Levodopa response in long-term bilateral Subthalamic stimulation for Parkinson's disease
Identifieur interne : 001616 ( PascalFrancis/Checkpoint ); précédent : 001615; suivant : 001617Levodopa response in long-term bilateral Subthalamic stimulation for Parkinson's disease
Auteurs : Panida Piboolnurak [Canada, Thaïlande] ; Anthony E. Lang [Canada] ; Andres M. Lozano [Canada] ; Janis M. Miyasaki [Canada] ; Jean A. Saint-Cyr [Canada] ; Yu-Yan W. Poon [Canada] ; William D. Hutchison [Canada] ; Jonathan O. Dostrovsky [Canada] ; Elena Moro [Canada]Source :
- Movement disorders [ 0885-3185 ] ; 2007.
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Abstract
Subthalamic nucleus deep brain stimulation (STN-DBS) is effective in advanced Parkinson's disease (PD), but its effects on the levodopa response are unclear. We studied the levodopa response after long-term STN-DBS, STN-DBS efficacy and predictive value of preoperative levodopa response to long-term DBS benefit in 33 PD patients with bilateral STN-DBS. Patients were assessed using the Unified Parkinson's Disease Rating Scale preoperatively (with and without medications) and postoperatively (without medications or stimulation, with only medications or stimulation, and with both medications and stimulation). Levodopa response significantly decreased postoperatively by 31.1% at 3 years and 32.3% at 5 years, possibly related to the reduction in medication requirement, direct STN stimulation effect or PD progression. STN-DBS alone significantly improved motor scores (37.2% at 3 years and 35.1% at 5 years) and activities of daily living scores (27.1% at 3 years and 19.2% at 5 years). Anti-PD drugs were significantly reduced by 47.9% at 3 years and 39.8% at 5 years. However, the magnitude of the preoperative response to levodopa did not predict DBS benefit at 3 and 5 years.
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">Levodopa response in long-term bilateral Subthalamic stimulation for Parkinson's disease</title><author><name sortKey="Piboolnurak, Panida" sort="Piboolnurak, Panida" uniqKey="Piboolnurak P" first="Panida" last="Piboolnurak">Panida Piboolnurak</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Movement Disorders Center, Division of Neurology, University of Toronto, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Bumrungrad International Hospital</s1><s2>Wattana, Bangkok</s2><s3>THA</s3><sZ>1 aut.</sZ></inist:fA14><country>Thaïlande</country><wicri:noRegion>Bumrungrad International Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. 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Saint-Cyr</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Department of Neurosurgery, University of Toronto, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Poon, Yu Yan W" sort="Poon, Yu Yan W" uniqKey="Poon Y" first="Yu-Yan W." last="Poon">Yu-Yan W. Poon</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Movement Disorders Center, Division of Neurology, University of Toronto, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Hutchison, William D" sort="Hutchison, William D" uniqKey="Hutchison W" first="William D." last="Hutchison">William D. Hutchison</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Department of Neurosurgery, University of Toronto, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Dostrovsky, Jonathan O" sort="Dostrovsky, Jonathan O" uniqKey="Dostrovsky J" first="Jonathan O." last="Dostrovsky">Jonathan O. Dostrovsky</name><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Department of Physiology, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>8 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Movement Disorders Center, Division of Neurology, University of Toronto, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">07-0314955</idno><date when="2007">2007</date><idno type="stanalyst">PASCAL 07-0314955 INIST</idno><idno type="RBID">Pascal:07-0314955</idno><idno type="wicri:Area/PascalFrancis/Corpus">001668</idno><idno type="wicri:Area/PascalFrancis/Curation">001653</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">001616</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Levodopa response in long-term bilateral Subthalamic stimulation for Parkinson's disease</title><author><name sortKey="Piboolnurak, Panida" sort="Piboolnurak, Panida" uniqKey="Piboolnurak P" first="Panida" last="Piboolnurak">Panida Piboolnurak</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Movement Disorders Center, Division of Neurology, University of Toronto, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Bumrungrad International Hospital</s1><s2>Wattana, Bangkok</s2><s3>THA</s3><sZ>1 aut.</sZ></inist:fA14><country>Thaïlande</country><wicri:noRegion>Bumrungrad International Hospital</wicri:noRegion></affiliation></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Movement Disorders Center, Division of Neurology, University of Toronto, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Department of Neurosurgery, University of Toronto, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Miyasaki, Janis M" sort="Miyasaki, Janis M" uniqKey="Miyasaki J" first="Janis M." last="Miyasaki">Janis M. Miyasaki</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Movement Disorders Center, Division of Neurology, University of Toronto, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Saint Cyr, Jean A" sort="Saint Cyr, Jean A" uniqKey="Saint Cyr J" first="Jean A." last="Saint-Cyr">Jean A. Saint-Cyr</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Department of Neurosurgery, University of Toronto, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Poon, Yu Yan W" sort="Poon, Yu Yan W" uniqKey="Poon Y" first="Yu-Yan W." last="Poon">Yu-Yan W. Poon</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Movement Disorders Center, Division of Neurology, University of Toronto, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Hutchison, William D" sort="Hutchison, William D" uniqKey="Hutchison W" first="William D." last="Hutchison">William D. Hutchison</name><affiliation wicri:level="4"><inist:fA14 i1="03"><s1>Department of Neurosurgery, University of Toronto, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Dostrovsky, Jonathan O" sort="Dostrovsky, Jonathan O" uniqKey="Dostrovsky J" first="Jonathan O." last="Dostrovsky">Jonathan O. Dostrovsky</name><affiliation wicri:level="4"><inist:fA14 i1="04"><s1>Department of Physiology, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>8 aut.</sZ></inist:fA14><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName><orgName type="university">Université de Toronto</orgName></affiliation></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>Movement Disorders Center, Division of Neurology, University of Toronto, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Toronto, Ontario</wicri:noRegion><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2007">2007</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Deep brain stimulation</term><term>Levodopa</term><term>Long term</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Subthalamic nucleus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term><term>Parkinson maladie</term><term>Lévodopa</term><term>Long terme</term><term>Noyau sousthalamique</term><term>Stimulation cérébrale profonde</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Subthalamic nucleus deep brain stimulation (STN-DBS) is effective in advanced Parkinson's disease (PD), but its effects on the levodopa response are unclear. We studied the levodopa response after long-term STN-DBS, STN-DBS efficacy and predictive value of preoperative levodopa response to long-term DBS benefit in 33 PD patients with bilateral STN-DBS. Patients were assessed using the Unified Parkinson's Disease Rating Scale preoperatively (with and without medications) and postoperatively (without medications or stimulation, with only medications or stimulation, and with both medications and stimulation). Levodopa response significantly decreased postoperatively by 31.1% at 3 years and 32.3% at 5 years, possibly related to the reduction in medication requirement, direct STN stimulation effect or PD progression. STN-DBS alone significantly improved motor scores (37.2% at 3 years and 35.1% at 5 years) and activities of daily living scores (27.1% at 3 years and 19.2% at 5 years). Anti-PD drugs were significantly reduced by 47.9% at 3 years and 39.8% at 5 years. However, the magnitude of the preoperative response to levodopa did not predict DBS benefit at 3 and 5 years.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>22</s2></fA05><fA06><s2>7</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Levodopa response in long-term bilateral Subthalamic stimulation for Parkinson's disease</s1></fA08><fA11 i1="01" i2="1"><s1>PIBOOLNURAK (Panida)</s1></fA11><fA11 i1="02" i2="1"><s1>LANG (Anthony E.)</s1></fA11><fA11 i1="03" i2="1"><s1>LOZANO (Andres M.)</s1></fA11><fA11 i1="04" i2="1"><s1>MIYASAKI (Janis M.)</s1></fA11><fA11 i1="05" i2="1"><s1>SAINT-CYR (Jean A.)</s1></fA11><fA11 i1="06" i2="1"><s1>POON (Yu-Yan W.)</s1></fA11><fA11 i1="07" i2="1"><s1>HUTCHISON (William D.)</s1></fA11><fA11 i1="08" i2="1"><s1>DOSTROVSKY (Jonathan O.)</s1></fA11><fA11 i1="09" i2="1"><s1>MORO (Elena)</s1></fA11><fA14 i1="01"><s1>Movement Disorders Center, Division of Neurology, University of Toronto, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>9 aut.</sZ></fA14><fA14 i1="02"><s1>Bumrungrad International Hospital</s1><s2>Wattana, Bangkok</s2><s3>THA</s3><sZ>1 aut.</sZ></fA14><fA14 i1="03"><s1>Department of Neurosurgery, University of Toronto, Toronto Western Hospital</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ></fA14><fA14 i1="04"><s1>Department of Physiology, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>8 aut.</sZ></fA14><fA20><s1>990-997</s1></fA20><fA21><s1>2007</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000149881420130</s5></fA43><fA44><s0>0000</s0><s1>© 2007 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>32 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>07-0314955</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Subthalamic nucleus deep brain stimulation (STN-DBS) is effective in advanced Parkinson's disease (PD), but its effects on the levodopa response are unclear. We studied the levodopa response after long-term STN-DBS, STN-DBS efficacy and predictive value of preoperative levodopa response to long-term DBS benefit in 33 PD patients with bilateral STN-DBS. Patients were assessed using the Unified Parkinson's Disease Rating Scale preoperatively (with and without medications) and postoperatively (without medications or stimulation, with only medications or stimulation, and with both medications and stimulation). Levodopa response significantly decreased postoperatively by 31.1% at 3 years and 32.3% at 5 years, possibly related to the reduction in medication requirement, direct STN stimulation effect or PD progression. STN-DBS alone significantly improved motor scores (37.2% at 3 years and 35.1% at 5 years) and activities of daily living scores (27.1% at 3 years and 19.2% at 5 years). Anti-PD drugs were significantly reduced by 47.9% at 3 years and 39.8% at 5 years. However, the magnitude of the preoperative response to levodopa did not predict DBS benefit at 3 and 5 years.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17G</s0></fC02><fC02 i1="03" i2="X"><s0>002B02U01</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Système nerveux pathologie</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Parkinson maladie</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Parkinson disease</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Lévodopa</s0><s2>NK</s2><s2>FR</s2><s5>09</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Levodopa</s0><s2>NK</s2><s2>FR</s2><s5>09</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Levodopa</s0><s2>NK</s2><s2>FR</s2><s5>09</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Long terme</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Long term</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Largo plazo</s0><s5>10</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Noyau sousthalamique</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Subthalamic nucleus</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Núcleo subtalámico</s0><s5>11</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Stimulation cérébrale profonde</s0><s4>CD</s4><s5>96</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Deep brain stimulation</s0><s4>CD</s4><s5>96</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Encéphale pathologie</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Extrapyramidal syndrome</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Système nerveux central pathologie</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Système nerveux central</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Central nervous system</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Sistema nervioso central</s0><s5>41</s5></fC07><fN21><s1>204</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>Canada</li><li>Thaïlande</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><region name="Ontario"><name sortKey="Piboolnurak, Panida" sort="Piboolnurak, Panida" uniqKey="Piboolnurak P" first="Panida" last="Piboolnurak">Panida Piboolnurak</name></region><name sortKey="Dostrovsky, Jonathan O" sort="Dostrovsky, Jonathan O" uniqKey="Dostrovsky J" first="Jonathan O." last="Dostrovsky">Jonathan O. Dostrovsky</name><name sortKey="Hutchison, William D" sort="Hutchison, William D" uniqKey="Hutchison W" first="William D." last="Hutchison">William D. Hutchison</name><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M." last="Lozano">Andres M. Lozano</name><name sortKey="Miyasaki, Janis M" sort="Miyasaki, Janis M" uniqKey="Miyasaki J" first="Janis M." last="Miyasaki">Janis M. Miyasaki</name><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><name sortKey="Poon, Yu Yan W" sort="Poon, Yu Yan W" uniqKey="Poon Y" first="Yu-Yan W." last="Poon">Yu-Yan W. Poon</name><name sortKey="Saint Cyr, Jean A" sort="Saint Cyr, Jean A" uniqKey="Saint Cyr J" first="Jean A." last="Saint-Cyr">Jean A. Saint-Cyr</name></country><country name="Thaïlande"><noRegion><name sortKey="Piboolnurak, Panida" sort="Piboolnurak, Panida" uniqKey="Piboolnurak P" first="Panida" last="Piboolnurak">Panida Piboolnurak</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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