Evolution of Parkinson's disease during 4 years of bilateral deep brain stimulation of the subthalamic nucleus.
Identifieur interne : 002D95 ( PubMed/Corpus ); précédent : 002D94; suivant : 002D96Evolution of Parkinson's disease during 4 years of bilateral deep brain stimulation of the subthalamic nucleus.
Auteurs : Karen Stergaard ; Niels Aa SundeSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2006.
English descriptors
- KwdEn :
- Activities of Daily Living, Adult, Aged, Analysis of Variance, Antiparkinson Agents (therapeutic use), Body Weight (physiology), Body Weight (radiation effects), Deep Brain Stimulation (adverse effects), Deep Brain Stimulation (methods), Disease Progression, Dyskinesias (etiology), Female, Follow-Up Studies, Humans, Levodopa (therapeutic use), Male, Middle Aged, Motor Activity (drug effects), Motor Activity (physiology), Motor Skills (drug effects), Motor Skills (radiation effects), Neuropsychological Tests, Parkinson Disease (drug therapy), Parkinson Disease (pathology), Parkinson Disease (surgery), Severity of Illness Index, Subthalamic Nucleus (radiation effects), Treatment Outcome.
- MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- adverse effects : Deep Brain Stimulation.
- drug effects : Motor Activity, Motor Skills.
- drug therapy : Parkinson Disease.
- etiology : Dyskinesias.
- methods : Deep Brain Stimulation.
- pathology : Parkinson Disease.
- physiology : Body Weight, Motor Activity.
- radiation effects : Body Weight, Motor Skills, Subthalamic Nucleus.
- surgery : Parkinson Disease.
- Activities of Daily Living, Adult, Aged, Analysis of Variance, Disease Progression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neuropsychological Tests, Severity of Illness Index, Treatment Outcome.
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.
DOI: 10.1002/mds.20776
PubMed: 16283616
Links to Exploration step
pubmed:16283616Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Evolution of Parkinson's disease during 4 years of bilateral deep brain stimulation of the subthalamic nucleus.</title><author><name sortKey=" Stergaard, Karen" sort=" Stergaard, Karen" uniqKey=" Stergaard K" first="Karen" last=" Stergaard">Karen Stergaard</name><affiliation><nlm:affiliation>Department of Neurology, Aarhus University Hospital, Nørrebrogade, Aarhus C, Denmark. karen.ostergaard@oncable.dk</nlm:affiliation></affiliation></author><author><name sortKey="Aa Sunde, Niels" sort="Aa Sunde, Niels" uniqKey="Aa Sunde N" first="Niels" last="Aa Sunde">Niels Aa Sunde</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2006">2006</date><idno type="doi">10.1002/mds.20776</idno><idno type="RBID">pubmed:16283616</idno><idno type="pmid">16283616</idno><idno type="wicri:Area/PubMed/Corpus">002D95</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Evolution of Parkinson's disease during 4 years of bilateral deep brain stimulation of the subthalamic nucleus.</title><author><name sortKey=" Stergaard, Karen" sort=" Stergaard, Karen" uniqKey=" Stergaard K" first="Karen" last=" Stergaard">Karen Stergaard</name><affiliation><nlm:affiliation>Department of Neurology, Aarhus University Hospital, Nørrebrogade, Aarhus C, Denmark. karen.ostergaard@oncable.dk</nlm:affiliation></affiliation></author><author><name sortKey="Aa Sunde, Niels" sort="Aa Sunde, Niels" uniqKey="Aa Sunde N" first="Niels" last="Aa Sunde">Niels Aa Sunde</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="2006" type="published">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activities of Daily Living</term><term>Adult</term><term>Aged</term><term>Analysis of Variance</term><term>Antiparkinson Agents (therapeutic use)</term><term>Body Weight (physiology)</term><term>Body Weight (radiation effects)</term><term>Deep Brain Stimulation (adverse effects)</term><term>Deep Brain Stimulation (methods)</term><term>Disease Progression</term><term>Dyskinesias (etiology)</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Levodopa (therapeutic use)</term><term>Male</term><term>Middle Aged</term><term>Motor Activity (drug effects)</term><term>Motor Activity (physiology)</term><term>Motor Skills (drug effects)</term><term>Motor Skills (radiation effects)</term><term>Neuropsychological Tests</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (pathology)</term><term>Parkinson Disease (surgery)</term><term>Severity of Illness Index</term><term>Subthalamic Nucleus (radiation effects)</term><term>Treatment Outcome</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="adverse effects" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Motor Activity</term><term>Motor Skills</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Dyskinesias</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Deep Brain Stimulation</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Body Weight</term><term>Motor Activity</term></keywords><keywords scheme="MESH" qualifier="radiation effects" xml:lang="en"><term>Body Weight</term><term>Motor Skills</term><term>Subthalamic Nucleus</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Activities of Daily Living</term><term>Adult</term><term>Aged</term><term>Analysis of Variance</term><term>Disease Progression</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Neuropsychological Tests</term><term>Severity of Illness Index</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">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.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">16283616</PMID><DateCreated><Year>2006</Year><Month>05</Month><Day>11</Day></DateCreated><DateCompleted><Year>2006</Year><Month>10</Month><Day>18</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>21</Volume><Issue>5</Issue><PubDate><Year>2006</Year><Month>May</Month></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Evolution of Parkinson's disease during 4 years of bilateral deep brain stimulation of the subthalamic nucleus.</ArticleTitle><Pagination><MedlinePgn>624-31</MedlinePgn></Pagination><Abstract><AbstractText>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.</AbstractText><CopyrightInformation>Copyright (c) 2005 Movement Disorder Society.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Østergaard</LastName><ForeName>Karen</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Neurology, Aarhus University Hospital, Nørrebrogade, Aarhus C, Denmark. karen.ostergaard@oncable.dk</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Aa Sunde</LastName><ForeName>Niels</ForeName><Initials>N</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D023362">Evaluation Studies</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United 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MajorTopicYN="N" UI="Q000627">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D001835">Body Weight</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000502">physiology</QualifierName><QualifierName MajorTopicYN="N" UI="Q000528">radiation effects</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D046690">Deep Brain Stimulation</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000009">adverse effects</QualifierName><QualifierName MajorTopicYN="N" UI="Q000379">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D018450">Disease Progression</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D020820">Dyskinesias</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000209">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D005260">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName 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UI="Q000528">radiation effects</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D009483">Neuropsychological Tests</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D010300">Parkinson Disease</DescriptorName><QualifierName MajorTopicYN="N" UI="Q000188">drug therapy</QualifierName><QualifierName MajorTopicYN="N" UI="Q000473">pathology</QualifierName><QualifierName MajorTopicYN="Y" UI="Q000601">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D012720">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D020531">Subthalamic Nucleus</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000528">radiation effects</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D016896">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate 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