Pallidal stimulation in advanced Parkinson's patients with contraindications for subthalamic stimulation.
Identifieur interne : 000B68 ( Ncbi/Checkpoint ); précédent : 000B67; suivant : 000B69Pallidal stimulation in advanced Parkinson's patients with contraindications for subthalamic stimulation.
Auteurs : Tiphaine Rouaud [France] ; Thibaut Dondaine ; Sophie Drapier ; Claire Haegelen ; François Lallement ; Julie Péron ; Sylvie Raoul ; Paul Sauleau ; Marc VérinSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2010.
English descriptors
- KwdEn :
- MESH :
- surgery : Globus Pallidus, Subthalamic Nucleus.
- therapy : Parkinson Disease.
- Aged, Deep Brain Stimulation, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Severity of Illness Index, Treatment Outcome.
Abstract
The aim of this study was to evaluate the efficacy and safety of bilateral pallidal (GPi) deep brain stimulation (DBS) 6 months after surgery in advanced parkinsonian patients whose dopa-resistant axial motor signs or cognitive decline constituted contraindications for subthalamic nucleus (STN) DBS. Seventeen patients with a mean age of 59.3 ± 7.1 years (range, 45-70), mean disease duration of 12.5 ± 4.3 years (range, 7-20), and contraindications for STN DBS, underwent bilateral GPi DBS. They were evaluated before surgery and 6 months afterward, in accordance with Core Assessment Program for Intracerebral Transplantation recommendations. There were mean improvements of 41.1% in the UPDRS III motor score in the off-dopa condition and 20.3% in the activities of daily living score. Motor fluctuations were reduced by 22.9% and dyskinesias by 68.6%. Axial motor signs improved in the off-dopa condition by 34.2%. Neuropsychological performances remained unchanged at the 6-month assessment. Bilateral GPi DBS is both safe and effective in advanced parkinsonian patients with untreatable motor fluctuations, for whom STN DBS is contraindicated due to dopa-resistant axial motor signs or cognitive decline. As such, it should be regarded as a viable option for these patients.
DOI: 10.1002/mds.23171
PubMed: 20568094
Affiliations:
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first="Tiphaine" last="Rouaud">Tiphaine Rouaud</name><affiliation wicri:level="3"><nlm:affiliation>Department of Neurology, University Hospital of Rennes, Rennes, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Neurology, University Hospital of Rennes, Rennes</wicri:regionArea><placeName><region type="region">Région Bretagne</region><region type="old region">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Dondaine, Thibaut" sort="Dondaine, Thibaut" uniqKey="Dondaine T" first="Thibaut" last="Dondaine">Thibaut Dondaine</name></author><author><name sortKey="Drapier, Sophie" sort="Drapier, Sophie" uniqKey="Drapier S" first="Sophie" last="Drapier">Sophie Drapier</name></author><author><name sortKey="Haegelen, Claire" sort="Haegelen, Claire" uniqKey="Haegelen C" first="Claire" last="Haegelen">Claire Haegelen</name></author><author><name sortKey="Lallement, Francois" 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Stimulation</term><term>Female</term><term>Globus Pallidus (surgery)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Neuropsychological Tests</term><term>Parkinson Disease (therapy)</term><term>Severity of Illness Index</term><term>Subthalamic Nucleus (surgery)</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Globus Pallidus</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>Deep Brain Stimulation</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Neuropsychological Tests</term><term>Severity of Illness Index</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aim of this study was to evaluate the efficacy and safety of bilateral pallidal (GPi) deep brain stimulation (DBS) 6 months after surgery in advanced parkinsonian patients whose dopa-resistant axial motor signs or cognitive decline constituted contraindications for subthalamic nucleus (STN) DBS. Seventeen patients with a mean age of 59.3 ± 7.1 years (range, 45-70), mean disease duration of 12.5 ± 4.3 years (range, 7-20), and contraindications for STN DBS, underwent bilateral GPi DBS. They were evaluated before surgery and 6 months afterward, in accordance with Core Assessment Program for Intracerebral Transplantation recommendations. There were mean improvements of 41.1% in the UPDRS III motor score in the off-dopa condition and 20.3% in the activities of daily living score. Motor fluctuations were reduced by 22.9% and dyskinesias by 68.6%. Axial motor signs improved in the off-dopa condition by 34.2%. Neuropsychological performances remained unchanged at the 6-month assessment. Bilateral GPi DBS is both safe and effective in advanced parkinsonian patients with untreatable motor fluctuations, for whom STN DBS is contraindicated due to dopa-resistant axial motor signs or cognitive decline. As such, it should be regarded as a viable option for these patients.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Région Bretagne</li></region><settlement><li>Rennes</li></settlement></list><tree><noCountry><name sortKey="Dondaine, Thibaut" sort="Dondaine, Thibaut" uniqKey="Dondaine T" first="Thibaut" last="Dondaine">Thibaut Dondaine</name><name sortKey="Drapier, Sophie" sort="Drapier, Sophie" uniqKey="Drapier S" first="Sophie" last="Drapier">Sophie Drapier</name><name sortKey="Haegelen, Claire" sort="Haegelen, Claire" uniqKey="Haegelen C" first="Claire" last="Haegelen">Claire Haegelen</name><name sortKey="Lallement, Francois" sort="Lallement, Francois" uniqKey="Lallement F" first="François" last="Lallement">François Lallement</name><name sortKey="Peron, Julie" sort="Peron, Julie" uniqKey="Peron J" first="Julie" last="Péron">Julie Péron</name><name sortKey="Raoul, Sylvie" sort="Raoul, Sylvie" uniqKey="Raoul S" first="Sylvie" last="Raoul">Sylvie Raoul</name><name sortKey="Sauleau, Paul" sort="Sauleau, Paul" uniqKey="Sauleau P" first="Paul" last="Sauleau">Paul Sauleau</name><name sortKey="Verin, Marc" sort="Verin, Marc" uniqKey="Verin M" first="Marc" last="Vérin">Marc Vérin</name></noCountry><country name="France"><region name="Région Bretagne"><name sortKey="Rouaud, Tiphaine" sort="Rouaud, Tiphaine" uniqKey="Rouaud T" first="Tiphaine" last="Rouaud">Tiphaine Rouaud</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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