ParkinsonFranceV1, Main, Exploration, bibRecordById, pubmed:9770557

Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease

Identifieur interne : 004159 ( Main/Exploration ); précédent : 004158; suivant : 004160

Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease

Auteurs : P. Limousin [France, Royaume-Uni] ; P. Krack [France, Allemagne] ; P. Pollak [France] ; A. Benazzouz [France] ; C. Ardouin [France] ; D. Hoffmann [France] ; A.-L. Benabid [France]

Source :

The New England journal of medicine [ 0028-4793 ] ; 1998.

RBID : Pascal:98-0491323

Descripteurs français

Pascal (Inist)
- Parkinson maladie, Stade avancé, Stimulation instrumentale, Electrique, Noyau sousthalamique, Traitement, Homme.
Wicri :
- topic : Homme.

English descriptors

KwdEn :
- Activities of Daily Living, Advanced stage, Antiparkinson Agents (therapeutic use), Combined Modality Therapy, Dyskinesia, Drug-Induced (etiology), Electric, Electric Stimulation Therapy, Electrodes, Implanted, Female, Follow-Up Studies, Human, Humans, Instrumental stimulation, Levodopa (therapeutic use), Male, Middle Aged, Parkinson Disease (classification), Parkinson Disease (drug therapy), Parkinson Disease (therapy), Parkinson disease, Severity of Illness Index, Subthalamic nucleus, Thalamic Nuclei, Treatment.
MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- classification : Parkinson Disease.
- drug therapy : Parkinson Disease.
- etiology : Dyskinesia, Drug-Induced.
- therapy : Parkinson Disease.
- Activities of Daily Living, Combined Modality Therapy, Electric Stimulation Therapy, Electrodes, Implanted, Female, Follow-Up Studies, Humans, Male, Middle Aged, Severity of Illness Index, Thalamic Nuclei.

Abstract

Background In many patients with idiopathic Par kinson's disease, treatment with levodopa is compli cated by fluctuations between an "off" period (also referred to as "off medication"), when the medicatior is not working and the motor symptoms of parkin sonism are present, and an "on" period, when the medication is causing improved mobility (also re ferred to as "on medication"), often accompanied by debilitating dyskinesias. In animal models of Parkin son's disease, there is overactivity in the subthalamic nucleus, and electrical stimulation of the subthalamic nucleus improves parkinsonism. We therefore sought to determine the efficacy and safety of electrical stimulation of the subthalamic nucleus in patients with Parkinson's disease. Methods We studied 24 patients with idiopathic Parkinson's disease in whom electrodes were implant ed bilaterally in the subthalamic nucleus under stereotactic guidance with imaging and electrophysiologic testing of the location. Twenty were followed for at least 12 months. Clinical evaluations included the Unified Parkinson's Disease Rating Scale, a dyskinesia scale, and timed tests conducted before and after surgery, when patients were off and on medications. Results After one year of electrical stimulation ol the subthalamic nucleus, the patients' scores for activities of daily living and motor examination scores (Unified Parkinson's Disease Rating Scale parts II and III, respectively) off medication improved by 60 percent (P<0.001). The subscores improved for limb akinesia, rigidity, tremor, and gait. In the testing done on medication, the scores on part III improved by 10 percent (P<0.005). The mean dose of dopaminergic drugs was reduced by half. The cognitive-performance scores remained unchanged, but one patient had paralysis and aphasia after an intracerebral hematoma during the implantation procedure. Conclusions Electrical stimulation of the subthalamic nucleus is an effective treatment for advanced Parkinson's disease. The severity of symptoms off medication decreases, and the dose of levodopa can be reduced, with a consequent reduction in dyskinesias.

Affiliations:

Le document en format XML

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<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activities of Daily Living</term>
<term>Advanced stage</term>
<term>Antiparkinson Agents (therapeutic use)</term>
<term>Combined Modality Therapy</term>
<term>Dyskinesia, Drug-Induced (etiology)</term>
<term>Electric</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>Levodopa (therapeutic use)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Parkinson Disease (classification)</term>
<term>Parkinson Disease (drug therapy)</term>
<term>Parkinson Disease (therapy)</term>
<term>Parkinson disease</term>
<term>Severity of Illness Index</term>
<term>Subthalamic nucleus</term>
<term>Thalamic Nuclei</term>
<term>Treatment</term>
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<keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term>
<term>Levodopa</term>
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<keywords scheme="MESH" qualifier="classification" xml:lang="en"><term>Parkinson Disease</term>
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<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term>
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<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Dyskinesia, Drug-Induced</term>
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<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term>
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<keywords scheme="MESH" xml:lang="en"><term>Activities of Daily Living</term>
<term>Combined Modality Therapy</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>Severity of Illness Index</term>
<term>Thalamic Nuclei</term>
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<keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term>
<term>Stade avancé</term>
<term>Stimulation instrumentale</term>
<term>Electrique</term>
<term>Noyau sousthalamique</term>
<term>Traitement</term>
<term>Homme</term>
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<front><div type="abstract" xml:lang="en">Background In many patients with idiopathic Par kinson's disease, treatment with levodopa is compli cated by fluctuations between an "off" period (also referred to as "off medication"), when the medicatior is not working and the motor symptoms of parkin sonism are present, and an "on" period, when the medication is causing improved mobility (also re ferred to as "on medication"), often accompanied by debilitating dyskinesias. In animal models of Parkin son's disease, there is overactivity in the subthalamic nucleus, and electrical stimulation of the subthalamic nucleus improves parkinsonism. We therefore sought to determine the efficacy and safety of electrical stimulation of the subthalamic nucleus in patients with Parkinson's disease. Methods We studied 24 patients with idiopathic Parkinson's disease in whom electrodes were implant ed bilaterally in the subthalamic nucleus under stereotactic guidance with imaging and electrophysiologic testing of the location. Twenty were followed for at least 12 months. Clinical evaluations included the Unified Parkinson's Disease Rating Scale, a dyskinesia scale, and timed tests conducted before and after surgery, when patients were off and on medications. Results After one year of electrical stimulation ol the subthalamic nucleus, the patients' scores for activities of daily living and motor examination scores (Unified Parkinson's Disease Rating Scale parts II and III, respectively) off medication improved by 60 percent (P<0.001). The subscores improved for limb akinesia, rigidity, tremor, and gait. In the testing done on medication, the scores on part III improved by 10 percent (P<0.005). The mean dose of dopaminergic drugs was reduced by half. The cognitive-performance scores remained unchanged, but one patient had paralysis and aphasia after an intracerebral hematoma during the implantation procedure. Conclusions Electrical stimulation of the subthalamic nucleus is an effective treatment for advanced Parkinson's disease. The severity of symptoms off medication decreases, and the dose of levodopa can be reduced, with a consequent reduction in dyskinesias.</div>
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<settlement><li>Grenoble</li>
<li>Kiel</li>
<li>Londres</li>
</settlement>
</list>
<tree><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Limousin, P" sort="Limousin, P" uniqKey="Limousin P" first="P." last="Limousin">P. Limousin</name>
</region>
<name sortKey="Ardouin, C" sort="Ardouin, C" uniqKey="Ardouin C" first="C." last="Ardouin">C. Ardouin</name>
<name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A.-L." last="Benabid">A.-L. Benabid</name>
<name sortKey="Benazzouz, A" sort="Benazzouz, A" uniqKey="Benazzouz A" first="A." last="Benazzouz">A. Benazzouz</name>
<name sortKey="Hoffmann, D" sort="Hoffmann, D" uniqKey="Hoffmann D" first="D." last="Hoffmann">D. Hoffmann</name>
<name sortKey="Krack, P" sort="Krack, P" uniqKey="Krack P" first="P." last="Krack">P. Krack</name>
<name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P." last="Pollak">P. Pollak</name>
</country>
<country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Limousin, P" sort="Limousin, P" uniqKey="Limousin P" first="P." last="Limousin">P. Limousin</name>
</region>
</country>
<country name="Allemagne"><region name="Schleswig-Holstein"><name sortKey="Krack, P" sort="Krack, P" uniqKey="Krack P" first="P." last="Krack">P. Krack</name>
</region>
</country>
</tree>
</affiliations>
</record>

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   |texte=   Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease
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Data generation: Wed May 17 19:46:39 2017. Site generation: Mon Mar 4 15:48:15 2024

La maladie de Parkinson en France (serveur d'exploration)

Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease

Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease

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	La maladie de Parkinson en France (serveur d'exploration)
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