Extradural motor cortex stimulation in Parkinson's disease.
Identifieur interne : 001934 ( Ncbi/Merge ); précédent : 001933; suivant : 001935Extradural motor cortex stimulation in Parkinson's disease.
Auteurs : Roberto Cilia [Italie] ; Andrea Landi ; Francesco Vergani ; Erik Sganzerla ; Gianni Pezzoli ; Angelo AntoniniSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2007.
English descriptors
- KwdEn :
- MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- methods : Electric Stimulation.
- pathology : Parkinson Disease.
- radiation effects : Motor Cortex.
- therapy : Parkinson Disease.
- Aged, Female, Humans, Male, Severity of Illness Index, Treatment Outcome.
Abstract
Extradural motor cortex stimulation (EMCS) is a surgical procedure proposed for patients with advanced Parkinson's disease (PD) who cannot undergo deep brain stimulation (DBS). Five PD patients with motor fluctuations and dyskinesia underwent EMCS of the left hemisphere. All fulfilled CAPSIT criteria for DBS, with the exception of age > 70 years. Patients were assessed preoperatively and 6 months after surgery on and off medications, with stimulator on, and 2 weeks later with stimulator off. Outcome measures included changes in mean medication dosage (levodopa and dopamine agonists), Unified Parkinson's Disease Rating Scale (UPDRS Parts II-III and Item 39), and dyskinesias (Abnormal Involuntary Movements Scale [AIMS]). We found no significant mean changes following EMCS. However, there was a trend for a reduction of mean daily medication intake (-30%) and AIMS (-19%). There were 3 patients who reported reduced OFF time (UPDRS Item 39) and 4 of 5 who felt a subjective benefit in stability and gait. In our PD cohort, EMCS induced no objective benefit, although some subjective improvement was reported mostly on axial symptoms.
DOI: 10.1002/mds.21207
PubMed: 17083104
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pubmed:17083104Le document en format XML
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<author><name sortKey="Cilia, Roberto" sort="Cilia, Roberto" uniqKey="Cilia R" first="Roberto" last="Cilia">Roberto Cilia</name>
<affiliation wicri:level="3"><nlm:affiliation>Parkinson Institute, Istituti Clinici di Perfezionamento, Milan, Italy.</nlm:affiliation>
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<wicri:regionArea>Parkinson Institute, Istituti Clinici di Perfezionamento, Milan</wicri:regionArea>
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<author><name sortKey="Landi, Andrea" sort="Landi, Andrea" uniqKey="Landi A" first="Andrea" last="Landi">Andrea Landi</name>
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<author><name sortKey="Vergani, Francesco" sort="Vergani, Francesco" uniqKey="Vergani F" first="Francesco" last="Vergani">Francesco Vergani</name>
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<author><name sortKey="Sganzerla, Erik" sort="Sganzerla, Erik" uniqKey="Sganzerla E" first="Erik" last="Sganzerla">Erik Sganzerla</name>
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<author><name sortKey="Pezzoli, Gianni" sort="Pezzoli, Gianni" uniqKey="Pezzoli G" first="Gianni" last="Pezzoli">Gianni Pezzoli</name>
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<author><name sortKey="Antonini, Angelo" sort="Antonini, Angelo" uniqKey="Antonini A" first="Angelo" last="Antonini">Angelo Antonini</name>
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<term>Humans</term>
<term>Levodopa (therapeutic use)</term>
<term>Male</term>
<term>Motor Cortex (radiation effects)</term>
<term>Parkinson Disease (pathology)</term>
<term>Parkinson Disease (therapy)</term>
<term>Severity of Illness Index</term>
<term>Treatment Outcome</term>
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<front><div type="abstract" xml:lang="en">Extradural motor cortex stimulation (EMCS) is a surgical procedure proposed for patients with advanced Parkinson's disease (PD) who cannot undergo deep brain stimulation (DBS). Five PD patients with motor fluctuations and dyskinesia underwent EMCS of the left hemisphere. All fulfilled CAPSIT criteria for DBS, with the exception of age > 70 years. Patients were assessed preoperatively and 6 months after surgery on and off medications, with stimulator on, and 2 weeks later with stimulator off. Outcome measures included changes in mean medication dosage (levodopa and dopamine agonists), Unified Parkinson's Disease Rating Scale (UPDRS Parts II-III and Item 39), and dyskinesias (Abnormal Involuntary Movements Scale [AIMS]). We found no significant mean changes following EMCS. However, there was a trend for a reduction of mean daily medication intake (-30%) and AIMS (-19%). There were 3 patients who reported reduced OFF time (UPDRS Item 39) and 4 of 5 who felt a subjective benefit in stability and gait. In our PD cohort, EMCS induced no objective benefit, although some subjective improvement was reported mostly on axial symptoms.</div>
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<Abstract><AbstractText>Extradural motor cortex stimulation (EMCS) is a surgical procedure proposed for patients with advanced Parkinson's disease (PD) who cannot undergo deep brain stimulation (DBS). Five PD patients with motor fluctuations and dyskinesia underwent EMCS of the left hemisphere. All fulfilled CAPSIT criteria for DBS, with the exception of age > 70 years. Patients were assessed preoperatively and 6 months after surgery on and off medications, with stimulator on, and 2 weeks later with stimulator off. Outcome measures included changes in mean medication dosage (levodopa and dopamine agonists), Unified Parkinson's Disease Rating Scale (UPDRS Parts II-III and Item 39), and dyskinesias (Abnormal Involuntary Movements Scale [AIMS]). We found no significant mean changes following EMCS. However, there was a trend for a reduction of mean daily medication intake (-30%) and AIMS (-19%). There were 3 patients who reported reduced OFF time (UPDRS Item 39) and 4 of 5 who felt a subjective benefit in stability and gait. In our PD cohort, EMCS induced no objective benefit, although some subjective improvement was reported mostly on axial symptoms.</AbstractText>
<CopyrightInformation>Copyright 2006 Movement Disorder Society.</CopyrightInformation>
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