Subthalamic stimulation in Parkinson disease : A multidisciplinary approach
Identifieur interne : 003B60 ( Main/Exploration ); précédent : 003B59; suivant : 003B61Subthalamic stimulation in Parkinson disease : A multidisciplinary approach
Auteurs : J. L. Houeto [France] ; P. Damier [France] ; P. B. Bejjani [France] ; C. Staedler [France] ; A. M. Bonnet [France] ; I. Arnulf [France] ; B. Pidoux [France] ; D. Dormont [France] ; P. Cornu [France] ; Yves Agid [France]Source :
- Archives of neurology : (Chicago) [ 0003-9942 ] ; 2000.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Activities of Daily Living, Bilateral, Continuous, Electric Stimulation Therapy (adverse effects), Electric Stimulation Therapy (methods), Electrodes, Implanted, Female, High frequency, Human, Humans, Instrumental stimulation, Levodopa (adverse effects), Levodopa (therapeutic use), Magnetic Resonance Imaging, Male, Middle Aged, Parkinson Disease (surgery), Parkinson Disease (therapy), Parkinson disease, Performance evaluation, Prospective Studies, Sickness Impact Profile, Stereotaxic Techniques, Subthalamic Nucleus (physiopathology), Subthalamic Nucleus (surgery), Subthalamic nucleus, Treatment, Treatment Outcome.
- MESH :
- chemical , adverse effects : Levodopa.
- adverse effects : Electric Stimulation Therapy.
- methods : Electric Stimulation Therapy.
- physiopathology : Subthalamic Nucleus.
- surgery : Parkinson Disease, Subthalamic Nucleus.
- chemical , therapeutic use : Levodopa.
- therapy : Parkinson Disease.
- Activities of Daily Living, Electrodes, Implanted, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Prospective Studies, Sickness Impact Profile, Stereotaxic Techniques, Treatment Outcome.
Abstract
Background: High-frequency stimulation of the subthalamic nucleus constitutes a therapeutic advance for severely disabled patients with Parkinson disease. Objective: To evaluate the efficacy and safety of continuous bilateral high-frequency stimulation of the subthalamic nucleus in patients with Parkinson disease. Design: A prospective study of patients with Parkinson disease treated at a university hospital. Patients and Methods: Electrodes were implanted bilaterally in the subthalamic nucleus of 23 consecutive patients with Parkinson disease who responded well to levodopa but had severe motor complications. There were 16 men and 7 women (mean ± SEM age, 53 ± 2 years) who had a mean ± SEM disease duration of 14.7 ± 1.0 years. Targets were determined by 3-dimensional magnetic resonance imaging, combined with intraoperative electrophysiologic recordings and stimulation. Results: Six months after surgery, motor disability, levodopa-induced motor fluctuations, dyskinesias, and the daily dose of levodopa equivalent decreased significantly by 67%, 78%, 77%, and 61%, respectively, compared with the preoperative state. No significant morbidity was ohserved, except transient depression in 4 patients. Conclusions: The beneficial effects of subthalamic stimulation depend on (1) the criteria used for patient selection, (2) the precision with which the subthalamic nucleus is targeted (dependent on the 3-dimensional magnetic resonance imaging and the intraoperative electrophysiologic and clinical assessments), and (3) the long-term postoperative adjustment of stimulation variables.
Affiliations:
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Le document en format XML
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activities of Daily Living</term>
<term>Bilateral</term>
<term>Continuous</term>
<term>Electric Stimulation Therapy (adverse effects)</term>
<term>Electric Stimulation Therapy (methods)</term>
<term>Electrodes, Implanted</term>
<term>Female</term>
<term>High frequency</term>
<term>Human</term>
<term>Humans</term>
<term>Instrumental stimulation</term>
<term>Levodopa (adverse effects)</term>
<term>Levodopa (therapeutic use)</term>
<term>Magnetic Resonance Imaging</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Parkinson Disease (surgery)</term>
<term>Parkinson Disease (therapy)</term>
<term>Parkinson disease</term>
<term>Performance evaluation</term>
<term>Prospective Studies</term>
<term>Sickness Impact Profile</term>
<term>Stereotaxic Techniques</term>
<term>Subthalamic Nucleus (physiopathology)</term>
<term>Subthalamic Nucleus (surgery)</term>
<term>Subthalamic nucleus</term>
<term>Treatment</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Levodopa</term>
</keywords>
<keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Electric Stimulation Therapy</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Electric Stimulation Therapy</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Subthalamic Nucleus</term>
</keywords>
<keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Parkinson Disease</term>
<term>Subthalamic Nucleus</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Levodopa</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Activities of Daily Living</term>
<term>Electrodes, Implanted</term>
<term>Female</term>
<term>Humans</term>
<term>Magnetic Resonance Imaging</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Prospective Studies</term>
<term>Sickness Impact Profile</term>
<term>Stereotaxic Techniques</term>
<term>Treatment Outcome</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term>
<term>Stimulation instrumentale</term>
<term>Haute fréquence</term>
<term>Noyau sousthalamique</term>
<term>Evaluation performance</term>
<term>Traitement</term>
<term>Homme</term>
<term>Bilatéral</term>
<term>Continu</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Background: High-frequency stimulation of the subthalamic nucleus constitutes a therapeutic advance for severely disabled patients with Parkinson disease. Objective: To evaluate the efficacy and safety of continuous bilateral high-frequency stimulation of the subthalamic nucleus in patients with Parkinson disease. Design: A prospective study of patients with Parkinson disease treated at a university hospital. Patients and Methods: Electrodes were implanted bilaterally in the subthalamic nucleus of 23 consecutive patients with Parkinson disease who responded well to levodopa but had severe motor complications. There were 16 men and 7 women (mean ± SEM age, 53 ± 2 years) who had a mean ± SEM disease duration of 14.7 ± 1.0 years. Targets were determined by 3-dimensional magnetic resonance imaging, combined with intraoperative electrophysiologic recordings and stimulation. Results: Six months after surgery, motor disability, levodopa-induced motor fluctuations, dyskinesias, and the daily dose of levodopa equivalent decreased significantly by 67%, 78%, 77%, and 61%, respectively, compared with the preoperative state. No significant morbidity was ohserved, except transient depression in 4 patients. Conclusions: The beneficial effects of subthalamic stimulation depend on (1) the criteria used for patient selection, (2) the precision with which the subthalamic nucleus is targeted (dependent on the 3-dimensional magnetic resonance imaging and the intraoperative electrophysiologic and clinical assessments), and (3) the long-term postoperative adjustment of stimulation variables.</div>
</front>
</TEI>
<affiliations><list><country><li>France</li>
</country>
<region><li>Île-de-France</li>
</region>
<settlement><li>Paris</li>
</settlement>
<orgName><li>Hôpital de la Salpêtrière</li>
</orgName>
</list>
<tree><country name="France"><region name="Île-de-France"><name sortKey="Houeto, J L" sort="Houeto, J L" uniqKey="Houeto J" first="J. L." last="Houeto">J. L. Houeto</name>
</region>
<name sortKey="Agid, Y" sort="Agid, Y" uniqKey="Agid Y" first="Y." last="Agid">Yves Agid</name>
<name sortKey="Arnulf, I" sort="Arnulf, I" uniqKey="Arnulf I" first="I." last="Arnulf">I. Arnulf</name>
<name sortKey="Bejjani, P B" sort="Bejjani, P B" uniqKey="Bejjani P" first="P. B." last="Bejjani">P. B. Bejjani</name>
<name sortKey="Bonnet, A M" sort="Bonnet, A M" uniqKey="Bonnet A" first="A. M." last="Bonnet">A. M. Bonnet</name>
<name sortKey="Cornu, P" sort="Cornu, P" uniqKey="Cornu P" first="P." last="Cornu">P. Cornu</name>
<name sortKey="Damier, P" sort="Damier, P" uniqKey="Damier P" first="P." last="Damier">P. Damier</name>
<name sortKey="Dormont, D" sort="Dormont, D" uniqKey="Dormont D" first="D." last="Dormont">D. Dormont</name>
<name sortKey="Pidoux, B" sort="Pidoux, B" uniqKey="Pidoux B" first="B." last="Pidoux">B. Pidoux</name>
<name sortKey="Staedler, C" sort="Staedler, C" uniqKey="Staedler C" first="C." last="Staedler">C. Staedler</name>
</country>
</tree>
</affiliations>
</record>
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