Effects of chronic subthalamic stimulation on nonmotor fluctuations in Parkinson's disease.
Identifieur interne : 001C97 ( Ncbi/Merge ); précédent : 001C96; suivant : 001C98Effects of chronic subthalamic stimulation on nonmotor fluctuations in Parkinson's disease.
Auteurs : Tatiana Witjas [France] ; Elsa Kaphan ; Jean Régis ; Elisabeth Jouve ; André Ali Chérif ; Jean-Claude Péragut ; Jean Philippe AzulaySource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2007.
English descriptors
- KwdEn :
- Aged, Autonomic Nervous System Diseases (etiology), Autonomic Nervous System Diseases (therapy), Deep Brain Stimulation (methods), Female, Humans, Male, Mental Disorders (etiology), Mental Disorders (therapy), Middle Aged, Pain (etiology), Pain Management, Parkinson Disease (complications), Parkinson Disease (psychology), Parkinson Disease (therapy), Retrospective Studies, Subthalamic Nucleus (physiopathology), Subthalamic Nucleus (radiation effects).
- MESH :
- complications : Parkinson Disease.
- etiology : Autonomic Nervous System Diseases, Mental Disorders, Pain.
- methods : Deep Brain Stimulation.
- physiopathology : Subthalamic Nucleus.
- psychology : Parkinson Disease.
- radiation effects : Subthalamic Nucleus.
- therapy : Autonomic Nervous System Diseases, Mental Disorders, Parkinson Disease.
- Aged, Female, Humans, Male, Middle Aged, Pain Management, Retrospective Studies.
Abstract
The aim of this study was to assess the outcome of nonmotor fluctuations (NMF) after chronic Subthalamic nucleus (STN) Deep Brain Stimulation (DBS) in Parkinson's disease(PD). Chronic stimulation of the STN has proved to be an effective treatment for advanced PD with motor complications. The outcome of NMF, which are also disabling, remains unknown. Forty-patients underwent bilateral STN stimulation. Each patient was interviewed before and after 1 yr of STN DBS with a structured questionnaire about their NMF. After 1 yr of chronic stimulation, the improvement in the motor score (UPDRS III) and dyskinesia amounted respectively to 67.4 and 76.3%. The decrease in motor fluctuations (MF) was 59% and 13 patients reported that their MF had disappeared. Comparatively, a reduction of the total number of NMF was also observed (mean number preoperatively: 15.6 per patient, postoperatively: 6.6). Most of the nonmotor fluctuating symptoms occurred in the "off" state preoperatively and no longer depended on the patient's motor state after surgery. The improvement in NMF was not identical for the different categories: pain/sensory fluctuations showed the best response to STN DBS (84.2%). Dysautonomic and cognitive fluctuations were also markedly improved (>60%) while psychic fluctuations remained the most frequent postoperative NMF observed. Some incapacitating manifestations such as drenching sweats and akathisia showed a remarkably good response to STN stimulation. In conclusion STN DBS alleviates NMF. It has strikingly successful effects on sensory, dysautonomic and cognitive fluctuations. However, psychic fluctuations respond less consistently to this treatment.
DOI: 10.1002/mds.21602
PubMed: 17557355
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Effects of chronic subthalamic stimulation on nonmotor fluctuations in Parkinson's disease.</title><author><name sortKey="Witjas, Tatiana" sort="Witjas, Tatiana" uniqKey="Witjas T" first="Tatiana" last="Witjas">Tatiana Witjas</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Neurosciences, University Hospital Timone, Marseille, France. tatiana.witjas@ap-hm.fr</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical Neurosciences, University Hospital Timone, Marseille</wicri:regionArea><placeName><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Kaphan, Elsa" sort="Kaphan, Elsa" uniqKey="Kaphan E" first="Elsa" last="Kaphan">Elsa Kaphan</name></author><author><name sortKey="Regis, Jean" sort="Regis, Jean" uniqKey="Regis J" first="Jean" last="Régis">Jean Régis</name></author><author><name sortKey="Jouve, Elisabeth" sort="Jouve, Elisabeth" uniqKey="Jouve E" first="Elisabeth" last="Jouve">Elisabeth Jouve</name></author><author><name sortKey="Cherif, Andre Ali" sort="Cherif, Andre Ali" uniqKey="Cherif A" first="André Ali" last="Chérif">André Ali Chérif</name></author><author><name sortKey="Peragut, Jean Claude" sort="Peragut, Jean Claude" uniqKey="Peragut J" first="Jean-Claude" last="Péragut">Jean-Claude Péragut</name></author><author><name sortKey="Azulay, Jean Philippe" sort="Azulay, Jean Philippe" uniqKey="Azulay J" first="Jean Philippe" last="Azulay">Jean Philippe Azulay</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2007">2007</date><idno type="doi">10.1002/mds.21602</idno><idno type="RBID">pubmed:17557355</idno><idno type="pmid">17557355</idno><idno type="wicri:Area/PubMed/Corpus">002642</idno><idno type="wicri:Area/PubMed/Curation">002642</idno><idno type="wicri:Area/PubMed/Checkpoint">002841</idno><idno 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Régis</name></author><author><name sortKey="Jouve, Elisabeth" sort="Jouve, Elisabeth" uniqKey="Jouve E" first="Elisabeth" last="Jouve">Elisabeth Jouve</name></author><author><name sortKey="Cherif, Andre Ali" sort="Cherif, Andre Ali" uniqKey="Cherif A" first="André Ali" last="Chérif">André Ali Chérif</name></author><author><name sortKey="Peragut, Jean Claude" sort="Peragut, Jean Claude" uniqKey="Peragut J" first="Jean-Claude" last="Péragut">Jean-Claude Péragut</name></author><author><name sortKey="Azulay, Jean Philippe" sort="Azulay, Jean Philippe" uniqKey="Azulay J" first="Jean Philippe" last="Azulay">Jean Philippe Azulay</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="2007" type="published">2007</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Autonomic Nervous System Diseases (etiology)</term><term>Autonomic Nervous System Diseases (therapy)</term><term>Deep Brain Stimulation (methods)</term><term>Female</term><term>Humans</term><term>Male</term><term>Mental Disorders (etiology)</term><term>Mental Disorders (therapy)</term><term>Middle Aged</term><term>Pain (etiology)</term><term>Pain Management</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (psychology)</term><term>Parkinson Disease (therapy)</term><term>Retrospective Studies</term><term>Subthalamic Nucleus (physiopathology)</term><term>Subthalamic Nucleus (radiation effects)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Autonomic Nervous System Diseases</term><term>Mental Disorders</term><term>Pain</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="radiation effects" xml:lang="en"><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Autonomic Nervous System Diseases</term><term>Mental Disorders</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pain Management</term><term>Retrospective Studies</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aim of this study was to assess the outcome of nonmotor fluctuations (NMF) after chronic Subthalamic nucleus (STN) Deep Brain Stimulation (DBS) in Parkinson's disease(PD). Chronic stimulation of the STN has proved to be an effective treatment for advanced PD with motor complications. The outcome of NMF, which are also disabling, remains unknown. Forty-patients underwent bilateral STN stimulation. Each patient was interviewed before and after 1 yr of STN DBS with a structured questionnaire about their NMF. After 1 yr of chronic stimulation, the improvement in the motor score (UPDRS III) and dyskinesia amounted respectively to 67.4 and 76.3%. The decrease in motor fluctuations (MF) was 59% and 13 patients reported that their MF had disappeared. Comparatively, a reduction of the total number of NMF was also observed (mean number preoperatively: 15.6 per patient, postoperatively: 6.6). Most of the nonmotor fluctuating symptoms occurred in the "off" state preoperatively and no longer depended on the patient's motor state after surgery. The improvement in NMF was not identical for the different categories: pain/sensory fluctuations showed the best response to STN DBS (84.2%). Dysautonomic and cognitive fluctuations were also markedly improved (>60%) while psychic fluctuations remained the most frequent postoperative NMF observed. Some incapacitating manifestations such as drenching sweats and akathisia showed a remarkably good response to STN stimulation. In conclusion STN DBS alleviates NMF. It has strikingly successful effects on sensory, dysautonomic and cognitive fluctuations. However, psychic fluctuations respond less consistently to this treatment.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">17557355</PMID><DateCreated><Year>2007</Year><Month>10</Month><Day>01</Day></DateCreated><DateCompleted><Year>2008</Year><Month>01</Month><Day>09</Day></DateCompleted><DateRevised><Year>2011</Year><Month>11</Month><Day>17</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0885-3185</ISSN><JournalIssue CitedMedium="Print"><Volume>22</Volume><Issue>12</Issue><PubDate><Year>2007</Year><Month>Sep</Month><Day>15</Day></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Effects of chronic subthalamic stimulation on nonmotor fluctuations in Parkinson's disease.</ArticleTitle><Pagination><MedlinePgn>1729-34</MedlinePgn></Pagination><Abstract><AbstractText>The aim of this study was to assess the outcome of nonmotor fluctuations (NMF) after chronic Subthalamic nucleus (STN) Deep Brain Stimulation (DBS) in Parkinson's disease(PD). Chronic stimulation of the STN has proved to be an effective treatment for advanced PD with motor complications. The outcome of NMF, which are also disabling, remains unknown. Forty-patients underwent bilateral STN stimulation. Each patient was interviewed before and after 1 yr of STN DBS with a structured questionnaire about their NMF. After 1 yr of chronic stimulation, the improvement in the motor score (UPDRS III) and dyskinesia amounted respectively to 67.4 and 76.3%. The decrease in motor fluctuations (MF) was 59% and 13 patients reported that their MF had disappeared. Comparatively, a reduction of the total number of NMF was also observed (mean number preoperatively: 15.6 per patient, postoperatively: 6.6). Most of the nonmotor fluctuating symptoms occurred in the "off" state preoperatively and no longer depended on the patient's motor state after surgery. The improvement in NMF was not identical for the different categories: pain/sensory fluctuations showed the best response to STN DBS (84.2%). Dysautonomic and cognitive fluctuations were also markedly improved (>60%) while psychic fluctuations remained the most frequent postoperative NMF observed. Some incapacitating manifestations such as drenching sweats and akathisia showed a remarkably good response to STN stimulation. In conclusion STN DBS alleviates NMF. It has strikingly successful effects on sensory, dysautonomic and cognitive fluctuations. However, psychic fluctuations respond less consistently to this treatment.</AbstractText><CopyrightInformation>(c) 2007 Movement Disorder Society.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Witjas</LastName><ForeName>Tatiana</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Department of Clinical Neurosciences, University Hospital Timone, Marseille, France. tatiana.witjas@ap-hm.fr</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kaphan</LastName><ForeName>Elsa</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Régis</LastName><ForeName>Jean</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Jouve</LastName><ForeName>Elisabeth</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Chérif</LastName><ForeName>André Ali</ForeName><Initials>AA</Initials></Author><Author ValidYN="Y"><LastName>Péragut</LastName><ForeName>Jean-Claude</ForeName><Initials>JC</Initials></Author><Author ValidYN="Y"><LastName>Azulay</LastName><ForeName>Jean Philippe</ForeName><Initials>JP</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mov Disord</MedlineTA><NlmUniqueID>8610688</NlmUniqueID><ISSNLinking>0885-3185</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000368">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D001342">Autonomic Nervous System Diseases</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000209">etiology</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000628">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D046690">Deep Brain Stimulation</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000379">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D005260">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008297">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D001523">Mental Disorders</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000209">etiology</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000628">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D008875">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D010146">Pain</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000209">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="Y" UI="D059408">Pain Management</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="Y" UI="D010300">Parkinson Disease</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000150">complications</QualifierName><QualifierName MajorTopicYN="N" UI="Q000523">psychology</QualifierName><QualifierName MajorTopicYN="N" UI="Q000628">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D012189">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D020531">Subthalamic Nucleus</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000503">physiopathology</QualifierName><QualifierName MajorTopicYN="N" UI="Q000528">radiation effects</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2007</Year><Month>6</Month><Day>9</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2008</Year><Month>1</Month><Day>10</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2007</Year><Month>6</Month><Day>9</Day><Hour>9</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="doi">10.1002/mds.21602</ArticleId><ArticleId IdType="pubmed">17557355</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>France</li></country><settlement><li>Marseille</li></settlement></list><tree><noCountry><name sortKey="Azulay, Jean Philippe" sort="Azulay, Jean Philippe" uniqKey="Azulay J" first="Jean Philippe" last="Azulay">Jean Philippe Azulay</name><name sortKey="Cherif, Andre Ali" sort="Cherif, Andre Ali" uniqKey="Cherif A" first="André Ali" last="Chérif">André Ali Chérif</name><name sortKey="Jouve, Elisabeth" sort="Jouve, Elisabeth" uniqKey="Jouve E" first="Elisabeth" last="Jouve">Elisabeth Jouve</name><name sortKey="Kaphan, Elsa" sort="Kaphan, Elsa" uniqKey="Kaphan E" first="Elsa" last="Kaphan">Elsa Kaphan</name><name sortKey="Peragut, Jean Claude" sort="Peragut, Jean Claude" uniqKey="Peragut J" first="Jean-Claude" last="Péragut">Jean-Claude Péragut</name><name sortKey="Regis, Jean" sort="Regis, Jean" uniqKey="Regis J" first="Jean" last="Régis">Jean Régis</name></noCountry><country name="France"><noRegion><name sortKey="Witjas, Tatiana" sort="Witjas, Tatiana" uniqKey="Witjas T" first="Tatiana" last="Witjas">Tatiana Witjas</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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