Movement Disorders (revue)

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Pallidotomy effect on the cortical excitability in patients with severe Parkinson's disease

Identifieur interne : 000E16 ( PascalFrancis/Curation ); précédent : 000E15; suivant : 000E17

Pallidotomy effect on the cortical excitability in patients with severe Parkinson's disease

Auteurs : Chon-Haw Tsai [Taïwan] ; Fang-Chia Chang [Taïwan] ; Chin-Song Lu [Taïwan] ; Shih-Tseng Lee [Taïwan] ; Yu-Ting Huang [Taïwan] ; Ming-Kuei Lu [Taïwan] ; Rou-Shayn Chen [Taïwan] ; TONY WU [Taïwan] ; Jiann-Der Lee [Taïwan] ; Yi-Hsin Weng [Taïwan] ; Hsiu-Chen Chang [Taïwan]

Source :

RBID : Pascal:05-0262069

Descripteurs français

English descriptors

Abstract

Surgical lesions in the medial pallidum have been shown to ameliorate motor deficits in patients with Parkinson's disease (PD). It is believed that interruption of the pallidothalamocortical projections to the motor cortex is required for the satisfactory results. In this report, we adopt cortico-cortical inhibition as the tool to assess the pallidotomy effect on cortical excitability in PD. Interstimulus interval between 1 and 15 msec were investigated. The average peak-to-peak amplitude was measured and calculated at each delay. A total of 8 patients (M:F = 4:4) 54.9 years of age (SD = 9.6) and 10 controls were recruited for the study. In the controls, the inhibitory phenomenon was observed from the 1-msec to the 4-msec delay points and the maximal inhibition was at the 3-msec delay point (33.69% ± 6.50% of the control response). Mild facilitation was noticed since the 5-msec delay point and thereafter. In patients before operation, a similar trend of inhibition was also observed in the initial 4 msec with the maximal inhibition also at the 3-msec delay point (64.66 ± 6.77% of the control response). In the postoperative group, the short interstimulus interval inhibition can no longer be observed and the conditioned response was 95.06 ± 23.68% of the control at the 3-msec delay point. The suppression was gone at and after the 7-msec delay point. Results of repeated-measures analysis of variance show a significant difference among the controls and PD patients before and 3 months after pallidotomy (F = 3.40, P = 0.05). Post hoc examination revealed a significant difference between the controls and PD patients 3 months after pallidotomy at the 3-msec delay point (P = 0.004). However, no correlation was observed between the 3-msec inhibition and the Unified Parkinson's Disease Rating Scale Motor score or the dyskinesia score. The results suggest that pallidotomy can modulate the cortical inhibitory circuitry in patients with PD.
pA  
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A03   1    @0 Mov. disord.
A05       @2 20
A06       @2 4
A08 01  1  ENG  @1 Pallidotomy effect on the cortical excitability in patients with severe Parkinson's disease
A11 01  1    @1 TSAI (Chon-Haw)
A11 02  1    @1 CHANG (Fang-Chia)
A11 03  1    @1 LU (Chin-Song)
A11 04  1    @1 LEE (Shih-Tseng)
A11 05  1    @1 HUANG (Yu-Ting)
A11 06  1    @1 LU (Ming-Kuei)
A11 07  1    @1 CHEN (Rou-Shayn)
A11 08  1    @1 TONY WU
A11 09  1    @1 LEE (Jiann-Der)
A11 10  1    @1 WENG (Yi-Hsin)
A11 11  1    @1 CHANG (Hsiu-Chen)
A14 01      @1 Neuroscience Laboratory, Department of Neurology, China Medical University Hospital @2 Taichung @3 TWN @Z 1 aut. @Z 2 aut. @Z 6 aut.
A14 02      @1 Institute of Medical Science, China Medical University @2 Taichung @3 TWN @Z 1 aut.
A14 03      @1 Movement Disorders Unit, Department of Neurology, Chang Gung Memorial Hospital @2 Taipei @3 TWN @Z 3 aut. @Z 5 aut. @Z 7 aut. @Z 8 aut. @Z 10 aut. @Z 11 aut.
A14 04      @1 Department of Neurosurgery, Chang Gung Memorial Hospital @2 Taipei @3 TWN @Z 4 aut.
A14 05      @1 Department of Electrical Engineering, Chang Gung Memorial Hospital @2 Taipei @3 TWN @Z 9 aut.
A20       @1 463-470
A21       @1 2005
A23 01      @0 ENG
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A44       @0 0000 @1 © 2005 INIST-CNRS. All rights reserved.
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A47 01  1    @0 05-0262069
A60       @1 P
A61       @0 A
A64 01  1    @0 Movement disorders
A66 01      @0 USA
C01 01    ENG  @0 Surgical lesions in the medial pallidum have been shown to ameliorate motor deficits in patients with Parkinson's disease (PD). It is believed that interruption of the pallidothalamocortical projections to the motor cortex is required for the satisfactory results. In this report, we adopt cortico-cortical inhibition as the tool to assess the pallidotomy effect on cortical excitability in PD. Interstimulus interval between 1 and 15 msec were investigated. The average peak-to-peak amplitude was measured and calculated at each delay. A total of 8 patients (M:F = 4:4) 54.9 years of age (SD = 9.6) and 10 controls were recruited for the study. In the controls, the inhibitory phenomenon was observed from the 1-msec to the 4-msec delay points and the maximal inhibition was at the 3-msec delay point (33.69% ± 6.50% of the control response). Mild facilitation was noticed since the 5-msec delay point and thereafter. In patients before operation, a similar trend of inhibition was also observed in the initial 4 msec with the maximal inhibition also at the 3-msec delay point (64.66 ± 6.77% of the control response). In the postoperative group, the short interstimulus interval inhibition can no longer be observed and the conditioned response was 95.06 ± 23.68% of the control at the 3-msec delay point. The suppression was gone at and after the 7-msec delay point. Results of repeated-measures analysis of variance show a significant difference among the controls and PD patients before and 3 months after pallidotomy (F = 3.40, P = 0.05). Post hoc examination revealed a significant difference between the controls and PD patients 3 months after pallidotomy at the 3-msec delay point (P = 0.004). However, no correlation was observed between the 3-msec inhibition and the Unified Parkinson's Disease Rating Scale Motor score or the dyskinesia score. The results suggest that pallidotomy can modulate the cortical inhibitory circuitry in patients with PD.
C02 01  X    @0 002B17
C02 02  X    @0 002B17G
C02 03  X    @0 002B17F
C03 01  X  FRE  @0 Système nerveux pathologie @5 01
C03 01  X  ENG  @0 Nervous system diseases @5 01
C03 01  X  SPA  @0 Sistema nervioso patología @5 01
C03 02  X  FRE  @0 Excitabilité @5 02
C03 02  X  ENG  @0 Excitability @5 02
C03 02  X  SPA  @0 Excitabilidad @5 02
C03 03  X  FRE  @0 Homme @5 03
C03 03  X  ENG  @0 Human @5 03
C03 03  X  SPA  @0 Hombre @5 03
C03 04  X  FRE  @0 Parkinson maladie @5 04
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C03 04  X  SPA  @0 Parkinson enfermedad @5 04
C07 01  X  FRE  @0 Encéphale pathologie @5 37
C07 01  X  ENG  @0 Cerebral disorder @5 37
C07 01  X  SPA  @0 Encéfalo patología @5 37
C07 02  X  FRE  @0 Extrapyramidal syndrome @5 38
C07 02  X  ENG  @0 Extrapyramidal syndrome @5 38
C07 02  X  SPA  @0 Extrapiramidal síndrome @5 38
C07 03  X  FRE  @0 Maladie dégénérative @5 39
C07 03  X  ENG  @0 Degenerative disease @5 39
C07 03  X  SPA  @0 Enfermedad degenerativa @5 39
C07 04  X  FRE  @0 Système nerveux central pathologie @5 40
C07 04  X  ENG  @0 Central nervous system disease @5 40
C07 04  X  SPA  @0 Sistema nervosio central patología @5 40
N21       @1 185
N44 01      @1 OTO
N82       @1 OTO

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Pascal:05-0262069

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<div type="abstract" xml:lang="en">Surgical lesions in the medial pallidum have been shown to ameliorate motor deficits in patients with Parkinson's disease (PD). It is believed that interruption of the pallidothalamocortical projections to the motor cortex is required for the satisfactory results. In this report, we adopt cortico-cortical inhibition as the tool to assess the pallidotomy effect on cortical excitability in PD. Interstimulus interval between 1 and 15 msec were investigated. The average peak-to-peak amplitude was measured and calculated at each delay. A total of 8 patients (M:F = 4:4) 54.9 years of age (SD = 9.6) and 10 controls were recruited for the study. In the controls, the inhibitory phenomenon was observed from the 1-msec to the 4-msec delay points and the maximal inhibition was at the 3-msec delay point (33.69% ± 6.50% of the control response). Mild facilitation was noticed since the 5-msec delay point and thereafter. In patients before operation, a similar trend of inhibition was also observed in the initial 4 msec with the maximal inhibition also at the 3-msec delay point (64.66 ± 6.77% of the control response). In the postoperative group, the short interstimulus interval inhibition can no longer be observed and the conditioned response was 95.06 ± 23.68% of the control at the 3-msec delay point. The suppression was gone at and after the 7-msec delay point. Results of repeated-measures analysis of variance show a significant difference among the controls and PD patients before and 3 months after pallidotomy (F = 3.40, P = 0.05). Post hoc examination revealed a significant difference between the controls and PD patients 3 months after pallidotomy at the 3-msec delay point (P = 0.004). However, no correlation was observed between the 3-msec inhibition and the Unified Parkinson's Disease Rating Scale Motor score or the dyskinesia score. The results suggest that pallidotomy can modulate the cortical inhibitory circuitry in patients with PD.</div>
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