The timing of antiparkinsonian treatment reduction after subthalamic nucleus stimulation
Identifieur interne : 003224 ( Main/Exploration ); précédent : 003223; suivant : 003225The timing of antiparkinsonian treatment reduction after subthalamic nucleus stimulation
Auteurs : S. Thobois [France] ; S. Corvaisier [France] ; P. Mertens [France] ; C. Di Guardo [France] ; H. Mollion [France] ; M. Guenot [France] ; F. Rochefort [France] ; G. Chazot [France] ; M. Sindou [France] ; E. Broussolle [France]Source :
- European neurology [ 0014-3022 ] ; 2003.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
- Aged, Antiparkinson Agents (administration & dosage), Antiparkinson agent, Bilateral, Chemotherapy, Combined Modality Therapy, Dose-Response Relationship, Drug, Drug Administration Schedule, Electric Stimulation Therapy, Electrodes, Implanted, Female, Follow-Up Studies, Human, Humans, Instrumental stimulation, Male, Middle Aged, Neurologic Examination (drug effects), Parkinson Disease (physiopathology), Parkinson Disease (therapy), Parkinson disease, Postoperative, Postoperative Care, Reduction, Subthalamic Nucleus (physiopathology), Subthalamic nucleus, Treatment.
- MESH :
- chemical , administration & dosage : Antiparkinson Agents.
- drug effects : Neurologic Examination.
- physiopathology : Parkinson Disease, Subthalamic Nucleus.
- therapy : Parkinson Disease.
- Aged, Combined Modality Therapy, Dose-Response Relationship, Drug, Drug Administration Schedule, Electric Stimulation Therapy, Electrodes, Implanted, Female, Follow-Up Studies, Humans, Male, Middle Aged, Postoperative Care.
Abstract
The objective of this work was to precisely analyse the reduction of the antiparkinsonian treatment in 18 consecutive patients with Parkinson's disease (PD) operated on for bilateral subthalamic nucleus (STN) stimulation, first after 1 month of follow-up, then at 1 year postoperatively. Trihexyphenidyle, selegiline, entacapone, apomorphine and lisuride could be withdrawn shortly after starting STN electrical stimulation. The levodopa mean daily dose was reduced by 57% at 1 month after surgery and remained stable at 1 year. The mean ropinirole and bromocriptine daily dose decrements after surgery corresponded to 54 and 63%, respectively, at 1 month and to 77 and 40% at 1 year. At 12 months postoperatively, one third of the patients no longer received any antiparkinsonian drugs and the others were on monotherapy of either levodopa or dopamine agonists or received a combined treatment of a dopaminergic agonist and levodopa. In conclusion, STN stimulation allows a major reduction and simplification of antiparkinsonian treatment which can usually be achieved during the early postoperative period.
Affiliations:
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Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">The timing of antiparkinsonian treatment reduction after subthalamic nucleus stimulation</title>
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<series><title level="j" type="main">European neurology</title>
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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Antiparkinson Agents (administration & dosage)</term>
<term>Antiparkinson agent</term>
<term>Bilateral</term>
<term>Chemotherapy</term>
<term>Combined Modality Therapy</term>
<term>Dose-Response Relationship, Drug</term>
<term>Drug Administration Schedule</term>
<term>Electric Stimulation Therapy</term>
<term>Electrodes, Implanted</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Human</term>
<term>Humans</term>
<term>Instrumental stimulation</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Neurologic Examination (drug effects)</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson Disease (therapy)</term>
<term>Parkinson disease</term>
<term>Postoperative</term>
<term>Postoperative Care</term>
<term>Reduction</term>
<term>Subthalamic Nucleus (physiopathology)</term>
<term>Subthalamic nucleus</term>
<term>Treatment</term>
</keywords>
<keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Antiparkinson Agents</term>
</keywords>
<keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Neurologic Examination</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term>
<term>Subthalamic Nucleus</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>Combined Modality Therapy</term>
<term>Dose-Response Relationship, Drug</term>
<term>Drug Administration Schedule</term>
<term>Electric Stimulation Therapy</term>
<term>Electrodes, Implanted</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Postoperative Care</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term>
<term>Stimulation instrumentale</term>
<term>Bilatéral</term>
<term>Noyau sousthalamique</term>
<term>Réduction</term>
<term>Traitement</term>
<term>Antiparkinsonien</term>
<term>Postopératoire</term>
<term>Homme</term>
<term>Chimiothérapie</term>
</keywords>
<keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term>
</keywords>
</textClass>
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</teiHeader>
<front><div type="abstract" xml:lang="en">The objective of this work was to precisely analyse the reduction of the antiparkinsonian treatment in 18 consecutive patients with Parkinson's disease (PD) operated on for bilateral subthalamic nucleus (STN) stimulation, first after 1 month of follow-up, then at 1 year postoperatively. Trihexyphenidyle, selegiline, entacapone, apomorphine and lisuride could be withdrawn shortly after starting STN electrical stimulation. The levodopa mean daily dose was reduced by 57% at 1 month after surgery and remained stable at 1 year. The mean ropinirole and bromocriptine daily dose decrements after surgery corresponded to 54 and 63%, respectively, at 1 month and to 77 and 40% at 1 year. At 12 months postoperatively, one third of the patients no longer received any antiparkinsonian drugs and the others were on monotherapy of either levodopa or dopamine agonists or received a combined treatment of a dopaminergic agonist and levodopa. In conclusion, STN stimulation allows a major reduction and simplification of antiparkinsonian treatment which can usually be achieved during the early postoperative period.</div>
</front>
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<tree><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Thobois, S" sort="Thobois, S" uniqKey="Thobois S" first="S." last="Thobois">S. Thobois</name>
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<name sortKey="Broussolle, E" sort="Broussolle, E" uniqKey="Broussolle E" first="E." last="Broussolle">E. Broussolle</name>
<name sortKey="Chazot, G" sort="Chazot, G" uniqKey="Chazot G" first="G." last="Chazot">G. Chazot</name>
<name sortKey="Corvaisier, S" sort="Corvaisier, S" uniqKey="Corvaisier S" first="S." last="Corvaisier">S. Corvaisier</name>
<name sortKey="Di Guardo, C" sort="Di Guardo, C" uniqKey="Di Guardo C" first="C." last="Di Guardo">C. Di Guardo</name>
<name sortKey="Guenot, M" sort="Guenot, M" uniqKey="Guenot M" first="M." last="Guenot">M. Guenot</name>
<name sortKey="Mertens, P" sort="Mertens, P" uniqKey="Mertens P" first="P." last="Mertens">P. Mertens</name>
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<name sortKey="Sindou, M" sort="Sindou, M" uniqKey="Sindou M" first="M." last="Sindou">M. Sindou</name>
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