Movement Disorders (revue)

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Evolution of Parkinson's disease during 4 years of bilateral deep brain stimulation of the subthalamic nucleus

Identifieur interne : 001164 ( PascalFrancis/Curation ); précédent : 001163; suivant : 001165

Evolution of Parkinson's disease during 4 years of bilateral deep brain stimulation of the subthalamic nucleus

Auteurs : Karen Stergaard [Danemark] ; Niels Aa. Sunde [Danemark]

Source :

RBID : Pascal:06-0289027

Descripteurs français

English descriptors

Abstract

Patients with advanced Parkinson's disease (PD) and motor complications can obtain significant symptom improvement by deep brain stimulation (DBS) of the subthalamic nucleus (STN). Very little is published, however, about long-term effect and disease evolution during DBS. We performed a 4-year prospective study of the first 22 consecutive patients treated with STN DBS. The patients were evaluated with Unified Parkinson's Disease Rating Scale Part II to VI and a patient diary concerning on-off periods and dyskinesia. Patients were scored before surgery on medication and off medication for 10 to 12 hours and in four conditions 1 and 4 years after surgery: off medication ± stimulation and on medication ± stimulation. In advanced PD, a significant reduction of dyskinesia and off periods was present 4 years (90%/67%) after the operation. Total motor function on stimulation alone improved 55% at 4 years, compared with baseline and activities of daily living (42%). On stimulation, significant worsening of axial symptoms and speech was present from 1 to 4 years. To evaluate disease evolution, motor symptoms were assessed off stimulation and medication for 12 hours and were found not to worsen compared with baseline, which is remarkable in an otherwise progressive disorder. Five patients developed dementia. Severe adverse events were not observed.
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A08 01  1  ENG  @1 Evolution of Parkinson's disease during 4 years of bilateral deep brain stimulation of the subthalamic nucleus
A11 01  1    @1 ØSTERGAARD (Karen)
A11 02  1    @1 SUNDE (Niels Aa.)
A14 01      @1 Department of Neurology, Aarhus University Hospital, Nørrebrogade @2 Aarhus C @3 DNK @Z 1 aut.
A14 02      @1 Department of Neurosurgery, Aarhus University Hospital, Nørrebrogade @2 Aarhus C @3 DNK @Z 2 aut.
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C01 01    ENG  @0 Patients with advanced Parkinson's disease (PD) and motor complications can obtain significant symptom improvement by deep brain stimulation (DBS) of the subthalamic nucleus (STN). Very little is published, however, about long-term effect and disease evolution during DBS. We performed a 4-year prospective study of the first 22 consecutive patients treated with STN DBS. The patients were evaluated with Unified Parkinson's Disease Rating Scale Part II to VI and a patient diary concerning on-off periods and dyskinesia. Patients were scored before surgery on medication and off medication for 10 to 12 hours and in four conditions 1 and 4 years after surgery: off medication ± stimulation and on medication ± stimulation. In advanced PD, a significant reduction of dyskinesia and off periods was present 4 years (90%/67%) after the operation. Total motor function on stimulation alone improved 55% at 4 years, compared with baseline and activities of daily living (42%). On stimulation, significant worsening of axial symptoms and speech was present from 1 to 4 years. To evaluate disease evolution, motor symptoms were assessed off stimulation and medication for 12 hours and were found not to worsen compared with baseline, which is remarkable in an otherwise progressive disorder. Five patients developed dementia. Severe adverse events were not observed.
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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 Parkinson maladie @5 02
C03 02  X  ENG  @0 Parkinson disease @5 02
C03 02  X  SPA  @0 Parkinson enfermedad @5 02
C03 03  X  FRE  @0 Evolution @5 09
C03 03  X  ENG  @0 Evolution @5 09
C03 03  X  SPA  @0 Evolución @5 09
C03 04  X  FRE  @0 Noyau sousthalamique @5 10
C03 04  X  ENG  @0 Subthalamic nucleus @5 10
C03 04  X  SPA  @0 Núcleo subtalámico @5 10
C03 05  X  FRE  @0 Stimulation cérébrale profonde @4 CD @5 96
C03 05  X  ENG  @0 Deep brain stimulation @4 CD @5 96
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
C07 05  X  FRE  @0 Système nerveux central @5 41
C07 05  X  ENG  @0 Central nervous system @5 41
C07 05  X  SPA  @0 Sistema nervioso central @5 41
N21       @1 184
N44 01      @1 OTO
N82       @1 OTO

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Pascal:06-0289027

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