High-frequency stimulation of the globus pallidus internalis in Parkinson's disease : a study of seven cases
Identifieur interne : 004435 ( Main/Exploration ); précédent : 004434; suivant : 004436High-frequency stimulation of the globus pallidus internalis in Parkinson's disease : a study of seven cases
Auteurs : C. Gross [France] ; A. Rougier ; D. Guehl ; T. Boraud ; J. Julien ; B. BioulacSource :
- Journal of neurosurgery [ 0022-3085 ] ; 1997.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Adult, Case study, Disease Progression, Dyskinesia, Dyskinesia, Drug-Induced (etiology), Electric Stimulation Therapy (instrumentation), Electric Stimulation Therapy (methods), Electrodes, Electrodes, Implanted, Follow up study, Follow-Up Studies, Gait (physiology), Globus Pallidus (physiopathology), Globus Pallidus (surgery), High frequency, Humans, Hypokinesia, Hypokinesia (surgery), Hypokinesia (therapy), Implanted, Instrumental stimulation, Instrumentation therapy, Levodopa (adverse effects), Male, Middle Aged, Movement Disorders (therapy), Muscle Rigidity (surgery), Muscle Rigidity (therapy), Pallidum, Parkinson Disease (etiology), Parkinson Disease (physiopathology), Parkinson Disease (surgery), Parkinson Disease (therapy), Parkinson disease, Speech Disorders (therapy), Stereotaxic Techniques, Stiffness, Thalamic Nuclei (physiopathology), Treatment Outcome, Tremor (therapy), Young adult.
- MESH :
- chemical , adverse effects : Levodopa.
- etiology : Dyskinesia, Drug-Induced, Parkinson Disease.
- instrumentation : Electric Stimulation Therapy.
- methods : Electric Stimulation Therapy.
- physiology : Gait.
- physiopathology : Globus Pallidus, Parkinson Disease, Thalamic Nuclei.
- surgery : Globus Pallidus, Hypokinesia, Muscle Rigidity, Parkinson Disease.
- therapy : Hypokinesia, Movement Disorders, Muscle Rigidity, Parkinson Disease, Speech Disorders, Tremor.
- Adult, Disease Progression, Electrodes, Implanted, Follow-Up Studies, Humans, Male, Middle Aged, Stereotaxic Techniques, Treatment Outcome.
Abstract
The effectiveness of ventroposterolateral pallidotomy in the treatment of akinesia and rigidity is not a new discovery and agrees with recent investigations into the pathogenesis of Parkinson's disease, which highlight the role played by the unbridled activity of the subthalamic nucleus (STN) and the consequent overactivity of the globus pallidus internalis (GPi). Because high-frequency stimulation can reversibly incapacitate a nerve structure, we applied stimulation to the same target. Seven patients suffering from severe Parkinson's disease (Stages III-V on the Hoehn and Yahr scale) and. particularly, bradykinesia, rigidity, and levodopa-induced dyskinesias underwent unilateral electrode implantation in the posteroventral GPi. Follow-up evaluation using the regular Unified Parkinson's Disease Rating Scale has been conducted for I year in all seven patients, 2 years in five of them, and 3 years in one. In all cases high-frequency stimulation has alleviated akinesia and rigidity and has generally improved gait and speech disturbances. In some cases tremor was attenuated. In a similar manner, the authors observed a marked diminution in levodopa-induced dyskinesias. This could be an excellent primary therapy for younger patients exhibiting severe bradykinesia. rigidity, and levodopa-induced dyskinesias, which would allow therapists to keep ventroposterolateral pallidotomy in reserve as a second weapon.
Affiliations:
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Rougier</name></author><author><name sortKey="Guehl, D" sort="Guehl, D" uniqKey="Guehl D" first="D." last="Guehl">D. Guehl</name></author><author><name sortKey="Boraud, T" sort="Boraud, T" uniqKey="Boraud T" first="T." last="Boraud">T. Boraud</name></author><author><name sortKey="Julien, J" sort="Julien, J" uniqKey="Julien J" first="J." last="Julien">J. Julien</name></author><author><name sortKey="Bioulac, B" sort="Bioulac, B" uniqKey="Bioulac B" first="B." last="Bioulac">B. Bioulac</name></author></analytic><series><title level="j" type="main">Journal of neurosurgery</title><title level="j" type="abbreviated">J. neurosurg.</title><idno type="ISSN">0022-3085</idno><imprint><date when="1997">1997</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of neurosurgery</title><title level="j" type="abbreviated">J. neurosurg.</title><idno type="ISSN">0022-3085</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Case study</term><term>Disease Progression</term><term>Dyskinesia</term><term>Dyskinesia, Drug-Induced (etiology)</term><term>Electric Stimulation Therapy (instrumentation)</term><term>Electric Stimulation Therapy (methods)</term><term>Electrodes</term><term>Electrodes, Implanted</term><term>Follow up study</term><term>Follow-Up Studies</term><term>Gait (physiology)</term><term>Globus Pallidus (physiopathology)</term><term>Globus Pallidus (surgery)</term><term>High frequency</term><term>Humans</term><term>Hypokinesia</term><term>Hypokinesia (surgery)</term><term>Hypokinesia (therapy)</term><term>Implanted</term><term>Instrumental stimulation</term><term>Instrumentation therapy</term><term>Levodopa (adverse effects)</term><term>Male</term><term>Middle Aged</term><term>Movement Disorders (therapy)</term><term>Muscle Rigidity (surgery)</term><term>Muscle Rigidity (therapy)</term><term>Pallidum</term><term>Parkinson Disease (etiology)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (surgery)</term><term>Parkinson Disease (therapy)</term><term>Parkinson disease</term><term>Speech Disorders (therapy)</term><term>Stereotaxic Techniques</term><term>Stiffness</term><term>Thalamic Nuclei (physiopathology)</term><term>Treatment Outcome</term><term>Tremor (therapy)</term><term>Young adult</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Dyskinesia, Drug-Induced</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="instrumentation" 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="physiology" xml:lang="en"><term>Gait</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Globus Pallidus</term><term>Parkinson Disease</term><term>Thalamic Nuclei</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Globus Pallidus</term><term>Hypokinesia</term><term>Muscle Rigidity</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Hypokinesia</term><term>Movement Disorders</term><term>Muscle Rigidity</term><term>Parkinson Disease</term><term>Speech Disorders</term><term>Tremor</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Disease Progression</term><term>Electrodes, Implanted</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Stereotaxic Techniques</term><term>Treatment Outcome</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term><term>Dyskinésie</term><term>Hypokinésie</term><term>Rigidité</term><term>Stimulation instrumentale</term><term>Haute fréquence</term><term>Pallidum</term><term>Electrode</term><term>Implanté</term><term>Traitement instrumental</term><term>Etude longitudinale</term><term>Etude cas</term><term>Adulte jeune</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The effectiveness of ventroposterolateral pallidotomy in the treatment of akinesia and rigidity is not a new discovery and agrees with recent investigations into the pathogenesis of Parkinson's disease, which highlight the role played by the unbridled activity of the subthalamic nucleus (STN) and the consequent overactivity of the globus pallidus internalis (GPi). Because high-frequency stimulation can reversibly incapacitate a nerve structure, we applied stimulation to the same target. Seven patients suffering from severe Parkinson's disease (Stages III-V on the Hoehn and Yahr scale) and. particularly, bradykinesia, rigidity, and levodopa-induced dyskinesias underwent unilateral electrode implantation in the posteroventral GPi. Follow-up evaluation using the regular Unified Parkinson's Disease Rating Scale has been conducted for I year in all seven patients, 2 years in five of them, and 3 years in one. In all cases high-frequency stimulation has alleviated akinesia and rigidity and has generally improved gait and speech disturbances. In some cases tremor was attenuated. In a similar manner, the authors observed a marked diminution in levodopa-induced dyskinesias. This could be an excellent primary therapy for younger patients exhibiting severe bradykinesia. rigidity, and levodopa-induced dyskinesias, which would allow therapists to keep ventroposterolateral pallidotomy in reserve as a second weapon.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Aquitaine</li><li>Nouvelle-Aquitaine</li></region><settlement><li>Bordeaux</li></settlement></list><tree><noCountry><name sortKey="Bioulac, B" sort="Bioulac, B" uniqKey="Bioulac B" first="B." last="Bioulac">B. Bioulac</name><name sortKey="Boraud, T" sort="Boraud, T" uniqKey="Boraud T" first="T." last="Boraud">T. Boraud</name><name sortKey="Guehl, D" sort="Guehl, D" uniqKey="Guehl D" first="D." last="Guehl">D. Guehl</name><name sortKey="Julien, J" sort="Julien, J" uniqKey="Julien J" first="J." last="Julien">J. Julien</name><name sortKey="Rougier, A" sort="Rougier, A" uniqKey="Rougier A" first="A." last="Rougier">A. Rougier</name></noCountry><country name="France"><region name="Nouvelle-Aquitaine"><name sortKey="Gross, C" sort="Gross, C" uniqKey="Gross C" first="C." last="Gross">C. Gross</name></region><name sortKey="Gross, C" sort="Gross, C" uniqKey="Gross C" first="C." last="Gross">C. Gross</name><name sortKey="Gross, C" sort="Gross, C" uniqKey="Gross C" first="C." last="Gross">C. Gross</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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