sun Ha" uniqKey="Paek S" first="Sun Ha" last="Paek">Sun Ha Paek</name></noCountry><country name="Corée du Sud"><noRegion><name sortKey="Kim, Han Joon" sort="Kim, Han Joon" uniqKey="Kim H" first="Han-Joon" last="Kim">Han-Joon Kim</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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