Subthalamic stimulation in Parkinson disease : A multidisciplinary approach
Identifieur interne : 001180 ( PascalFrancis/Checkpoint ); précédent : 001179; suivant : 001181Subthalamic stimulation in Parkinson disease : A multidisciplinary approach
Auteurs : J. L. Houeto [France] ; P. Damier [France] ; P. B. Bejjani [France] ; C. Staedler [France] ; A. M. Bonnet [France] ; I. Arnulf [France] ; B. Pidoux [France] ; D. Dormont [France] ; P. Cornu [France] ; Yves Agid [France]Source :
- Archives of neurology : (Chicago) [ 0003-9942 ] ; 2000.
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Abstract
Background: High-frequency stimulation of the subthalamic nucleus constitutes a therapeutic advance for severely disabled patients with Parkinson disease. Objective: To evaluate the efficacy and safety of continuous bilateral high-frequency stimulation of the subthalamic nucleus in patients with Parkinson disease. Design: A prospective study of patients with Parkinson disease treated at a university hospital. Patients and Methods: Electrodes were implanted bilaterally in the subthalamic nucleus of 23 consecutive patients with Parkinson disease who responded well to levodopa but had severe motor complications. There were 16 men and 7 women (mean ± SEM age, 53 ± 2 years) who had a mean ± SEM disease duration of 14.7 ± 1.0 years. Targets were determined by 3-dimensional magnetic resonance imaging, combined with intraoperative electrophysiologic recordings and stimulation. Results: Six months after surgery, motor disability, levodopa-induced motor fluctuations, dyskinesias, and the daily dose of levodopa equivalent decreased significantly by 67%, 78%, 77%, and 61%, respectively, compared with the preoperative state. No significant morbidity was ohserved, except transient depression in 4 patients. Conclusions: The beneficial effects of subthalamic stimulation depend on (1) the criteria used for patient selection, (2) the precision with which the subthalamic nucleus is targeted (dependent on the 3-dimensional magnetic resonance imaging and the intraoperative electrophysiologic and clinical assessments), and (3) the long-term postoperative adjustment of stimulation variables.
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Staedler</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologic and Institut National de la Santé et de la Recherche Médicale, Unit 289, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Bonnet, A M" sort="Bonnet, A M" uniqKey="Bonnet A" first="A. M." last="Bonnet">A. M. Bonnet</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologic and Institut National de la Santé et de la Recherche Médicale, Unit 289, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Arnulf, I" sort="Arnulf, I" uniqKey="Arnulf I" first="I." last="Arnulf">I. Arnulf</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologic and Institut National de la Santé et de la Recherche Médicale, Unit 289, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Pidoux, B" sort="Pidoux, B" uniqKey="Pidoux B" first="B." last="Pidoux">B. Pidoux</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Service d'Exploration Fonctionnelle Neurologique, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Dormont, D" sort="Dormont, D" uniqKey="Dormont D" first="D." last="Dormont">D. Dormont</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Service de Neuroradiologie, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Cornu, P" sort="Cornu, P" uniqKey="Cornu P" first="P." last="Cornu">P. Cornu</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Service de Neurochirurgie, Groupe Hospitalier Pitic-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Agid, Y" sort="Agid, Y" uniqKey="Agid Y" first="Y." last="Agid">Yves Agid</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologic and Institut National de la Santé et de la Recherche Médicale, Unit 289, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">00-0226008</idno><date when="2000">2000</date><idno type="stanalyst">PASCAL 00-0226008 INIST</idno><idno type="RBID">Pascal:00-0226008</idno><idno type="wicri:Area/PascalFrancis/Corpus">001399</idno><idno type="wicri:Area/PascalFrancis/Curation">000039</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">001180</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">001180</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Subthalamic stimulation in Parkinson disease : A multidisciplinary approach</title><author><name sortKey="Houeto, J L" sort="Houeto, J L" uniqKey="Houeto J" first="J. L." last="Houeto">J. L. Houeto</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologic and Institut National de la Santé et de la Recherche Médicale, Unit 289, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Damier, P" sort="Damier, P" uniqKey="Damier P" first="P." last="Damier">P. Damier</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologic and Institut National de la Santé et de la Recherche Médicale, Unit 289, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Bejjani, P B" sort="Bejjani, P B" uniqKey="Bejjani P" first="P. B." last="Bejjani">P. B. Bejjani</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologic and Institut National de la Santé et de la Recherche Médicale, Unit 289, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Staedler, C" sort="Staedler, C" uniqKey="Staedler C" first="C." last="Staedler">C. Staedler</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologic and Institut National de la Santé et de la Recherche Médicale, Unit 289, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Bonnet, A M" sort="Bonnet, A M" uniqKey="Bonnet A" first="A. M." last="Bonnet">A. M. Bonnet</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologic and Institut National de la Santé et de la Recherche Médicale, Unit 289, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Arnulf, I" sort="Arnulf, I" uniqKey="Arnulf I" first="I." last="Arnulf">I. Arnulf</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologic and Institut National de la Santé et de la Recherche Médicale, Unit 289, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Pidoux, B" sort="Pidoux, B" uniqKey="Pidoux B" first="B." last="Pidoux">B. Pidoux</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Service d'Exploration Fonctionnelle Neurologique, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Dormont, D" sort="Dormont, D" uniqKey="Dormont D" first="D." last="Dormont">D. Dormont</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Service de Neuroradiologie, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Cornu, P" sort="Cornu, P" uniqKey="Cornu P" first="P." last="Cornu">P. Cornu</name><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>Service de Neurochirurgie, Groupe Hospitalier Pitic-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>9 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Agid, Y" sort="Agid, Y" uniqKey="Agid Y" first="Y." last="Agid">Yves Agid</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologic and Institut National de la Santé et de la Recherche Médicale, Unit 289, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName><placeName><settlement type="city">Paris</settlement><region type="region" nuts="2">Île-de-France</region></placeName><orgName type="hospital" n="4">Hôpital de la Salpêtrière</orgName></affiliation></author></analytic><series><title level="j" type="main">Archives of neurology : (Chicago)</title><title level="j" type="abbreviated">Arch. neurol. : (Chic.)</title><idno type="ISSN">0003-9942</idno><imprint><date when="2000">2000</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Archives of neurology : (Chicago)</title><title level="j" type="abbreviated">Arch. neurol. : (Chic.)</title><idno type="ISSN">0003-9942</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Bilateral</term><term>Continuous</term><term>High frequency</term><term>Human</term><term>Instrumental stimulation</term><term>Parkinson disease</term><term>Performance evaluation</term><term>Subthalamic nucleus</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term><term>Stimulation instrumentale</term><term>Haute fréquence</term><term>Noyau sousthalamique</term><term>Evaluation performance</term><term>Traitement</term><term>Homme</term><term>Bilatéral</term><term>Continu</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background: High-frequency stimulation of the subthalamic nucleus constitutes a therapeutic advance for severely disabled patients with Parkinson disease. Objective: To evaluate the efficacy and safety of continuous bilateral high-frequency stimulation of the subthalamic nucleus in patients with Parkinson disease. Design: A prospective study of patients with Parkinson disease treated at a university hospital. Patients and Methods: Electrodes were implanted bilaterally in the subthalamic nucleus of 23 consecutive patients with Parkinson disease who responded well to levodopa but had severe motor complications. There were 16 men and 7 women (mean ± SEM age, 53 ± 2 years) who had a mean ± SEM disease duration of 14.7 ± 1.0 years. Targets were determined by 3-dimensional magnetic resonance imaging, combined with intraoperative electrophysiologic recordings and stimulation. Results: Six months after surgery, motor disability, levodopa-induced motor fluctuations, dyskinesias, and the daily dose of levodopa equivalent decreased significantly by 67%, 78%, 77%, and 61%, respectively, compared with the preoperative state. No significant morbidity was ohserved, except transient depression in 4 patients. Conclusions: The beneficial effects of subthalamic stimulation depend on (1) the criteria used for patient selection, (2) the precision with which the subthalamic nucleus is targeted (dependent on the 3-dimensional magnetic resonance imaging and the intraoperative electrophysiologic and clinical assessments), and (3) the long-term postoperative adjustment of stimulation variables.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0003-9942</s0></fA01><fA02 i1="01"><s0>ARNEAS</s0></fA02><fA03 i2="1"><s0>Arch. neurol. : (Chic.)</s0></fA03><fA05><s2>57</s2></fA05><fA06><s2>4</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Subthalamic stimulation in Parkinson disease : A multidisciplinary approach</s1></fA08><fA11 i1="01" i2="1"><s1>HOUETO (J. L.)</s1></fA11><fA11 i1="02" i2="1"><s1>DAMIER (P.)</s1></fA11><fA11 i1="03" i2="1"><s1>BEJJANI (P. B.)</s1></fA11><fA11 i1="04" i2="1"><s1>STAEDLER (C.)</s1></fA11><fA11 i1="05" i2="1"><s1>BONNET (A. M.)</s1></fA11><fA11 i1="06" i2="1"><s1>ARNULF (I.)</s1></fA11><fA11 i1="07" i2="1"><s1>PIDOUX (B.)</s1></fA11><fA11 i1="08" i2="1"><s1>DORMONT (D.)</s1></fA11><fA11 i1="09" i2="1"><s1>CORNU (P.)</s1></fA11><fA11 i1="10" i2="1"><s1>AGID (Y.)</s1></fA11><fA14 i1="01"><s1>Centre d'Investigation Clinique, Fédération de Neurologic and Institut National de la Santé et de la Recherche Médicale, Unit 289, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>10 aut.</sZ></fA14><fA14 i1="02"><s1>Service d'Exploration Fonctionnelle Neurologique, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>7 aut.</sZ></fA14><fA14 i1="03"><s1>Service de Neuroradiologie, Groupe Hospitalier Pitié-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>8 aut.</sZ></fA14><fA14 i1="04"><s1>Service de Neurochirurgie, Groupe Hospitalier Pitic-Salpêtrière</s1><s2>Paris</s2><s3>FRA</s3><sZ>9 aut.</sZ></fA14><fA20><s1>461-465</s1></fA20><fA21><s1>2000</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>2048B</s2><s5>354000082204290020</s5></fA43><fA44><s0>0000</s0><s1>© 2000 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>16 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>00-0226008</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Archives of neurology : (Chicago)</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Background: High-frequency stimulation of the subthalamic nucleus constitutes a therapeutic advance for severely disabled patients with Parkinson disease. Objective: To evaluate the efficacy and safety of continuous bilateral high-frequency stimulation of the subthalamic nucleus in patients with Parkinson disease. Design: A prospective study of patients with Parkinson disease treated at a university hospital. Patients and Methods: Electrodes were implanted bilaterally in the subthalamic nucleus of 23 consecutive patients with Parkinson disease who responded well to levodopa but had severe motor complications. There were 16 men and 7 women (mean ± SEM age, 53 ± 2 years) who had a mean ± SEM disease duration of 14.7 ± 1.0 years. Targets were determined by 3-dimensional magnetic resonance imaging, combined with intraoperative electrophysiologic recordings and stimulation. Results: Six months after surgery, motor disability, levodopa-induced motor fluctuations, dyskinesias, and the daily dose of levodopa equivalent decreased significantly by 67%, 78%, 77%, and 61%, respectively, compared with the preoperative state. No significant morbidity was ohserved, except transient depression in 4 patients. Conclusions: The beneficial effects of subthalamic stimulation depend on (1) the criteria used for patient selection, (2) the precision with which the subthalamic nucleus is targeted (dependent on the 3-dimensional magnetic resonance imaging and the intraoperative electrophysiologic and clinical assessments), and (3) the long-term postoperative adjustment of stimulation variables.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17G</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Parkinson maladie</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Parkinson disease</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Stimulation instrumentale</s0><s5>04</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Instrumental stimulation</s0><s5>04</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Estimulación instrumental</s0><s5>04</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Haute fréquence</s0><s5>05</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>High frequency</s0><s5>05</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Alta frecuencia</s0><s5>05</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Noyau sousthalamique</s0><s5>07</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Subthalamic nucleus</s0><s5>07</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Núcleo subtalámico</s0><s5>07</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Evaluation performance</s0><s5>16</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Performance evaluation</s0><s5>16</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Evaluación prestación</s0><s5>16</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Traitement</s0><s5>17</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Treatment</s0><s5>17</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Tratamiento</s0><s5>17</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Homme</s0><s5>20</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Human</s0><s5>20</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Hombre</s0><s5>20</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Bilatéral</s0><s5>23</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Bilateral</s0><s5>23</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Bilateral</s0><s5>23</s5></fC03><fC03 i1="09" i2="X" l="FRE"><s0>Continu</s0><s5>24</s5></fC03><fC03 i1="09" i2="X" l="ENG"><s0>Continuous</s0><s5>24</s5></fC03><fC03 i1="09" i2="X" l="SPA"><s0>Contínuo</s0><s5>24</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Système nerveux pathologie</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Système nerveux central pathologie</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Encéphale pathologie</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Extrapyramidal syndrome</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>41</s5></fC07><fC07 i1="06" i2="X" l="FRE"><s0>Traitement instrumental</s0><s5>45</s5></fC07><fC07 i1="06" i2="X" l="ENG"><s0>Instrumentation therapy</s0><s5>45</s5></fC07><fC07 i1="06" i2="X" l="SPA"><s0>Tratamiento instrumental</s0><s5>45</s5></fC07><fC07 i1="07" i2="X" l="FRE"><s0>Encéphale</s0><s5>53</s5></fC07><fC07 i1="07" i2="X" l="ENG"><s0>Brain (vertebrata)</s0><s5>53</s5></fC07><fC07 i1="07" i2="X" l="SPA"><s0>Encéfalo</s0><s5>53</s5></fC07><fN21><s1>157</s1></fN21></pA></standard></inist><affiliations><list><country><li>France</li></country><region><li>Île-de-France</li></region><settlement><li>Paris</li></settlement><orgName><li>Hôpital de la Salpêtrière</li></orgName></list><tree><country name="France"><region name="Île-de-France"><name sortKey="Houeto, J L" sort="Houeto, J L" uniqKey="Houeto J" first="J. L." last="Houeto">J. L. Houeto</name></region><name sortKey="Agid, Y" sort="Agid, Y" uniqKey="Agid Y" first="Y." last="Agid">Yves Agid</name><name sortKey="Arnulf, I" sort="Arnulf, I" uniqKey="Arnulf I" first="I." last="Arnulf">I. Arnulf</name><name sortKey="Bejjani, P B" sort="Bejjani, P B" uniqKey="Bejjani P" first="P. B." last="Bejjani">P. B. Bejjani</name><name sortKey="Bonnet, A M" sort="Bonnet, A M" uniqKey="Bonnet A" first="A. M." last="Bonnet">A. M. Bonnet</name><name sortKey="Cornu, P" sort="Cornu, P" uniqKey="Cornu P" first="P." last="Cornu">P. Cornu</name><name sortKey="Damier, P" sort="Damier, P" uniqKey="Damier P" first="P." last="Damier">P. Damier</name><name sortKey="Dormont, D" sort="Dormont, D" uniqKey="Dormont D" first="D." last="Dormont">D. Dormont</name><name sortKey="Pidoux, B" sort="Pidoux, B" uniqKey="Pidoux B" first="B." last="Pidoux">B. Pidoux</name><name sortKey="Staedler, C" sort="Staedler, C" uniqKey="Staedler C" first="C." last="Staedler">C. 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