Interruption of deep brain stimulation of the globus pallidus in primary generalized dystonia.
Identifieur interne : 002891 ( Ncbi/Curation ); précédent : 002890; suivant : 002892Interruption of deep brain stimulation of the globus pallidus in primary generalized dystonia.
Auteurs : David Grabli [France] ; Claire Ewenczyk ; Maria-Clara Coelho-Braga ; Christelle Lagrange ; Valerie Fraix ; Philippe Cornu ; Alim-Louis Benabid ; Marie Vidailhet ; Pierre PollakSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2009.
English descriptors
- KwdEn :
- MESH :
- methods : Deep Brain Stimulation.
- physiology : Globus Pallidus.
- therapy : Dystonia.
- Adult, Disability Evaluation, Double-Blind Method, Female, Humans, Male, Middle Aged, Severity of Illness Index, Time Factors, Young Adult.
Abstract
Stimulation (DBS) of the globus pallidus (GP) is effective to treat generalized dystonia. Little is known about the evolution of dystonia in case of arrest after a long period of stimulation. This study describes the course of dystonia during a 48 hours period without stimulation followed by a 24 hours period after turning ON the stimulator. 14 patients with generalized dystonia treated with bilateral GP DBS for 3 years or more were recruited. Blinded video-based analysis was performed using Burke-Fahn-Marsden scale at (1) baseline (ON stimulation), (2) up to 48 hours after the stimulator was turned OFF, and (3) 24 hours after the stimulator was turned ON. 13 patients completed the 48 hours OFF-stimulation period. The dystonia movement score progressively worsened from 24.3 +/- 13.9 at baseline to 48.9 +/- 19.8 after 48 hours (P < 0.00001). The disability score also worsened from 4.4 +/- 1.2 at baseline to 5.7 +/- 1.5 after 48 hours without stimulation (P < 0.001). When the neurostimulator was turned ON, the dystonia scores returned to baseline level after 10 hours. The interruption of GP DBS in dystonia results in a progressive worsening which is rapidly reversible once the neurostimulator is turned ON.
DOI: 10.1002/mds.22827
PubMed: 19908309
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uniqKey="Coelho Braga M" first="Maria-Clara" last="Coelho-Braga">Maria-Clara Coelho-Braga</name></author><author><name sortKey="Lagrange, Christelle" sort="Lagrange, Christelle" uniqKey="Lagrange C" first="Christelle" last="Lagrange">Christelle Lagrange</name></author><author><name sortKey="Fraix, Valerie" sort="Fraix, Valerie" uniqKey="Fraix V" first="Valerie" last="Fraix">Valerie Fraix</name></author><author><name sortKey="Cornu, Philippe" sort="Cornu, Philippe" uniqKey="Cornu P" first="Philippe" last="Cornu">Philippe Cornu</name></author><author><name sortKey="Benabid, Alim Louis" sort="Benabid, Alim Louis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name></author><author><name sortKey="Vidailhet, Marie" sort="Vidailhet, Marie" uniqKey="Vidailhet M" first="Marie" last="Vidailhet">Marie Vidailhet</name></author><author><name sortKey="Pollak, Pierre" sort="Pollak, Pierre" uniqKey="Pollak P" first="Pierre" last="Pollak">Pierre 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david.grabli@psl.aphp.fr</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Neurology Department and Centre de Référence des Maladies Neurogénétiques, Hôpital de la Salpétrière, Paris</wicri:regionArea><placeName><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Ewenczyk, Claire" sort="Ewenczyk, Claire" uniqKey="Ewenczyk C" first="Claire" last="Ewenczyk">Claire Ewenczyk</name></author><author><name sortKey="Coelho Braga, Maria Clara" sort="Coelho Braga, Maria Clara" uniqKey="Coelho Braga M" first="Maria-Clara" last="Coelho-Braga">Maria-Clara Coelho-Braga</name></author><author><name sortKey="Lagrange, Christelle" sort="Lagrange, Christelle" uniqKey="Lagrange C" first="Christelle" last="Lagrange">Christelle Lagrange</name></author><author><name sortKey="Fraix, Valerie" sort="Fraix, Valerie" uniqKey="Fraix V" first="Valerie" last="Fraix">Valerie Fraix</name></author><author><name sortKey="Cornu, Philippe" sort="Cornu, Philippe" uniqKey="Cornu P" first="Philippe" last="Cornu">Philippe Cornu</name></author><author><name sortKey="Benabid, Alim Louis" sort="Benabid, Alim Louis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name></author><author><name sortKey="Vidailhet, Marie" sort="Vidailhet, Marie" uniqKey="Vidailhet M" first="Marie" last="Vidailhet">Marie Vidailhet</name></author><author><name sortKey="Pollak, Pierre" sort="Pollak, Pierre" uniqKey="Pollak P" first="Pierre" last="Pollak">Pierre Pollak</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>Adult</term><term>Deep Brain Stimulation (methods)</term><term>Disability Evaluation</term><term>Double-Blind Method</term><term>Dystonia (therapy)</term><term>Female</term><term>Globus Pallidus (physiology)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Severity of Illness Index</term><term>Time Factors</term><term>Young Adult</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>Globus Pallidus</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Dystonia</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Disability Evaluation</term><term>Double-Blind Method</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Severity of Illness Index</term><term>Time Factors</term><term>Young Adult</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Stimulation (DBS) of the globus pallidus (GP) is effective to treat generalized dystonia. Little is known about the evolution of dystonia in case of arrest after a long period of stimulation. This study describes the course of dystonia during a 48 hours period without stimulation followed by a 24 hours period after turning ON the stimulator. 14 patients with generalized dystonia treated with bilateral GP DBS for 3 years or more were recruited. Blinded video-based analysis was performed using Burke-Fahn-Marsden scale at (1) baseline (ON stimulation), (2) up to 48 hours after the stimulator was turned OFF, and (3) 24 hours after the stimulator was turned ON. 13 patients completed the 48 hours OFF-stimulation period. The dystonia movement score progressively worsened from 24.3 +/- 13.9 at baseline to 48.9 +/- 19.8 after 48 hours (P < 0.00001). The disability score also worsened from 4.4 +/- 1.2 at baseline to 5.7 +/- 1.5 after 48 hours without stimulation (P < 0.001). When the neurostimulator was turned ON, the dystonia scores returned to baseline level after 10 hours. The interruption of GP DBS in dystonia results in a progressive worsening which is rapidly reversible once the neurostimulator is turned ON.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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