Long-term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson's disease.
Identifieur interne : 001906 ( PubMed/Curation ); précédent : 001905; suivant : 001907Long-term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson's disease.
Auteurs : Elena Moro [Canada] ; Andres M. Lozano ; Pierre Pollak ; Yves Agid ; Stig Rehncrona ; Jens Volkmann ; Jaime Kulisevsky ; Jose A. Obeso ; Alberto Albanese ; Marwan I. Hariz ; Niall P. Quinn ; Jans D. Speelman ; Alim L. Benabid ; Valerie Fraix ; Alexandre Mendes ; Marie-Laure Welter ; Jean-Luc Houeto ; Philippe Cornu ; Didier Dormont ; Annalena L. Tornqvist ; Ron Ekberg ; Alfons Schnitzler ; Lars Timmermann ; Lars Wojtecki ; Andres Gironell ; Maria C. Rodriguez-Oroz ; Jorge Guridi ; Anna R. Bentivoglio ; Maria F. Contarino ; Luigi Romito ; Massimo Scerrati ; Marc Janssens ; Anthony E. LangSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2010.
English descriptors
- KwdEn :
- MESH :
- physiology : Globus Pallidus, Subthalamus.
- therapy : Parkinson Disease.
- Aged, Cross-Over Studies, Deep Brain Stimulation, Double-Blind Method, Female, Follow-Up Studies, Humans, Male, Middle Aged, Severity of Illness Index, Time Factors, Treatment Outcome.
Abstract
We report the 5 to 6 year follow-up of a multicenter study of bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) in advanced Parkinson's disease (PD) patients. Thirty-five STN patients and 16 GPi patients were assessed at 5 to 6 years after DBS surgery. Primary outcome measure was the stimulation effect on the motor Unified Parkinson's Disease Rating Scale (UPDRS) assessed with a prospective cross-over double-blind assessment without medications (stimulation was randomly switched on or off). Secondary outcomes were motor UPDRS changes with unblinded assessments in off- and on-medication states with and without stimulation, activities of daily living (ADL), anti-PD medications, and dyskinesias. In double-blind assessment, both STN and GPi DBS were significantly effective in improving the motor UPDRS scores (STN, P < 0.0001, 45.4%; GPi, P = 0.008, 20.0%) compared with off-stimulation, regardless of the sequence of stimulation. In open assessment, both STN- and GPi-DBS significantly improved the off-medication motor UPDRS when compared with before surgery (STN, P < 0.001, 50.5%; GPi, P = 0.002, 35.6%). Dyskinesias and ADL were significantly improved in both groups. Anti-PD medications were significantly reduced only in the STN group. Adverse events were more frequent in the STN group. These results confirm the long-term efficacy of STN and GPi DBS in advanced PD. Although the surgical targets were not randomized, there was a trend to a better outcome of motor signs in the STN-DBS patients and fewer adverse events in the GPi-DBS group.
DOI: 10.1002/mds.22735
PubMed: 20213817
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Lang</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2010">2010</date><idno type="doi">10.1002/mds.22735</idno><idno type="RBID">pubmed:20213817</idno><idno type="pmid">20213817</idno><idno type="wicri:Area/PubMed/Corpus">001906</idno><idno type="wicri:Area/PubMed/Curation">001906</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Long-term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson's disease.</title><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation wicri:level="1"><nlm:affiliation>Toronto Western Hospital, Movement Disorders Center, University of Toronto and University Health Network, Toronto, Ontario, Canada. elena.moro@uhn.on.ca</nlm:affiliation><country xml:lang="fr">Canada</country><wicri:regionArea>Toronto Western Hospital, Movement Disorders Center, University of Toronto and University Health Network, Toronto, Ontario</wicri:regionArea></affiliation></author><author><name sortKey="Lozano, Andres M" sort="Lozano, Andres M" uniqKey="Lozano A" first="Andres M" last="Lozano">Andres M. Lozano</name></author><author><name sortKey="Pollak, Pierre" sort="Pollak, Pierre" uniqKey="Pollak P" first="Pierre" last="Pollak">Pierre Pollak</name></author><author><name sortKey="Agid, Yves" sort="Agid, Yves" uniqKey="Agid Y" first="Yves" last="Agid">Yves Agid</name></author><author><name sortKey="Rehncrona, Stig" sort="Rehncrona, Stig" uniqKey="Rehncrona S" first="Stig" last="Rehncrona">Stig Rehncrona</name></author><author><name sortKey="Volkmann, Jens" sort="Volkmann, Jens" uniqKey="Volkmann J" first="Jens" last="Volkmann">Jens Volkmann</name></author><author><name sortKey="Kulisevsky, Jaime" sort="Kulisevsky, Jaime" uniqKey="Kulisevsky J" first="Jaime" last="Kulisevsky">Jaime Kulisevsky</name></author><author><name sortKey="Obeso, Jose A" sort="Obeso, Jose A" uniqKey="Obeso J" first="Jose A" last="Obeso">Jose A. Obeso</name></author><author><name sortKey="Albanese, Alberto" sort="Albanese, Alberto" uniqKey="Albanese A" first="Alberto" last="Albanese">Alberto Albanese</name></author><author><name sortKey="Hariz, Marwan I" sort="Hariz, Marwan I" uniqKey="Hariz M" first="Marwan I" last="Hariz">Marwan I. Hariz</name></author><author><name sortKey="Quinn, Niall P" sort="Quinn, Niall P" uniqKey="Quinn N" first="Niall P" last="Quinn">Niall P. Quinn</name></author><author><name sortKey="Speelman, Jans D" sort="Speelman, Jans D" uniqKey="Speelman J" first="Jans D" last="Speelman">Jans D. Speelman</name></author><author><name sortKey="Benabid, Alim L" sort="Benabid, Alim L" uniqKey="Benabid A" first="Alim L" last="Benabid">Alim L. Benabid</name></author><author><name sortKey="Fraix, Valerie" sort="Fraix, Valerie" uniqKey="Fraix V" first="Valerie" last="Fraix">Valerie Fraix</name></author><author><name sortKey="Mendes, Alexandre" sort="Mendes, Alexandre" uniqKey="Mendes A" first="Alexandre" last="Mendes">Alexandre Mendes</name></author><author><name sortKey="Welter, Marie Laure" sort="Welter, Marie Laure" uniqKey="Welter M" first="Marie-Laure" last="Welter">Marie-Laure Welter</name></author><author><name sortKey="Houeto, Jean Luc" sort="Houeto, Jean Luc" uniqKey="Houeto J" first="Jean-Luc" last="Houeto">Jean-Luc Houeto</name></author><author><name sortKey="Cornu, Philippe" sort="Cornu, Philippe" uniqKey="Cornu P" first="Philippe" last="Cornu">Philippe Cornu</name></author><author><name sortKey="Dormont, Didier" sort="Dormont, Didier" uniqKey="Dormont D" first="Didier" last="Dormont">Didier Dormont</name></author><author><name sortKey="Tornqvist, Annalena L" sort="Tornqvist, Annalena L" uniqKey="Tornqvist A" first="Annalena L" last="Tornqvist">Annalena L. Tornqvist</name></author><author><name sortKey="Ekberg, Ron" sort="Ekberg, Ron" uniqKey="Ekberg R" first="Ron" last="Ekberg">Ron Ekberg</name></author><author><name sortKey="Schnitzler, Alfons" sort="Schnitzler, Alfons" uniqKey="Schnitzler A" first="Alfons" last="Schnitzler">Alfons Schnitzler</name></author><author><name sortKey="Timmermann, Lars" sort="Timmermann, Lars" uniqKey="Timmermann L" first="Lars" last="Timmermann">Lars Timmermann</name></author><author><name sortKey="Wojtecki, Lars" sort="Wojtecki, Lars" uniqKey="Wojtecki L" first="Lars" last="Wojtecki">Lars Wojtecki</name></author><author><name sortKey="Gironell, Andres" sort="Gironell, Andres" uniqKey="Gironell A" first="Andres" last="Gironell">Andres Gironell</name></author><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></author><author><name sortKey="Guridi, Jorge" sort="Guridi, Jorge" uniqKey="Guridi J" first="Jorge" last="Guridi">Jorge Guridi</name></author><author><name sortKey="Bentivoglio, Anna R" sort="Bentivoglio, Anna R" uniqKey="Bentivoglio A" first="Anna R" last="Bentivoglio">Anna R. Bentivoglio</name></author><author><name sortKey="Contarino, Maria F" sort="Contarino, Maria F" uniqKey="Contarino M" first="Maria F" last="Contarino">Maria F. Contarino</name></author><author><name sortKey="Romito, Luigi" sort="Romito, Luigi" uniqKey="Romito L" first="Luigi" last="Romito">Luigi Romito</name></author><author><name sortKey="Scerrati, Massimo" sort="Scerrati, Massimo" uniqKey="Scerrati M" first="Massimo" last="Scerrati">Massimo Scerrati</name></author><author><name sortKey="Janssens, Marc" sort="Janssens, Marc" uniqKey="Janssens M" first="Marc" last="Janssens">Marc Janssens</name></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E" last="Lang">Anthony E. Lang</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2010" type="published">2010</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term><term>Cross-Over Studies</term><term>Deep Brain Stimulation</term><term>Double-Blind Method</term><term>Female</term><term>Follow-Up Studies</term><term>Globus Pallidus (physiology)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease (therapy)</term><term>Severity of Illness Index</term><term>Subthalamus (physiology)</term><term>Time Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Globus Pallidus</term><term>Subthalamus</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Cross-Over Studies</term><term>Deep Brain Stimulation</term><term>Double-Blind Method</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Severity of Illness Index</term><term>Time Factors</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We report the 5 to 6 year follow-up of a multicenter study of bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) in advanced Parkinson's disease (PD) patients. Thirty-five STN patients and 16 GPi patients were assessed at 5 to 6 years after DBS surgery. Primary outcome measure was the stimulation effect on the motor Unified Parkinson's Disease Rating Scale (UPDRS) assessed with a prospective cross-over double-blind assessment without medications (stimulation was randomly switched on or off). Secondary outcomes were motor UPDRS changes with unblinded assessments in off- and on-medication states with and without stimulation, activities of daily living (ADL), anti-PD medications, and dyskinesias. In double-blind assessment, both STN and GPi DBS were significantly effective in improving the motor UPDRS scores (STN, P < 0.0001, 45.4%; GPi, P = 0.008, 20.0%) compared with off-stimulation, regardless of the sequence of stimulation. In open assessment, both STN- and GPi-DBS significantly improved the off-medication motor UPDRS when compared with before surgery (STN, P < 0.001, 50.5%; GPi, P = 0.002, 35.6%). Dyskinesias and ADL were significantly improved in both groups. Anti-PD medications were significantly reduced only in the STN group. Adverse events were more frequent in the STN group. These results confirm the long-term efficacy of STN and GPi DBS in advanced PD. Although the surgical targets were not randomized, there was a trend to a better outcome of motor signs in the STN-DBS patients and fewer adverse events in the GPi-DBS group.</div></front></TEI><pubmed><MedlineCitation Owner="NLM" Status="MEDLINE"><PMID Version="1">20213817</PMID><DateCreated><Year>2010</Year><Month>04</Month><Day>28</Day></DateCreated><DateCompleted><Year>2010</Year><Month>07</Month><Day>23</Day></DateCompleted><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1531-8257</ISSN><JournalIssue CitedMedium="Internet"><Volume>25</Volume><Issue>5</Issue><PubDate><Year>2010</Year><Month>Apr</Month><Day>15</Day></PubDate></JournalIssue><Title>Movement disorders : official journal of the Movement Disorder Society</Title><ISOAbbreviation>Mov. Disord.</ISOAbbreviation></Journal><ArticleTitle>Long-term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson's disease.</ArticleTitle><Pagination><MedlinePgn>578-86</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/mds.22735</ELocationID><Abstract><AbstractText>We report the 5 to 6 year follow-up of a multicenter study of bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) in advanced Parkinson's disease (PD) patients. Thirty-five STN patients and 16 GPi patients were assessed at 5 to 6 years after DBS surgery. Primary outcome measure was the stimulation effect on the motor Unified Parkinson's Disease Rating Scale (UPDRS) assessed with a prospective cross-over double-blind assessment without medications (stimulation was randomly switched on or off). Secondary outcomes were motor UPDRS changes with unblinded assessments in off- and on-medication states with and without stimulation, activities of daily living (ADL), anti-PD medications, and dyskinesias. In double-blind assessment, both STN and GPi DBS were significantly effective in improving the motor UPDRS scores (STN, P < 0.0001, 45.4%; GPi, P = 0.008, 20.0%) compared with off-stimulation, regardless of the sequence of stimulation. In open assessment, both STN- and GPi-DBS significantly improved the off-medication motor UPDRS when compared with before surgery (STN, P < 0.001, 50.5%; GPi, P = 0.002, 35.6%). Dyskinesias and ADL were significantly improved in both groups. Anti-PD medications were significantly reduced only in the STN group. Adverse events were more frequent in the STN group. These results confirm the long-term efficacy of STN and GPi DBS in advanced PD. Although the surgical targets were not randomized, there was a trend to a better outcome of motor signs in the STN-DBS patients and fewer adverse events in the GPi-DBS group.</AbstractText><CopyrightInformation>(c) 2010 Movement Disorder Society.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Moro</LastName><ForeName>Elena</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Toronto Western Hospital, Movement Disorders Center, University of Toronto and University Health Network, Toronto, Ontario, Canada. elena.moro@uhn.on.ca</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lozano</LastName><ForeName>Andres M</ForeName><Initials>AM</Initials></Author><Author ValidYN="Y"><LastName>Pollak</LastName><ForeName>Pierre</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Agid</LastName><ForeName>Yves</ForeName><Initials>Y</Initials></Author><Author ValidYN="Y"><LastName>Rehncrona</LastName><ForeName>Stig</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Volkmann</LastName><ForeName>Jens</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Kulisevsky</LastName><ForeName>Jaime</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Obeso</LastName><ForeName>Jose A</ForeName><Initials>JA</Initials></Author><Author ValidYN="Y"><LastName>Albanese</LastName><ForeName>Alberto</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Hariz</LastName><ForeName>Marwan I</ForeName><Initials>MI</Initials></Author><Author ValidYN="Y"><LastName>Quinn</LastName><ForeName>Niall P</ForeName><Initials>NP</Initials></Author><Author ValidYN="Y"><LastName>Speelman</LastName><ForeName>Jans D</ForeName><Initials>JD</Initials></Author><Author ValidYN="Y"><LastName>Benabid</LastName><ForeName>Alim L</ForeName><Initials>AL</Initials></Author><Author ValidYN="Y"><LastName>Fraix</LastName><ForeName>Valerie</ForeName><Initials>V</Initials></Author><Author ValidYN="Y"><LastName>Mendes</LastName><ForeName>Alexandre</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Welter</LastName><ForeName>Marie-Laure</ForeName><Initials>ML</Initials></Author><Author ValidYN="Y"><LastName>Houeto</LastName><ForeName>Jean-Luc</ForeName><Initials>JL</Initials></Author><Author ValidYN="Y"><LastName>Cornu</LastName><ForeName>Philippe</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Dormont</LastName><ForeName>Didier</ForeName><Initials>D</Initials></Author><Author ValidYN="Y"><LastName>Tornqvist</LastName><ForeName>Annalena L</ForeName><Initials>AL</Initials></Author><Author ValidYN="Y"><LastName>Ekberg</LastName><ForeName>Ron</ForeName><Initials>R</Initials></Author><Author ValidYN="Y"><LastName>Schnitzler</LastName><ForeName>Alfons</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Timmermann</LastName><ForeName>Lars</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Wojtecki</LastName><ForeName>Lars</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Gironell</LastName><ForeName>Andres</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Rodriguez-Oroz</LastName><ForeName>Maria C</ForeName><Initials>MC</Initials></Author><Author ValidYN="Y"><LastName>Guridi</LastName><ForeName>Jorge</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Bentivoglio</LastName><ForeName>Anna R</ForeName><Initials>AR</Initials></Author><Author ValidYN="Y"><LastName>Contarino</LastName><ForeName>Maria F</ForeName><Initials>MF</Initials></Author><Author ValidYN="Y"><LastName>Romito</LastName><ForeName>Luigi</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Scerrati</LastName><ForeName>Massimo</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Janssens</LastName><ForeName>Marc</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Lang</LastName><ForeName>Anthony E</ForeName><Initials>AE</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016430">Clinical Trial</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType><PublicationType UI="D016449">Randomized Controlled Trial</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Mov Disord</MedlineTA><NlmUniqueID>8610688</NlmUniqueID><ISSNLinking>0885-3185</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName MajorTopicYN="N" UI="D000368">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D018592">Cross-Over Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="Y" UI="D046690">Deep Brain Stimulation</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D004311">Double-Blind Method</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D005260">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D005500">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D005917">Globus Pallidus</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000502">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D006801">Humans</DescriptorName></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="D010300">Parkinson Disease</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000628">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D012720">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D020530">Subthalamus</DescriptorName><QualifierName MajorTopicYN="Y" UI="Q000502">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D013997">Time Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName MajorTopicYN="N" UI="D016896">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2010</Year><Month>3</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2010</Year><Month>3</Month><Day>10</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2010</Year><Month>7</Month><Day>24</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="doi">10.1002/mds.22735</ArticleId><ArticleId IdType="pubmed">20213817</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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