Treatment of advanced Parkinson's disease by subthalamotomy: one-year results.
Identifieur interne : 003603 ( PubMed/Checkpoint ); précédent : 003602; suivant : 003604Treatment of advanced Parkinson's disease by subthalamotomy: one-year results.
Auteurs : Philip C. Su [République populaire de Chine] ; Ham-Min Tseng ; Hon-Man Liu ; Ruoh-Fang Yen ; Horng-Huei LiouSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2003.
English descriptors
- KwdEn :
- Adult, Aged, Antiparkinson Agents (therapeutic use), Dyskinesias (diagnosis), Dyskinesias (epidemiology), Electrocoagulation, Female, Follow-Up Studies, Humans, Hypokinesia (diagnosis), Levodopa (therapeutic use), Magnetic Resonance Imaging, Male, Microelectrodes, Middle Aged, Parkinson Disease (drug therapy), Parkinson Disease (physiopathology), Parkinson Disease (surgery), Postoperative Complications, Posture, Questionnaires, Severity of Illness Index, Subthalamic Nucleus (pathology), Subthalamic Nucleus (surgery), Time.
- MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- diagnosis : Dyskinesias, Hypokinesia.
- drug therapy : Parkinson Disease.
- epidemiology : Dyskinesias.
- pathology : Subthalamic Nucleus.
- physiopathology : Parkinson Disease.
- surgery : Parkinson Disease, Subthalamic Nucleus.
- Adult, Aged, Electrocoagulation, Female, Follow-Up Studies, Humans, Magnetic Resonance Imaging, Male, Microelectrodes, Middle Aged, Postoperative Complications, Posture, Questionnaires, Severity of Illness Index, Time.
Abstract
We studied effects on parkinsonian features at 6 and 12 months in 12 patients who underwent unilateral ablation of subthalamic nucleus (STN). Microelectrode mapping was used, and a lesion was created in the STN using thermal coagulation and confirmed with magnetic resonance imaging. At 6 months postoperatively, improvements were seen in several areas: 1) Unified Parkinson's Disease Rating Scales II and III (UPDRS II and III) scores, 30% in off period, 38% in on period; 2) Schwab and England Scale (S&E) score, 21%; and 3) on dyskinesia, 85%. Contralateral rigidity, bradykinesia, UPDRS II and III scores, and S&E scores remained improved at 12 months. Daily dosage of levodopa requirement was reduced by 42%. Axial motor features, gait, postural stability, off period tremor, and motor fluctuation improved at 6 and 12 months but showed a decline in benefits at 18 months. Complications include 3 cases of hemiballism, of whom 2 patients recovered spontaneously but 1 died from aspiration pneumonia. One patient had asymptomatic hematoma, and 2 suffered transient postural asymmetries. We conclude that unilateral subthalamotomy results in moderate improvement in all aspects of parkinsonian features, allows reduction in the dose of levodopa required, and ameliorates drug-induced complications throughout 12-month assessments.
DOI: 10.1002/mds.10393
PubMed: 12722167
Affiliations:
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Su</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan, China. philipsu@ha.mc.ntu.edu.tw</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan</wicri:regionArea><wicri:noRegion>Taiwan</wicri:noRegion></affiliation></author><author><name sortKey="Tseng, Ham Min" sort="Tseng, Ham Min" uniqKey="Tseng H" first="Ham-Min" last="Tseng">Ham-Min Tseng</name></author><author><name sortKey="Liu, Hon Man" sort="Liu, Hon Man" uniqKey="Liu H" first="Hon-Man" last="Liu">Hon-Man Liu</name></author><author><name sortKey="Yen, Ruoh Fang" sort="Yen, Ruoh Fang" uniqKey="Yen R" first="Ruoh-Fang" last="Yen">Ruoh-Fang Yen</name></author><author><name sortKey="Liou, Horng Huei" sort="Liou, Horng Huei" uniqKey="Liou H" first="Horng-Huei" last="Liou">Horng-Huei Liou</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2003">2003</date><idno type="RBID">pubmed:12722167</idno><idno type="pmid">12722167</idno><idno type="doi">10.1002/mds.10393</idno><idno type="wicri:Area/PubMed/Corpus">003793</idno><idno type="wicri:Area/PubMed/Curation">003793</idno><idno type="wicri:Area/PubMed/Checkpoint">003603</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Treatment of advanced Parkinson's disease by subthalamotomy: one-year results.</title><author><name sortKey="Su, Philip C" sort="Su, Philip C" uniqKey="Su P" first="Philip C" last="Su">Philip C. Su</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan, China. philipsu@ha.mc.ntu.edu.tw</nlm:affiliation><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan</wicri:regionArea><wicri:noRegion>Taiwan</wicri:noRegion></affiliation></author><author><name sortKey="Tseng, Ham Min" sort="Tseng, Ham Min" uniqKey="Tseng H" first="Ham-Min" last="Tseng">Ham-Min Tseng</name></author><author><name sortKey="Liu, Hon Man" sort="Liu, Hon Man" uniqKey="Liu H" first="Hon-Man" last="Liu">Hon-Man Liu</name></author><author><name sortKey="Yen, Ruoh Fang" sort="Yen, Ruoh Fang" uniqKey="Yen R" first="Ruoh-Fang" last="Yen">Ruoh-Fang Yen</name></author><author><name sortKey="Liou, Horng Huei" sort="Liou, Horng Huei" uniqKey="Liou H" first="Horng-Huei" last="Liou">Horng-Huei Liou</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="2003" type="published">2003</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Antiparkinson Agents (therapeutic use)</term><term>Dyskinesias (diagnosis)</term><term>Dyskinesias (epidemiology)</term><term>Electrocoagulation</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Hypokinesia (diagnosis)</term><term>Levodopa (therapeutic use)</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Microelectrodes</term><term>Middle Aged</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (surgery)</term><term>Postoperative Complications</term><term>Posture</term><term>Questionnaires</term><term>Severity of Illness Index</term><term>Subthalamic Nucleus (pathology)</term><term>Subthalamic Nucleus (surgery)</term><term>Time</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Dyskinesias</term><term>Hypokinesia</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Dyskinesias</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Parkinson Disease</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Electrocoagulation</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Magnetic Resonance Imaging</term><term>Male</term><term>Microelectrodes</term><term>Middle Aged</term><term>Postoperative Complications</term><term>Posture</term><term>Questionnaires</term><term>Severity of Illness Index</term><term>Time</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We studied effects on parkinsonian features at 6 and 12 months in 12 patients who underwent unilateral ablation of subthalamic nucleus (STN). Microelectrode mapping was used, and a lesion was created in the STN using thermal coagulation and confirmed with magnetic resonance imaging. At 6 months postoperatively, improvements were seen in several areas: 1) Unified Parkinson's Disease Rating Scales II and III (UPDRS II and III) scores, 30% in off period, 38% in on period; 2) Schwab and England Scale (S&E) score, 21%; and 3) on dyskinesia, 85%. Contralateral rigidity, bradykinesia, UPDRS II and III scores, and S&E scores remained improved at 12 months. Daily dosage of levodopa requirement was reduced by 42%. Axial motor features, gait, postural stability, off period tremor, and motor fluctuation improved at 6 and 12 months but showed a decline in benefits at 18 months. Complications include 3 cases of hemiballism, of whom 2 patients recovered spontaneously but 1 died from aspiration pneumonia. One patient had asymptomatic hematoma, and 2 suffered transient postural asymmetries. We conclude that unilateral subthalamotomy results in moderate improvement in all aspects of parkinsonian features, allows reduction in the dose of levodopa required, and ameliorates drug-induced complications throughout 12-month assessments.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">12722167</PMID><DateCreated><Year>2003</Year><Month>04</Month><Day>30</Day></DateCreated><DateCompleted><Year>2003</Year><Month>09</Month><Day>17</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0885-3185</ISSN><JournalIssue CitedMedium="Print"><Volume>18</Volume><Issue>5</Issue><PubDate><Year>2003</Year><Month>May</Month></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Treatment of advanced Parkinson's disease by subthalamotomy: one-year results.</ArticleTitle><Pagination><MedlinePgn>531-8</MedlinePgn></Pagination><Abstract><AbstractText>We studied effects on parkinsonian features at 6 and 12 months in 12 patients who underwent unilateral ablation of subthalamic nucleus (STN). Microelectrode mapping was used, and a lesion was created in the STN using thermal coagulation and confirmed with magnetic resonance imaging. At 6 months postoperatively, improvements were seen in several areas: 1) Unified Parkinson's Disease Rating Scales II and III (UPDRS II and III) scores, 30% in off period, 38% in on period; 2) Schwab and England Scale (S&E) score, 21%; and 3) on dyskinesia, 85%. Contralateral rigidity, bradykinesia, UPDRS II and III scores, and S&E scores remained improved at 12 months. Daily dosage of levodopa requirement was reduced by 42%. Axial motor features, gait, postural stability, off period tremor, and motor fluctuation improved at 6 and 12 months but showed a decline in benefits at 18 months. Complications include 3 cases of hemiballism, of whom 2 patients recovered spontaneously but 1 died from aspiration pneumonia. One patient had asymptomatic hematoma, and 2 suffered transient postural asymmetries. We conclude that unilateral subthalamotomy results in moderate improvement in all aspects of parkinsonian features, allows reduction in the dose of levodopa required, and ameliorates drug-induced complications throughout 12-month assessments.</AbstractText><CopyrightInformation>Copyright 2003 Movement Disorder Society</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Su</LastName><ForeName>Philip C</ForeName><Initials>PC</Initials><AffiliationInfo><Affiliation>Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan, China. philipsu@ha.mc.ntu.edu.tw</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tseng</LastName><ForeName>Ham-Min</ForeName><Initials>HM</Initials></Author><Author ValidYN="Y"><LastName>Liu</LastName><ForeName>Hon-Man</ForeName><Initials>HM</Initials></Author><Author ValidYN="Y"><LastName>Yen</LastName><ForeName>Ruoh-Fang</ForeName><Initials>RF</Initials></Author><Author 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Complications</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D011187">Posture</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D011795">Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D012720">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D020531">Subthalamic Nucleus</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000473">pathology</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000601">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D013995">Time</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2003</Year><Month>5</Month><Day>2</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2003</Year><Month>9</Month><Day>18</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2003</Year><Month>5</Month><Day>2</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">12722167</ArticleId><ArticleId IdType="doi">10.1002/mds.10393</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>République populaire de Chine</li></country></list><tree><noCountry><name sortKey="Liou, Horng Huei" sort="Liou, Horng Huei" uniqKey="Liou H" first="Horng-Huei" last="Liou">Horng-Huei Liou</name><name sortKey="Liu, Hon Man" sort="Liu, Hon Man" uniqKey="Liu H" first="Hon-Man" last="Liu">Hon-Man Liu</name><name sortKey="Tseng, Ham Min" sort="Tseng, Ham Min" uniqKey="Tseng H" first="Ham-Min" last="Tseng">Ham-Min Tseng</name><name sortKey="Yen, Ruoh Fang" sort="Yen, Ruoh Fang" uniqKey="Yen R" first="Ruoh-Fang" last="Yen">Ruoh-Fang Yen</name></noCountry><country name="République populaire de Chine"><noRegion><name sortKey="Su, Philip C" sort="Su, Philip C" uniqKey="Su P" first="Philip C" last="Su">Philip C. 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