Pallidotomy improves motor responses and widens the levodopa therapeutic window in Parkinson's disease.
Identifieur interne : 004371 ( PubMed/Checkpoint ); précédent : 004370; suivant : 004372Pallidotomy improves motor responses and widens the levodopa therapeutic window in Parkinson's disease.
Auteurs : E J Skalabrin [États-Unis] ; E R Laws ; J P BennettSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1998.
English descriptors
- KwdEn :
- Administration, Oral, Aged, Antiparkinson Agents (administration & dosage), Combined Modality Therapy, Dihydroxyphenylalanine (blood), Dominance, Cerebral (drug effects), Dominance, Cerebral (physiology), Female, Gait (drug effects), Globus Pallidus (physiopathology), Globus Pallidus (surgery), Humans, Infusions, Intravenous, Levodopa (administration & dosage), Male, Middle Aged, Motor Skills (drug effects), Motor Skills (physiology), Neurologic Examination (drug effects), Parkinson Disease (physiopathology), Parkinson Disease (surgery), Prolactin (blood), Stereotaxic Techniques.
- MESH :
- chemical , administration & dosage : Antiparkinson Agents, Levodopa.
- chemical , blood : Dihydroxyphenylalanine, Prolactin.
- drug effects : Dominance, Cerebral, Gait, Motor Skills, Neurologic Examination.
- physiology : Dominance, Cerebral, Motor Skills.
- physiopathology : Globus Pallidus, Parkinson Disease.
- surgery : Globus Pallidus, Parkinson Disease.
- Administration, Oral, Aged, Combined Modality Therapy, Female, Humans, Infusions, Intravenous, Male, Middle Aged, Stereotaxic Techniques.
Abstract
Stereotactic posteroventral pallidotomy (PVP) as a treatment for Parkinson's disease (PD) symptoms has been increasingly used in moderate-advanced disease. We examined the pharmacodynamic responses of PD patients to single oral levodopa doses and intravenous levodopa infusions before and after PVP surgery. Nine subjects with advanced PD received a single oral dose and ramped intravenous levodopa infusions before and 3-5 weeks after unilateral PVP. Timed motor tasks, Unified Parkinson's Disease Rating Scale (UPDRS) evaluations, and ordinal dyskinesia rating were performed after oral levodopa and during i.v. levodopa infusions. Serum prolactin and dopa levels were measured during the levodopa infusions. Overall timed motor but not motor UPDRS scores were improved after PVP in both the worst ("off") and best ("on") states. Contralateral but not ipsilateral limb dyskinesias were substantially reduced at all serum (dopa) levels after PVP. Ipsilateral and contralateral timed motor performance at low serum (dopa) levels was improved by PVP. Walking speeds at all serum (dopa) levels were not changed by PVP. Serum prolactin was reduced equally by increasing (dopa) preoperatively and postoperatively. PVP significantly and favorably altered oral and intravenous levodopa pharmacodynamics by improving bilateral limb motor function and contralateral dyskinesia but did not alter walking speed. PVP appears to widen significantly the therapeutic window for levodopa in PD.
DOI: 10.1002/mds.870130504
PubMed: 9756145
Affiliations:
Links toward previous steps (curation, corpus...)
Links to Exploration step
pubmed:9756145Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Pallidotomy improves motor responses and widens the levodopa therapeutic window in Parkinson's disease.</title>
<author><name sortKey="Skalabrin, E J" sort="Skalabrin, E J" uniqKey="Skalabrin E" first="E J" last="Skalabrin">E J Skalabrin</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, University of Virginia Health Sciences Center, Charlottesville 22908, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, University of Virginia Health Sciences Center, Charlottesville 22908</wicri:regionArea>
<wicri:noRegion>Charlottesville 22908</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Laws, E R" sort="Laws, E R" uniqKey="Laws E" first="E R" last="Laws">E R Laws</name>
</author>
<author><name sortKey="Bennett, J P" sort="Bennett, J P" uniqKey="Bennett J" first="J P" last="Bennett">J P Bennett</name>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PubMed</idno>
<date when="1998">1998</date>
<idno type="RBID">pubmed:9756145</idno>
<idno type="pmid">9756145</idno>
<idno type="doi">10.1002/mds.870130504</idno>
<idno type="wicri:Area/PubMed/Corpus">004339</idno>
<idno type="wicri:Area/PubMed/Curation">004339</idno>
<idno type="wicri:Area/PubMed/Checkpoint">004371</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en">Pallidotomy improves motor responses and widens the levodopa therapeutic window in Parkinson's disease.</title>
<author><name sortKey="Skalabrin, E J" sort="Skalabrin, E J" uniqKey="Skalabrin E" first="E J" last="Skalabrin">E J Skalabrin</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, University of Virginia Health Sciences Center, Charlottesville 22908, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, University of Virginia Health Sciences Center, Charlottesville 22908</wicri:regionArea>
<wicri:noRegion>Charlottesville 22908</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Laws, E R" sort="Laws, E R" uniqKey="Laws E" first="E R" last="Laws">E R Laws</name>
</author>
<author><name sortKey="Bennett, J P" sort="Bennett, J P" uniqKey="Bennett J" first="J P" last="Bennett">J P Bennett</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="1998" type="published">1998</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Administration, Oral</term>
<term>Aged</term>
<term>Antiparkinson Agents (administration & dosage)</term>
<term>Combined Modality Therapy</term>
<term>Dihydroxyphenylalanine (blood)</term>
<term>Dominance, Cerebral (drug effects)</term>
<term>Dominance, Cerebral (physiology)</term>
<term>Female</term>
<term>Gait (drug effects)</term>
<term>Globus Pallidus (physiopathology)</term>
<term>Globus Pallidus (surgery)</term>
<term>Humans</term>
<term>Infusions, Intravenous</term>
<term>Levodopa (administration & dosage)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Motor Skills (drug effects)</term>
<term>Motor Skills (physiology)</term>
<term>Neurologic Examination (drug effects)</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson Disease (surgery)</term>
<term>Prolactin (blood)</term>
<term>Stereotaxic Techniques</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antiparkinson Agents</term>
<term>Levodopa</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Dihydroxyphenylalanine</term>
<term>Prolactin</term>
</keywords>
<keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Dominance, Cerebral</term>
<term>Gait</term>
<term>Motor Skills</term>
<term>Neurologic Examination</term>
</keywords>
<keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Dominance, Cerebral</term>
<term>Motor Skills</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Globus Pallidus</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Globus Pallidus</term>
<term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Administration, Oral</term>
<term>Aged</term>
<term>Combined Modality Therapy</term>
<term>Female</term>
<term>Humans</term>
<term>Infusions, Intravenous</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Stereotaxic Techniques</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Stereotactic posteroventral pallidotomy (PVP) as a treatment for Parkinson's disease (PD) symptoms has been increasingly used in moderate-advanced disease. We examined the pharmacodynamic responses of PD patients to single oral levodopa doses and intravenous levodopa infusions before and after PVP surgery. Nine subjects with advanced PD received a single oral dose and ramped intravenous levodopa infusions before and 3-5 weeks after unilateral PVP. Timed motor tasks, Unified Parkinson's Disease Rating Scale (UPDRS) evaluations, and ordinal dyskinesia rating were performed after oral levodopa and during i.v. levodopa infusions. Serum prolactin and dopa levels were measured during the levodopa infusions. Overall timed motor but not motor UPDRS scores were improved after PVP in both the worst ("off") and best ("on") states. Contralateral but not ipsilateral limb dyskinesias were substantially reduced at all serum (dopa) levels after PVP. Ipsilateral and contralateral timed motor performance at low serum (dopa) levels was improved by PVP. Walking speeds at all serum (dopa) levels were not changed by PVP. Serum prolactin was reduced equally by increasing (dopa) preoperatively and postoperatively. PVP significantly and favorably altered oral and intravenous levodopa pharmacodynamics by improving bilateral limb motor function and contralateral dyskinesia but did not alter walking speed. PVP appears to widen significantly the therapeutic window for levodopa in PD.</div>
</front>
</TEI>
<pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">9756145</PMID>
<DateCreated><Year>1999</Year>
<Month>01</Month>
<Day>05</Day>
</DateCreated>
<DateCompleted><Year>1999</Year>
<Month>01</Month>
<Day>05</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>13</Volume>
<Issue>5</Issue>
<PubDate><Year>1998</Year>
<Month>Sep</Month>
</PubDate>
</JournalIssue>
<Title>Movement disorders : official journal of the Movement Disorder Society</Title>
<ISOAbbreviation>Mov. Disord.</ISOAbbreviation>
</Journal>
<ArticleTitle>Pallidotomy improves motor responses and widens the levodopa therapeutic window in Parkinson's disease.</ArticleTitle>
<Pagination><MedlinePgn>775-81</MedlinePgn>
</Pagination>
<Abstract><AbstractText>Stereotactic posteroventral pallidotomy (PVP) as a treatment for Parkinson's disease (PD) symptoms has been increasingly used in moderate-advanced disease. We examined the pharmacodynamic responses of PD patients to single oral levodopa doses and intravenous levodopa infusions before and after PVP surgery. Nine subjects with advanced PD received a single oral dose and ramped intravenous levodopa infusions before and 3-5 weeks after unilateral PVP. Timed motor tasks, Unified Parkinson's Disease Rating Scale (UPDRS) evaluations, and ordinal dyskinesia rating were performed after oral levodopa and during i.v. levodopa infusions. Serum prolactin and dopa levels were measured during the levodopa infusions. Overall timed motor but not motor UPDRS scores were improved after PVP in both the worst ("off") and best ("on") states. Contralateral but not ipsilateral limb dyskinesias were substantially reduced at all serum (dopa) levels after PVP. Ipsilateral and contralateral timed motor performance at low serum (dopa) levels was improved by PVP. Walking speeds at all serum (dopa) levels were not changed by PVP. Serum prolactin was reduced equally by increasing (dopa) preoperatively and postoperatively. PVP significantly and favorably altered oral and intravenous levodopa pharmacodynamics by improving bilateral limb motor function and contralateral dyskinesia but did not alter walking speed. PVP appears to widen significantly the therapeutic window for levodopa in PD.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Skalabrin</LastName>
<ForeName>E J</ForeName>
<Initials>EJ</Initials>
<AffiliationInfo><Affiliation>Department of Neurology, University of Virginia Health Sciences Center, Charlottesville 22908, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Laws</LastName>
<ForeName>E R</ForeName>
<Initials>ER</Initials>
<Suffix>Jr</Suffix>
</Author>
<Author ValidYN="Y"><LastName>Bennett</LastName>
<ForeName>J P</ForeName>
<Initials>JP</Initials>
<Suffix>Jr</Suffix>
</Author>
</AuthorList>
<Language>eng</Language>
<GrantList CompleteYN="Y"><Grant><GrantID>M01 RR00847</GrantID>
<Acronym>RR</Acronym>
<Agency>NCRR NIH HHS</Agency>
<Country>United States</Country>
</Grant>
<Grant><GrantID>NS34299</GrantID>
<Acronym>NS</Acronym>
<Agency>NINDS NIH HHS</Agency>
<Country>United States</Country>
</Grant>
</GrantList>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D013487">Research Support, U.S. Gov't, P.H.S.</PublicationType>
</PublicationTypeList>
</Article>
<MedlineJournalInfo><Country>UNITED STATES</Country>
<MedlineTA>Mov Disord</MedlineTA>
<NlmUniqueID>8610688</NlmUniqueID>
<ISSNLinking>0885-3185</ISSNLinking>
</MedlineJournalInfo>
<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D000978">Antiparkinson Agents</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>46627O600J</RegistryNumber>
<NameOfSubstance UI="D007980">Levodopa</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>63-84-3</RegistryNumber>
<NameOfSubstance UI="D004295">Dihydroxyphenylalanine</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>9002-62-4</RegistryNumber>
<NameOfSubstance UI="D011388">Prolactin</NameOfSubstance>
</Chemical>
</ChemicalList>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000284">Administration, Oral</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D000368">Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D000978">Antiparkinson Agents</DescriptorName>
<QualifierName MajorTopicYN="Y" UI="Q000008">administration & dosage</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D003131">Combined Modality Therapy</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D004295">Dihydroxyphenylalanine</DescriptorName>
<QualifierName MajorTopicYN="N" UI="Q000097">blood</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D004292">Dominance, Cerebral</DescriptorName>
<QualifierName MajorTopicYN="N" UI="Q000187">drug effects</QualifierName>
<QualifierName MajorTopicYN="N" UI="Q000502">physiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D005260">Female</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D005684">Gait</DescriptorName>
<QualifierName MajorTopicYN="N" UI="Q000187">drug effects</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D005917">Globus Pallidus</DescriptorName>
<QualifierName MajorTopicYN="N" UI="Q000503">physiopathology</QualifierName>
<QualifierName MajorTopicYN="Y" UI="Q000601">surgery</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D007262">Infusions, Intravenous</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D007980">Levodopa</DescriptorName>
<QualifierName MajorTopicYN="Y" UI="Q000008">administration & dosage</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D008297">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D008875">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D009048">Motor Skills</DescriptorName>
<QualifierName MajorTopicYN="Y" UI="Q000187">drug effects</QualifierName>
<QualifierName MajorTopicYN="N" UI="Q000502">physiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D009460">Neurologic Examination</DescriptorName>
<QualifierName MajorTopicYN="Y" UI="Q000187">drug effects</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D010300">Parkinson Disease</DescriptorName>
<QualifierName MajorTopicYN="N" UI="Q000503">physiopathology</QualifierName>
<QualifierName MajorTopicYN="Y" UI="Q000601">surgery</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D011388">Prolactin</DescriptorName>
<QualifierName MajorTopicYN="N" UI="Q000097">blood</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName MajorTopicYN="N" UI="D013238">Stereotaxic Techniques</DescriptorName>
</MeshHeading>
</MeshHeadingList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1998</Year>
<Month>10</Month>
<Day>2</Day>
<Hour>2</Hour>
<Minute>3</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2001</Year>
<Month>3</Month>
<Day>28</Day>
<Hour>10</Hour>
<Minute>1</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez"><Year>1998</Year>
<Month>10</Month>
<Day>2</Day>
<Hour>2</Hour>
<Minute>3</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">9756145</ArticleId>
<ArticleId IdType="doi">10.1002/mds.870130504</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
<affiliations><list><country><li>États-Unis</li>
</country>
</list>
<tree><noCountry><name sortKey="Bennett, J P" sort="Bennett, J P" uniqKey="Bennett J" first="J P" last="Bennett">J P Bennett</name>
<name sortKey="Laws, E R" sort="Laws, E R" uniqKey="Laws E" first="E R" last="Laws">E R Laws</name>
</noCountry>
<country name="États-Unis"><noRegion><name sortKey="Skalabrin, E J" sort="Skalabrin, E J" uniqKey="Skalabrin E" first="E J" last="Skalabrin">E J Skalabrin</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>
Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Santé/explor/MovDisordV3/Data/PubMed/Checkpoint
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 004371 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/PubMed/Checkpoint/biblio.hfd -nk 004371 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien |wiki= Wicri/Santé |area= MovDisordV3 |flux= PubMed |étape= Checkpoint |type= RBID |clé= pubmed:9756145 |texte= Pallidotomy improves motor responses and widens the levodopa therapeutic window in Parkinson's disease. }}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/PubMed/Checkpoint/RBID.i -Sk "pubmed:9756145" \ | HfdSelect -Kh $EXPLOR_AREA/Data/PubMed/Checkpoint/biblio.hfd \ | NlmPubMed2Wicri -a MovDisordV3
![]() | This area was generated with Dilib version V0.6.23. | ![]() |