Treatment results: Parkinson's disease.
Identifieur interne : 000235 ( Ncbi/Checkpoint ); précédent : 000234; suivant : 000236Treatment results: Parkinson's disease.
Auteurs : Pierre Pollak [France] ; Valérie Fraix ; Paul Krack ; Elena Moro ; Alexandre Mendes ; Stephan Chabardes ; Adnan Koudsie ; Alim-Louis BenabidSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2002.
English descriptors
- KwdEn :
- Electric Stimulation Therapy (adverse effects), Electric Stimulation Therapy (methods), Globus Pallidus (physiopathology), Globus Pallidus (surgery), Humans, Parkinson Disease (physiopathology), Parkinson Disease (surgery), Parkinson Disease (therapy), Patient Selection, Risk Assessment, Subthalamic Nucleus (physiopathology), Subthalamic Nucleus (surgery), Thalamus (physiopathology), Thalamus (surgery), Treatment Outcome.
- MESH :
- adverse effects : Electric Stimulation Therapy.
- methods : Electric Stimulation Therapy.
- physiopathology : Globus Pallidus, Parkinson Disease, Subthalamic Nucleus, Thalamus.
- surgery : Globus Pallidus, Parkinson Disease, Subthalamic Nucleus, Thalamus.
- therapy : Parkinson Disease.
- Humans, Patient Selection, Risk Assessment, Treatment Outcome.
Abstract
Deep brain stimulation (DBS) is a neurosurgical treatment of Parkinson's disease that is applied to three targets: the ventral intermediate nucleus of the thalamus (Vim), the globus pallidus internas (GPi) and the subthalamic nucleus (STN). Vim DBS mainly improves contralateral tremor and, therefore, is being supplanted by DBS of the two other targets, even in patients with tremor dominant disease. STN and GPi DBS improve off-motor phases and dyskinesias. There is little comparative data between these procedures. The magnitude of the motor improvement seems more constant with STN than GPi DBS. STN DBS allows a decrease in antiparkinsonian drug doses and consumes moderate current. These advantages of STN over GPi DBS are offset by the need for more intensive postoperative management. The DBS procedure has the unique advantage of reversibility and adjustability over time. Patients with young-onset Parkinson's disease suffering from levodopa-induced motor complications but still responding well to levodopa and who exhibit no behavioral, mood, or cognitive impairment benefit the most from STN DBS. Adverse effects more specific of the DBS procedure are infection, cutaneous erosion, and lead breaking or disconnection. Intracranial electrode implantation can induce a hematoma or contusion. Most authors agree that the benefit to risk ratio of DBS is favorable.
PubMed: 11948759
Affiliations:
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sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name></author><author><name sortKey="Mendes, Alexandre" sort="Mendes, Alexandre" uniqKey="Mendes A" first="Alexandre" last="Mendes">Alexandre Mendes</name></author><author><name sortKey="Chabardes, Stephan" sort="Chabardes, Stephan" uniqKey="Chabardes S" first="Stephan" last="Chabardes">Stephan Chabardes</name></author><author><name sortKey="Koudsie, Adnan" sort="Koudsie, Adnan" uniqKey="Koudsie A" first="Adnan" last="Koudsie">Adnan Koudsie</name></author><author><name sortKey="Benabid, Alim Louis" sort="Benabid, Alim Louis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2002">2002</date><idno type="RBID">pubmed:11948759</idno><idno 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Hospitalier Universitaire de Grenoble, France. pierre.pollak@ujf-grenoble.fr</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble</wicri:regionArea><wicri:noRegion>Centre Hospitalier Universitaire de Grenoble</wicri:noRegion><wicri:noRegion>Centre Hospitalier Universitaire de Grenoble</wicri:noRegion></affiliation></author><author><name sortKey="Fraix, Valerie" sort="Fraix, Valerie" uniqKey="Fraix V" first="Valérie" last="Fraix">Valérie Fraix</name></author><author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name></author><author><name sortKey="Mendes, Alexandre" sort="Mendes, Alexandre" uniqKey="Mendes A" first="Alexandre" last="Mendes">Alexandre Mendes</name></author><author><name sortKey="Chabardes, Stephan" sort="Chabardes, Stephan" uniqKey="Chabardes S" first="Stephan" last="Chabardes">Stephan Chabardes</name></author><author><name sortKey="Koudsie, Adnan" sort="Koudsie, Adnan" uniqKey="Koudsie A" first="Adnan" last="Koudsie">Adnan Koudsie</name></author><author><name sortKey="Benabid, Alim Louis" sort="Benabid, Alim Louis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="ISSN">0885-3185</idno><imprint><date when="2002" type="published">2002</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Electric Stimulation Therapy (adverse effects)</term><term>Electric Stimulation Therapy (methods)</term><term>Globus Pallidus (physiopathology)</term><term>Globus Pallidus (surgery)</term><term>Humans</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (surgery)</term><term>Parkinson Disease (therapy)</term><term>Patient Selection</term><term>Risk Assessment</term><term>Subthalamic Nucleus (physiopathology)</term><term>Subthalamic Nucleus (surgery)</term><term>Thalamus (physiopathology)</term><term>Thalamus (surgery)</term><term>Treatment Outcome</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>Globus Pallidus</term><term>Parkinson Disease</term><term>Subthalamic Nucleus</term><term>Thalamus</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Globus Pallidus</term><term>Parkinson Disease</term><term>Subthalamic Nucleus</term><term>Thalamus</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Humans</term><term>Patient Selection</term><term>Risk Assessment</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Deep brain stimulation (DBS) is a neurosurgical treatment of Parkinson's disease that is applied to three targets: the ventral intermediate nucleus of the thalamus (Vim), the globus pallidus internas (GPi) and the subthalamic nucleus (STN). Vim DBS mainly improves contralateral tremor and, therefore, is being supplanted by DBS of the two other targets, even in patients with tremor dominant disease. STN and GPi DBS improve off-motor phases and dyskinesias. There is little comparative data between these procedures. The magnitude of the motor improvement seems more constant with STN than GPi DBS. STN DBS allows a decrease in antiparkinsonian drug doses and consumes moderate current. These advantages of STN over GPi DBS are offset by the need for more intensive postoperative management. The DBS procedure has the unique advantage of reversibility and adjustability over time. Patients with young-onset Parkinson's disease suffering from levodopa-induced motor complications but still responding well to levodopa and who exhibit no behavioral, mood, or cognitive impairment benefit the most from STN DBS. Adverse effects more specific of the DBS procedure are infection, cutaneous erosion, and lead breaking or disconnection. Intracranial electrode implantation can induce a hematoma or contusion. Most authors agree that the benefit to risk ratio of DBS is favorable.</div></front></TEI><affiliations><list><country><li>France</li></country></list><tree><noCountry><name sortKey="Benabid, Alim Louis" sort="Benabid, Alim Louis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name><name sortKey="Chabardes, Stephan" sort="Chabardes, Stephan" uniqKey="Chabardes S" first="Stephan" last="Chabardes">Stephan Chabardes</name><name sortKey="Fraix, Valerie" sort="Fraix, Valerie" uniqKey="Fraix V" first="Valérie" last="Fraix">Valérie Fraix</name><name sortKey="Koudsie, Adnan" sort="Koudsie, Adnan" uniqKey="Koudsie A" first="Adnan" last="Koudsie">Adnan Koudsie</name><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name><name sortKey="Mendes, Alexandre" sort="Mendes, Alexandre" uniqKey="Mendes A" first="Alexandre" last="Mendes">Alexandre Mendes</name><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name></noCountry><country name="France"><noRegion><name sortKey="Pollak, Pierre" sort="Pollak, Pierre" uniqKey="Pollak P" first="Pierre" last="Pollak">Pierre Pollak</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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