Effect on parkinsonian signs and symptoms of bilateral subthalamic nucleus stimulation
Identifieur interne : 001730 ( PascalFrancis/Checkpoint ); précédent : 001729; suivant : 001731Effect on parkinsonian signs and symptoms of bilateral subthalamic nucleus stimulation
Auteurs : P. Limousin [États-Unis] ; P. Pollak [États-Unis] ; A. Benazzouz [États-Unis] ; D. Hoffmann [États-Unis] ; J.-F. Le Bas [États-Unis] ; E. Broussolle [France] ; J. E. Perret [États-Unis] ; A.-L. Benabid [États-Unis]Source :
- Lancet : (British edition) [ 0140-6736 ] ; 1995.
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Abstract
In monkeys rendered parkinsonian, lesions and electrical stimulation of the subthalamic nucleus reduce all major motor disturbances. The effect of electrical stimulation of the subthalamic nucleus was assessed in three patients with disabling akinetic-rigid Parkinson's disease and severe motor fluctuations. Quadripolar electrodes connected to a pulse generator were implanted in the subthalamic nuclei on both sides. Patients were evaluated with the unified Parkinson's disease rating scale and timed motor tests. 3 months after surgery, activities of daily living scores had improved by 58-88% and motor scores by 42-84%. This improvement was maintained for up to 8 months in the first patient operated upon. One patient was confused for 2 weeks after surgery, and another developed neuropsychological impairment related to a thalamic infarction which improved over 3 months. In one patient, stimulation could induce ballism that was stopped by reduction of stimulation. This is the first demonstration in human beings of the part played by the subthalamic nuclei in the pathophysiology of Parkinson's disease
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Grenoble, dep. clin. biological neurosci.</s1><s2>Grenoble</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Grenoble</settlement><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region></placeName></affiliation></author><author><name sortKey="Benazzouz, A" sort="Benazzouz, A" uniqKey="Benazzouz A" first="A." last="Benazzouz">A. Benazzouz</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Joseph Fourier univ. 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Grenoble, dep. clin. biological neurosci.</s1><s2>Grenoble</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Grenoble</settlement><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region></placeName></affiliation></author><author><name sortKey="Le Bas, J F" sort="Le Bas, J F" uniqKey="Le Bas J" first="J.-F." last="Le Bas">J.-F. Le Bas</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Joseph Fourier univ. Grenoble, dep. clin. biological neurosci.</s1><s2>Grenoble</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Grenoble</settlement><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region></placeName></affiliation></author><author><name sortKey="Broussolle, E" sort="Broussolle, E" uniqKey="Broussolle E" first="E." last="Broussolle">E. Broussolle</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Hôp. neurologique</s1><s2>Lyon</s2><s3>FRA</s3><sZ>6 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Lyon</settlement></placeName></affiliation></author><author><name sortKey="Perret, J E" sort="Perret, J E" uniqKey="Perret J" first="J. E." last="Perret">J. E. Perret</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Joseph Fourier univ. Grenoble, dep. clin. biological neurosci.</s1><s2>Grenoble</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Grenoble</settlement><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region></placeName></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="3"><inist:fA14 i1="01"><s1>Joseph Fourier univ. Grenoble, dep. clin. biological neurosci.</s1><s2>Grenoble</s2><s3>USA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><settlement type="city">Grenoble</settlement><region type="region" nuts="2">Auvergne-Rhône-Alpes</region><region type="old region" nuts="2">Rhône-Alpes</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Lancet : (British edition)</title><title level="j" type="abbreviated">Lancet : (Br. ed.)</title><idno type="ISSN">0140-6736</idno><imprint><date when="1995">1995</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Lancet : (British edition)</title><title level="j" type="abbreviated">Lancet : (Br. ed.)</title><idno type="ISSN">0140-6736</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Electrical stimulus</term><term>Human</term><term>Microsurgery</term><term>Parkinson disease</term><term>Pathogenesis</term><term>Subthalamic nucleus</term><term>Surgery</term><term>Treatment</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term><term>Homme</term><term>Stimulus électrique</term><term>Noyau sousthalamique</term><term>Chirurgie</term><term>Microchirurgie</term><term>Traitement</term><term>Pathogénie</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term><term>Chirurgie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In monkeys rendered parkinsonian, lesions and electrical stimulation of the subthalamic nucleus reduce all major motor disturbances. The effect of electrical stimulation of the subthalamic nucleus was assessed in three patients with disabling akinetic-rigid Parkinson's disease and severe motor fluctuations. Quadripolar electrodes connected to a pulse generator were implanted in the subthalamic nuclei on both sides. Patients were evaluated with the unified Parkinson's disease rating scale and timed motor tests. 3 months after surgery, activities of daily living scores had improved by 58-88% and motor scores by 42-84%. This improvement was maintained for up to 8 months in the first patient operated upon. One patient was confused for 2 weeks after surgery, and another developed neuropsychological impairment related to a thalamic infarction which improved over 3 months. In one patient, stimulation could induce ballism that was stopped by reduction of stimulation. This is the first demonstration in human beings of the part played by the subthalamic nuclei in the pathophysiology of Parkinson's disease</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0140-6736</s0></fA01><fA02 i1="01"><s0>LANCAO</s0></fA02><fA03 i2="1"><s0>Lancet : (Br. ed.)</s0></fA03><fA05><s2>345</s2></fA05><fA06><s2>8942</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Effect on parkinsonian signs and symptoms of bilateral subthalamic nucleus stimulation</s1></fA08><fA11 i1="01" i2="1"><s1>LIMOUSIN (P.)</s1></fA11><fA11 i1="02" i2="1"><s1>POLLAK (P.)</s1></fA11><fA11 i1="03" i2="1"><s1>BENAZZOUZ (A.)</s1></fA11><fA11 i1="04" i2="1"><s1>HOFFMANN (D.)</s1></fA11><fA11 i1="05" i2="1"><s1>LE BAS (J.-F.)</s1></fA11><fA11 i1="06" i2="1"><s1>BROUSSOLLE (E.)</s1></fA11><fA11 i1="07" i2="1"><s1>PERRET (J. E.)</s1></fA11><fA11 i1="08" i2="1"><s1>BENABID (A.-L.)</s1></fA11><fA14 i1="01"><s1>Joseph Fourier univ. 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Limousin</name></region><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A.-L." last="Benabid">A.-L. Benabid</name><name sortKey="Benazzouz, A" sort="Benazzouz, A" uniqKey="Benazzouz A" first="A." last="Benazzouz">A. Benazzouz</name><name sortKey="Hoffmann, D" sort="Hoffmann, D" uniqKey="Hoffmann D" first="D." last="Hoffmann">D. Hoffmann</name><name sortKey="Le Bas, J F" sort="Le Bas, J F" uniqKey="Le Bas J" first="J.-F." last="Le Bas">J.-F. Le Bas</name><name sortKey="Perret, J E" sort="Perret, J E" uniqKey="Perret J" first="J. E." last="Perret">J. E. Perret</name><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P." last="Pollak">P. Pollak</name></country><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Broussolle, E" sort="Broussolle, E" uniqKey="Broussolle E" first="E." last="Broussolle">E. Broussolle</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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