Long-Term Outcomes of Surgical Therapies for Parkinson's Disease
Identifieur interne : 002C94 ( PascalFrancis/Curation ); précédent : 002C93; suivant : 002C95Long-Term Outcomes of Surgical Therapies for Parkinson's Disease
Auteurs : Maria C. Rodriguez-Oroz [Espagne] ; Elena Moro [Canada] ; Paul Krack [France]Source :
- Movement disorders [ 0885-3185 ] ; 2012.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Chirurgie.
English descriptors
- KwdEn :
Abstract
The surgical lesion of different brain structures has been used as a treatment for Parkinson's disease (PD) for several decades. More recently, the favored therapeutic approach has involved the administration of levodopa and the use of DBS. These two major therapeutic advances have greatly modified both the clinical condition of patients and the history of the disease. With the introduction of L-dopa in 1967, patients could regain mobility, because their akinesia, tremor, and rigidity were greatly improved, with consequent significant improvement in quality of life and increased life expectancy. However, after the so-called "honeymoon" period in which the disease seemed to be controlled, motor fluctuations and L-dopa-induced dyskinesias mitigated the initial enthusiasm. In the 1990s, unilateral pallidotomy and DBS of the globus palllidus internus and STN reduced these motor fluctuations and dyskinesias remarkably, thereby inaugurating a new era in the surgical treatment of PD. Short- and medium-term follow-up studies of patients who underwent surgery have documented sustained, significant motor benefits. However, given the progressive nature of PD and the purely symptomatic effects of pallidotomy and DBS, the long-term clinical evolution of these surgical patients currently seems to be associated with a new PD phenotype, mainly characterized by axial motor problems and cognitive impairment. Here, we analyze the long-term clinical outcomes of surgical PD patients with at least 5-year follow-up, focusing on the long-term motor symptoms that were initially responsive to surgery.
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Rodriguez-Oroz</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, University Hospital Donostia, Neuroscience Unit, BioDonostia Research Institute</s1><s2>San Sebastian</s2><s3>ESP</s3><sZ>1 aut.</sZ></inist:fA14><country>Espagne</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Ikerbasque, Basque Foundation for Science</s1><s2>Bilbao</s2><s3>ESP</s3><sZ>1 aut.</sZ></inist:fA14><country>Espagne</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas</s1><s2>Madrid</s2><s3>ESP</s3><sZ>1 aut.</sZ></inist:fA14><country>Espagne</country></affiliation></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Movement Disorders Center, Toronto Western Hospital, University Health Network, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>2 aut.</sZ></inist:fA14><country>Canada</country></affiliation></author><author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>3 aut.</sZ></inist:fA14><country>France</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>INSERM, Unité 836, Grenoble Institut des Neurosciences</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>3 aut.</sZ></inist:fA14><country>France</country></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">13-0063582</idno><date when="2012">2012</date><idno type="stanalyst">PASCAL 13-0063582 INIST</idno><idno type="RBID">Pascal:13-0063582</idno><idno type="wicri:Area/PascalFrancis/Corpus">000020</idno><idno type="wicri:Area/PascalFrancis/Curation">002C94</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Long-Term Outcomes of Surgical Therapies for Parkinson's Disease</title><author><name sortKey="Rodriguez Oroz, Maria C" sort="Rodriguez Oroz, Maria C" uniqKey="Rodriguez Oroz M" first="Maria C." last="Rodriguez-Oroz">Maria C. Rodriguez-Oroz</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Neurology, University Hospital Donostia, Neuroscience Unit, BioDonostia Research Institute</s1><s2>San Sebastian</s2><s3>ESP</s3><sZ>1 aut.</sZ></inist:fA14><country>Espagne</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Ikerbasque, Basque Foundation for Science</s1><s2>Bilbao</s2><s3>ESP</s3><sZ>1 aut.</sZ></inist:fA14><country>Espagne</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas</s1><s2>Madrid</s2><s3>ESP</s3><sZ>1 aut.</sZ></inist:fA14><country>Espagne</country></affiliation></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Movement Disorders Center, Toronto Western Hospital, University Health Network, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>2 aut.</sZ></inist:fA14><country>Canada</country></affiliation></author><author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>3 aut.</sZ></inist:fA14><country>France</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>INSERM, Unité 836, Grenoble Institut des Neurosciences</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>3 aut.</sZ></inist:fA14><country>France</country></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="2012">2012</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>Evolution</term><term>Long term</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Prognosis</term><term>Surgery</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Long terme</term><term>Pronostic</term><term>Chirurgie</term><term>Traitement</term><term>Evolution</term><term>Stimulation cérébrale profonde</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Chirurgie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The surgical lesion of different brain structures has been used as a treatment for Parkinson's disease (PD) for several decades. More recently, the favored therapeutic approach has involved the administration of levodopa and the use of DBS. These two major therapeutic advances have greatly modified both the clinical condition of patients and the history of the disease. With the introduction of <sub>L</sub>-dopa in 1967, patients could regain mobility, because their akinesia, tremor, and rigidity were greatly improved, with consequent significant improvement in quality of life and increased life expectancy. However, after the so-called "honeymoon" period in which the disease seemed to be controlled, motor fluctuations and <sub>L</sub>-dopa-induced dyskinesias mitigated the initial enthusiasm. In the 1990s, unilateral pallidotomy and DBS of the globus palllidus internus and STN reduced these motor fluctuations and dyskinesias remarkably, thereby inaugurating a new era in the surgical treatment of PD. Short- and medium-term follow-up studies of patients who underwent surgery have documented sustained, significant motor benefits. However, given the progressive nature of PD and the purely symptomatic effects of pallidotomy and DBS, the long-term clinical evolution of these surgical patients currently seems to be associated with a new PD phenotype, mainly characterized by axial motor problems and cognitive impairment. Here, we analyze the long-term clinical outcomes of surgical PD patients with at least 5-year follow-up, focusing on the long-term motor symptoms that were initially responsive to surgery.</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>27</s2></fA05><fA06><s2>14</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Long-Term Outcomes of Surgical Therapies for Parkinson's Disease</s1></fA08><fA11 i1="01" i2="1"><s1>RODRIGUEZ-OROZ (Maria C.)</s1></fA11><fA11 i1="02" i2="1"><s1>MORO (Elena)</s1></fA11><fA11 i1="03" i2="1"><s1>KRACK (Paul)</s1></fA11><fA14 i1="01"><s1>Department of Neurology, University Hospital Donostia, Neuroscience Unit, BioDonostia Research Institute</s1><s2>San Sebastian</s2><s3>ESP</s3><sZ>1 aut.</sZ></fA14><fA14 i1="02"><s1>Ikerbasque, Basque Foundation for Science</s1><s2>Bilbao</s2><s3>ESP</s3><sZ>1 aut.</sZ></fA14><fA14 i1="03"><s1>Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas</s1><s2>Madrid</s2><s3>ESP</s3><sZ>1 aut.</sZ></fA14><fA14 i1="04"><s1>Movement Disorders Center, Toronto Western Hospital, University Health Network, University of Toronto</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>2 aut.</sZ></fA14><fA14 i1="05"><s1>Movement Disorder Unit, Department of Psychiatry and Neurology, CHU de Grenoble, Joseph Fourier University</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>3 aut.</sZ></fA14><fA14 i1="06"><s1>INSERM, Unité 836, Grenoble Institut des Neurosciences</s1><s2>Grenoble</s2><s3>FRA</s3><sZ>3 aut.</sZ></fA14><fA20><s1>1718-1728</s1></fA20><fA21><s1>2012</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000503000040030</s5></fA43><fA44><s0>0000</s0><s1>© 2013 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>72 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>13-0063582</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>The surgical lesion of different brain structures has been used as a treatment for Parkinson's disease (PD) for several decades. More recently, the favored therapeutic approach has involved the administration of levodopa and the use of DBS. These two major therapeutic advances have greatly modified both the clinical condition of patients and the history of the disease. With the introduction of <sub>L</sub>-dopa in 1967, patients could regain mobility, because their akinesia, tremor, and rigidity were greatly improved, with consequent significant improvement in quality of life and increased life expectancy. However, after the so-called "honeymoon" period in which the disease seemed to be controlled, motor fluctuations and <sub>L</sub>-dopa-induced dyskinesias mitigated the initial enthusiasm. In the 1990s, unilateral pallidotomy and DBS of the globus palllidus internus and STN reduced these motor fluctuations and dyskinesias remarkably, thereby inaugurating a new era in the surgical treatment of PD. Short- and medium-term follow-up studies of patients who underwent surgery have documented sustained, significant motor benefits. However, given the progressive nature of PD and the purely symptomatic effects of pallidotomy and DBS, the long-term clinical evolution of these surgical patients currently seems to be associated with a new PD phenotype, mainly characterized by axial motor problems and cognitive impairment. 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