La maladie de Parkinson en France (serveur d'exploration)

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Alleviation of off-period dystonia in Parkinson disease by a microlesion following subthalamic implantation.

Identifieur interne : 000A81 ( PubMed/Corpus ); précédent : 000A80; suivant : 000A82

Alleviation of off-period dystonia in Parkinson disease by a microlesion following subthalamic implantation.

Auteurs : Stéphane Derrey ; Romain Lefaucheur ; Nathalie Chastan ; Emmanuel Gérardin ; Didier Hannequin ; Marie Desbordes ; David Maltête

Source :

RBID : pubmed:19877801

English descriptors

Abstract

A collision/implantation or microlesion effect is commonly described after subthalamic nucleus (STN) implantation for high-frequency stimulation, and this is presumed to reflect disruption of cells and/or fibers. Off-period dystonia, a frequent cause of disability in patients with advanced Parkinson disease, can lead to the need for surgical treatment. The authors assessed the early effect of this microlesion on off-period dystonia.

DOI: 10.3171/2009.10.JNS091032
PubMed: 19877801

Links to Exploration step

pubmed:19877801

Le document en format XML

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<title xml:lang="en">Alleviation of off-period dystonia in Parkinson disease by a microlesion following subthalamic implantation.</title>
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<name sortKey="Derrey, Stephane" sort="Derrey, Stephane" uniqKey="Derrey S" first="Stéphane" last="Derrey">Stéphane Derrey</name>
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<nlm:affiliation>Department of Neurosurgery, Rouen University Hospital and University of Rouen, France. david.maltete@chu-rouen.fr</nlm:affiliation>
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<name sortKey="Lefaucheur, Romain" sort="Lefaucheur, Romain" uniqKey="Lefaucheur R" first="Romain" last="Lefaucheur">Romain Lefaucheur</name>
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<name sortKey="Chastan, Nathalie" sort="Chastan, Nathalie" uniqKey="Chastan N" first="Nathalie" last="Chastan">Nathalie Chastan</name>
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<name sortKey="Gerardin, Emmanuel" sort="Gerardin, Emmanuel" uniqKey="Gerardin E" first="Emmanuel" last="Gérardin">Emmanuel Gérardin</name>
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<name sortKey="Hannequin, Didier" sort="Hannequin, Didier" uniqKey="Hannequin D" first="Didier" last="Hannequin">Didier Hannequin</name>
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<name sortKey="Desbordes, Marie" sort="Desbordes, Marie" uniqKey="Desbordes M" first="Marie" last="Desbordes">Marie Desbordes</name>
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<title xml:lang="en">Alleviation of off-period dystonia in Parkinson disease by a microlesion following subthalamic implantation.</title>
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<term>Adult</term>
<term>Aged</term>
<term>Deep Brain Stimulation (methods)</term>
<term>Dystonia (physiopathology)</term>
<term>Dystonia (therapy)</term>
<term>Electrodes, Implanted</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Globus Pallidus (physiopathology)</term>
<term>Globus Pallidus (surgery)</term>
<term>Humans</term>
<term>Male</term>
<term>Microsurgery</term>
<term>Middle Aged</term>
<term>Neurologic Examination</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson Disease (therapy)</term>
<term>Subthalamic Nucleus (physiopathology)</term>
<term>Subthalamic Nucleus (surgery)</term>
<term>Treatment Outcome</term>
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<term>Deep Brain Stimulation</term>
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<term>Dystonia</term>
<term>Globus Pallidus</term>
<term>Parkinson Disease</term>
<term>Subthalamic Nucleus</term>
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<term>Globus Pallidus</term>
<term>Subthalamic Nucleus</term>
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<term>Dystonia</term>
<term>Parkinson Disease</term>
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<div type="abstract" xml:lang="en">A collision/implantation or microlesion effect is commonly described after subthalamic nucleus (STN) implantation for high-frequency stimulation, and this is presumed to reflect disruption of cells and/or fibers. Off-period dystonia, a frequent cause of disability in patients with advanced Parkinson disease, can lead to the need for surgical treatment. The authors assessed the early effect of this microlesion on off-period dystonia.</div>
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<Day>02</Day>
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<Day>02</Day>
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<ISSN IssnType="Electronic">1933-0693</ISSN>
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<Volume>112</Volume>
<Issue>6</Issue>
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<Month>Jun</Month>
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<Title>Journal of neurosurgery</Title>
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<ArticleTitle>Alleviation of off-period dystonia in Parkinson disease by a microlesion following subthalamic implantation.</ArticleTitle>
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<AbstractText Label="OBJECT" NlmCategory="OBJECTIVE">A collision/implantation or microlesion effect is commonly described after subthalamic nucleus (STN) implantation for high-frequency stimulation, and this is presumed to reflect disruption of cells and/or fibers. Off-period dystonia, a frequent cause of disability in patients with advanced Parkinson disease, can lead to the need for surgical treatment. The authors assessed the early effect of this microlesion on off-period dystonia.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">The authors assessed 30 consecutive patients with the advanced levodopa-responsive form of Parkinson disease. The patients' symptoms were Hoehn and Yahr Scale score > or = 3, the mean duration of their disease was 11.4 +/- 3.5 years, and they had undergone bilateral implantation of electrodes within the STN for high-frequency stimulation between February 2004 and December 2006. The microlesion effect was defined by the clinical improvement (Unified Parkinson's Disease Rating Scale [UPDRS] Part III score, UPDRS Part IV, item 35) assessed the morning of the 3rd day following STN implantation, after at least a 12-hour withdrawal of dopaminergic treatment and before the programmable pulse generator was switched on (off-drug/off-stimulation mode).</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Compared with baseline (off state), the microlesion effect improved the motor score (UPDRS Part III) by 27%. Subscores for tremor, rigidity, and bradykinesia respectively improved by 42, 37, and 25%. Nineteen patients (63%) suffered from off-period dystonia before surgery. Twelve (41%) reported complete relief of their symptoms in the immediate postoperative period and remained free of painful off-period dystonia throughout the 6-month follow-up period.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The author postulated that off-period dystonia alleviation may reflect both a microsubthalamotomy and micropallidotomy effect. They hypothesize, moreover, that the microlesion could play a role in the 6-month postoperative outcome.</AbstractText>
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