Thalamic deep brain stimulation: Effects on the nontarget limbs
Identifieur interne : 002894 ( PascalFrancis/Checkpoint ); précédent : 002893; suivant : 002895Thalamic deep brain stimulation: Effects on the nontarget limbs
Auteurs : William Ondo [États-Unis] ; Kevin Dat Vuong [États-Unis] ; Michael Almaguer [États-Unis] ; Joseph Jankovic [États-Unis] ; Richard K. Simpson [États-Unis]Source :
- Movement disorders [ 0885-3185 ] ; 2001.
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Abstract
Unilateral thalamic ventral intermediate (VIM) deep brain stimulation (DBS) is now accepted as an effective treatment for essential tremor (ET) and tremor related to Parkinson's disease (PD). The effects of unilateral placement on the side ipsilateral to the surgical site have not been carefully evaluated. To systematically assess the effects ipsilateral to the surgical side and to determine the effects of device inactivation on the baseline tremor, we evaluated tremor in 73 patients approximately 3 months after their unilateral thalamic placement. Assessment included blinded and unblinded ratings using the Unified Parkinson's Disease Rating Scale for PD patients and a modified Tremor Rating Scale in ET patients. All measures of tremor contralateral to the implantation site improved significantly and robustly in both PD and ET. Implantation did not worsen tremor by any measure on the ipsilateral side. There was mild ipsilateral improvement as measured by lower observed tremor scores in ET (6.0 ± 1.8 to 5.0 ± 1.9, P < 0.005), but not PD. There was no rebound augmentation of tremor in either hand alter the devices were deactivated in either group. We conclude that VIM DBS may mildly improve ipsilateral ET, and that concerns about meaningful ipsilateral tremor augmentation after device deactivation are not warranted.
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Simpson</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Neurosurgery, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">02-0177423</idno><date when="2001">2001</date><idno type="stanalyst">PASCAL 02-0177423 INIST</idno><idno type="RBID">Pascal:02-0177423</idno><idno type="wicri:Area/PascalFrancis/Corpus">002880</idno><idno type="wicri:Area/PascalFrancis/Curation">000441</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">002894</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Thalamic deep brain stimulation: Effects on the nontarget limbs</title><author><name sortKey="Ondo, William" sort="Ondo, William" uniqKey="Ondo W" first="William" last="Ondo">William Ondo</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Dat Vuong, Kevin" sort="Dat Vuong, Kevin" uniqKey="Dat Vuong K" first="Kevin" last="Dat Vuong">Kevin Dat Vuong</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Almaguer, Michael" sort="Almaguer, Michael" uniqKey="Almaguer M" first="Michael" last="Almaguer">Michael Almaguer</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Jankovic, Joseph" sort="Jankovic, Joseph" uniqKey="Jankovic J" first="Joseph" last="Jankovic">Joseph Jankovic</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Department of Neurology, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</region></placeName><placeName><settlement type="city">Houston</settlement><region type="state">Texas</region></placeName><orgName type="university" n="3">Baylor College of Medicine</orgName></affiliation></author><author><name sortKey="Simpson, Richard K" sort="Simpson, Richard K" uniqKey="Simpson R" first="Richard K." last="Simpson">Richard K. Simpson</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Neurosurgery, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Texas</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="2001">2001</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>Essential</term><term>Evolution</term><term>Human</term><term>Instrumental stimulation</term><term>Ipsilateral</term><term>Parkinson disease</term><term>Thalamus</term><term>Treatment</term><term>Tremor</term><term>Unilateral</term><term>Ventromedial nucleus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term><term>Tremblement</term><term>Essentiel</term><term>Stimulation instrumentale</term><term>Unilatéral</term><term>Noyau ventromédial</term><term>Thalamus</term><term>Homolatéral</term><term>Traitement</term><term>Evolution</term><term>Homme</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Unilateral thalamic ventral intermediate (VIM) deep brain stimulation (DBS) is now accepted as an effective treatment for essential tremor (ET) and tremor related to Parkinson's disease (PD). The effects of unilateral placement on the side ipsilateral to the surgical site have not been carefully evaluated. To systematically assess the effects ipsilateral to the surgical side and to determine the effects of device inactivation on the baseline tremor, we evaluated tremor in 73 patients approximately 3 months after their unilateral thalamic placement. Assessment included blinded and unblinded ratings using the Unified Parkinson's Disease Rating Scale for PD patients and a modified Tremor Rating Scale in ET patients. All measures of tremor contralateral to the implantation site improved significantly and robustly in both PD and ET. Implantation did not worsen tremor by any measure on the ipsilateral side. There was mild ipsilateral improvement as measured by lower observed tremor scores in ET (6.0 ± 1.8 to 5.0 ± 1.9, P < 0.005), but not PD. There was no rebound augmentation of tremor in either hand alter the devices were deactivated in either group. We conclude that VIM DBS may mildly improve ipsilateral ET, and that concerns about meaningful ipsilateral tremor augmentation after device deactivation are not warranted.</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>16</s2></fA05><fA06><s2>6</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Thalamic deep brain stimulation: Effects on the nontarget limbs</s1></fA08><fA11 i1="01" i2="1"><s1>ONDO (William)</s1></fA11><fA11 i1="02" i2="1"><s1>DAT VUONG (Kevin)</s1></fA11><fA11 i1="03" i2="1"><s1>ALMAGUER (Michael)</s1></fA11><fA11 i1="04" i2="1"><s1>JANKOVIC (Joseph)</s1></fA11><fA11 i1="05" i2="1"><s1>SIMPSON (Richard K.)</s1></fA11><fA14 i1="01"><s1>Department of Neurology, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Neurosurgery, Baylor College of Medicine</s1><s2>Houston, Texas</s2><s3>USA</s3><sZ>5 aut.</sZ></fA14><fA20><s1>1137-1142</s1></fA20><fA21><s1>2001</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000094252170200</s5></fA43><fA44><s0>0000</s0><s1>© 2002 INIST-CNRS. 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Assessment included blinded and unblinded ratings using the Unified Parkinson's Disease Rating Scale for PD patients and a modified Tremor Rating Scale in ET patients. All measures of tremor contralateral to the implantation site improved significantly and robustly in both PD and ET. Implantation did not worsen tremor by any measure on the ipsilateral side. There was mild ipsilateral improvement as measured by lower observed tremor scores in ET (6.0 ± 1.8 to 5.0 ± 1.9, P < 0.005), but not PD. There was no rebound augmentation of tremor in either hand alter the devices were deactivated in either group. We conclude that VIM DBS may mildly improve ipsilateral ET, and that concerns about meaningful ipsilateral tremor augmentation after device deactivation are not warranted.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17G</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Parkinson maladie</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Parkinson disease</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Tremblement</s0><s5>04</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Tremor</s0><s5>04</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Temblor</s0><s5>04</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Essentiel</s0><s5>05</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Essential</s0><s5>05</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Esencial</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Stimulation instrumentale</s0><s5>07</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Instrumental 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uniqKey="Ondo W" first="William" last="Ondo">William Ondo</name></region><name sortKey="Almaguer, Michael" sort="Almaguer, Michael" uniqKey="Almaguer M" first="Michael" last="Almaguer">Michael Almaguer</name><name sortKey="Dat Vuong, Kevin" sort="Dat Vuong, Kevin" uniqKey="Dat Vuong K" first="Kevin" last="Dat Vuong">Kevin Dat Vuong</name><name sortKey="Jankovic, Joseph" sort="Jankovic, Joseph" uniqKey="Jankovic J" first="Joseph" last="Jankovic">Joseph Jankovic</name><name sortKey="Simpson, Richard K" sort="Simpson, Richard K" uniqKey="Simpson R" first="Richard K." last="Simpson">Richard K. 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