Effect of stimulation of the subthalamic nucleus on oral control of patients with parkinsonism
Identifieur interne : 001346 ( PascalFrancis/Checkpoint ); précédent : 001345; suivant : 001347Effect of stimulation of the subthalamic nucleus on oral control of patients with parkinsonism
Auteurs : M. Gentil [France] ; P. Garcia-Ruiz [Espagne] ; P. Pollak [France] ; A.-L. Benabid [France]Source :
- Journal of neurology, neurosurgery and psychiatry [ 0022-3050 ] ; 1999.
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Abstract
Objectives-To assess the oral system of parkinsonian patients treated with chronic stimulation of the bilateral subthalamic nucleus (STN) to evaluate precisely the effectiveness of this procedure on the articulatory organs. Methods-Load sensitive cantilevers were used to sample ramp and hold force contractions generated by the upper lip, lower lip, and tongue. The subject was given the instruction to produce forces as rapidly and as accurately as possible in response to the target signal (ranging from 0.25 to 2 N), which appeared on a screen. Maximal force of each effector organ was also measured. Fourteen healthy control subjects and 10 patients participated in this study. After an overnight fast the patients were evaluated in the morning under two conditions: during bilateral stimulation and 1 hour after stopping STN stimulation. Results-During STN stimulation, dynamic and static control of the articulatory organs were improved: the maximal strength of the articulatory organs, their accuracy to reach the target, and the precision of the hold phase increased. In addition, the reaction time and the rise time of the ramp phase decreased. Patients' speech as assessed by the item 18 of the unified Parkinson's disease rating scale (UPDRS) was greatly improved by electrical stimulation of the STN Conclusions-Improvement of oral control of the stimulated patients suggests that STN stimulation modulates neuronal structures involved in speech. However, more patients have to be evaluated for a fuller understanding of the effect of this surgical procedure on speech.
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Garcia-Ruiz</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Neurology, Fundacion Jimenez-Diaz</s1><s2>Madrid</s2><s3>ESP</s3><sZ>2 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P." last="Pollak">P. Pollak</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>INSERM, Unit 318, CHU Grenoble</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>CHU Grenoble</wicri:noRegion><wicri:noRegion>INSERM, Unit 318, CHU Grenoble</wicri:noRegion></affiliation></author><author><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A.-L." last="Benabid">A.-L. 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Gentil</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>INSERM, Unit 318, CHU Grenoble</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>CHU Grenoble</wicri:noRegion><wicri:noRegion>INSERM, Unit 318, CHU Grenoble</wicri:noRegion></affiliation></author><author><name sortKey="Garcia Ruiz, P" sort="Garcia Ruiz, P" uniqKey="Garcia Ruiz P" first="P." last="Garcia-Ruiz">P. Garcia-Ruiz</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Neurology, Fundacion Jimenez-Diaz</s1><s2>Madrid</s2><s3>ESP</s3><sZ>2 aut.</sZ></inist:fA14><country>Espagne</country><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P." last="Pollak">P. Pollak</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>INSERM, Unit 318, CHU Grenoble</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>CHU Grenoble</wicri:noRegion><wicri:noRegion>INSERM, Unit 318, CHU Grenoble</wicri:noRegion></affiliation></author><author><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A.-L." last="Benabid">A.-L. Benabid</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>INSERM, Unit 318, CHU Grenoble</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>CHU Grenoble</wicri:noRegion><wicri:noRegion>INSERM, Unit 318, CHU Grenoble</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Journal of neurology, neurosurgery and psychiatry</title><title level="j" type="abbreviated">J. neurol. neurosurg. psychiatry</title><idno type="ISSN">0022-3050</idno><imprint><date when="1999">1999</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of neurology, neurosurgery and psychiatry</title><title level="j" type="abbreviated">J. neurol. neurosurg. psychiatry</title><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Articulation</term><term>Bilateral</term><term>Electrical stimulus</term><term>Instrumentation therapy</term><term>Motor control</term><term>Motor system disorder</term><term>Parkinsonism</term><term>Speech</term><term>Subthalamic nucleus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinsonisme</term><term>Noyau sousthalamique</term><term>Stimulus électrique</term><term>Bilatéral</term><term>Contrôle moteur</term><term>Parole</term><term>Articulation parole</term><term>Trouble moteur</term><term>Traitement instrumental</term><term>Adulte</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Adulte</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objectives-To assess the oral system of parkinsonian patients treated with chronic stimulation of the bilateral subthalamic nucleus (STN) to evaluate precisely the effectiveness of this procedure on the articulatory organs. Methods-Load sensitive cantilevers were used to sample ramp and hold force contractions generated by the upper lip, lower lip, and tongue. The subject was given the instruction to produce forces as rapidly and as accurately as possible in response to the target signal (ranging from 0.25 to 2 N), which appeared on a screen. Maximal force of each effector organ was also measured. Fourteen healthy control subjects and 10 patients participated in this study. After an overnight fast the patients were evaluated in the morning under two conditions: during bilateral stimulation and 1 hour after stopping STN stimulation. Results-During STN stimulation, dynamic and static control of the articulatory organs were improved: the maximal strength of the articulatory organs, their accuracy to reach the target, and the precision of the hold phase increased. In addition, the reaction time and the rise time of the ramp phase decreased. Patients' speech as assessed by the item 18 of the unified Parkinson's disease rating scale (UPDRS) was greatly improved by electrical stimulation of the STN Conclusions-Improvement of oral control of the stimulated patients suggests that STN stimulation modulates neuronal structures involved in speech. However, more patients have to be evaluated for a fuller understanding of the effect of this surgical procedure on speech.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0022-3050</s0></fA01><fA02 i1="01"><s0>JNNPAU</s0></fA02><fA03 i2="1"><s0>J. neurol. neurosurg. psychiatry</s0></fA03><fA05><s2>67</s2></fA05><fA06><s2>3</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Effect of stimulation of the subthalamic nucleus on oral control of patients with parkinsonism</s1></fA08><fA11 i1="01" i2="1"><s1>GENTIL (M.)</s1></fA11><fA11 i1="02" i2="1"><s1>GARCIA-RUIZ (P.)</s1></fA11><fA11 i1="03" i2="1"><s1>POLLAK (P.)</s1></fA11><fA11 i1="04" i2="1"><s1>BENABID (A.-L.)</s1></fA11><fA14 i1="01"><s1>INSERM, Unit 318, CHU Grenoble</s1><s3>FRA</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Neurology, Fundacion Jimenez-Diaz</s1><s2>Madrid</s2><s3>ESP</s3><sZ>2 aut.</sZ></fA14><fA20><s1>329-333</s1></fA20><fA21><s1>1999</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>6015</s2><s5>354000089556690110</s5></fA43><fA44><s0>0000</s0><s1>© 1999 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>28 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>99-0438704</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Journal of neurology, neurosurgery and psychiatry</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>Objectives-To assess the oral system of parkinsonian patients treated with chronic stimulation of the bilateral subthalamic nucleus (STN) to evaluate precisely the effectiveness of this procedure on the articulatory organs. Methods-Load sensitive cantilevers were used to sample ramp and hold force contractions generated by the upper lip, lower lip, and tongue. The subject was given the instruction to produce forces as rapidly and as accurately as possible in response to the target signal (ranging from 0.25 to 2 N), which appeared on a screen. Maximal force of each effector organ was also measured. Fourteen healthy control subjects and 10 patients participated in this study. After an overnight fast the patients were evaluated in the morning under two conditions: during bilateral stimulation and 1 hour after stopping STN stimulation. Results-During STN stimulation, dynamic and static control of the articulatory organs were improved: the maximal strength of the articulatory organs, their accuracy to reach the target, and the precision of the hold phase increased. In addition, the reaction time and the rise time of the ramp phase decreased. Patients' speech as assessed by the item 18 of the unified Parkinson's disease rating scale (UPDRS) was greatly improved by electrical stimulation of the STN Conclusions-Improvement of oral control of the stimulated patients suggests that STN stimulation modulates neuronal structures involved in speech. 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Gentil</name></noRegion><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A.-L." last="Benabid">A.-L. Benabid</name><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P." last="Pollak">P. Pollak</name></country><country name="Espagne"><region name="Communauté de Madrid"><name sortKey="Garcia Ruiz, P" sort="Garcia Ruiz, P" uniqKey="Garcia Ruiz P" first="P." last="Garcia-Ruiz">P. Garcia-Ruiz</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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