Microsubthalamotomy: an immediate predictor of long-term subthalamic stimulation efficacy in Parkinson disease.
Identifieur interne : 000842 ( Ncbi/Curation ); précédent : 000841; suivant : 000843Microsubthalamotomy: an immediate predictor of long-term subthalamic stimulation efficacy in Parkinson disease.
Auteurs : David Maltête [France] ; Stéphane Derrey ; Nathalie Chastan ; Bertrand Debono ; Emmanuel Gérardin ; Pierre Fréger ; Bruno Mihout ; Jean François Menard ; Didier HannequinSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2008.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Deep Brain Stimulation (methods), Female, Humans, Male, Microsurgery (methods), Middle Aged, Neurosurgical Procedures (methods), Parkinson Disease (surgery), Parkinson Disease (therapy), Postoperative Care, Predictive Value of Tests, Subthalamic Nucleus (surgery), Time Factors, Treatment Outcome.
- MESH :
- methods : Deep Brain Stimulation, Microsurgery, Neurosurgical Procedures.
- surgery : Parkinson Disease, Subthalamic Nucleus.
- therapy : Parkinson Disease.
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Postoperative Care, Predictive Value of Tests, Time Factors, Treatment Outcome.
Abstract
A microsubthalamotomy (mSTN) effect is commonly described after implantation that improves Parkinson's motor disability and is considered to be an obvious sign of good placement of the definitive electrode within the subthalamic nucleus (STN). There has been no formal study, however, demonstrating whether this mSTN effect can predict the long-term efficacy of STN stimulation in Parkinson Disease. The mSTN effect was defined by the percentage improvement of unified parkinson's disease rating scale (UPDRS III) baseline score assessed the third day morning following STN implantation, after at least a 12 hour withdrawal of dopaminergic treatment and before the programmable pulse generator was switched on. It was assessed in 30 consecutive patients with PD submitted for STN stimulation. Multiple stepwise regression analysis showed that mSTN effect (P = 0.005) and global mean intensity of stimulation (P = 0.004) were accurate independent predictors of the 6-month postoperative UPDRS III motor score improvement in the off-drug/on-stimulation condition.
DOI: 10.1002/mds.22054
PubMed: 18412281
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pubmed:18412281Le document en format XML
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<front><div type="abstract" xml:lang="en">A microsubthalamotomy (mSTN) effect is commonly described after implantation that improves Parkinson's motor disability and is considered to be an obvious sign of good placement of the definitive electrode within the subthalamic nucleus (STN). There has been no formal study, however, demonstrating whether this mSTN effect can predict the long-term efficacy of STN stimulation in Parkinson Disease. The mSTN effect was defined by the percentage improvement of unified parkinson's disease rating scale (UPDRS III) baseline score assessed the third day morning following STN implantation, after at least a 12 hour withdrawal of dopaminergic treatment and before the programmable pulse generator was switched on. It was assessed in 30 consecutive patients with PD submitted for STN stimulation. Multiple stepwise regression analysis showed that mSTN effect (P = 0.005) and global mean intensity of stimulation (P = 0.004) were accurate independent predictors of the 6-month postoperative UPDRS III motor score improvement in the off-drug/on-stimulation condition.</div>
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