Off-period dystonia in Parkinson's disease but not generalized dystonia is improved by high-frequency stimulation of the subthalamic nucleus.
Identifieur interne : 001047 ( PubMed/Corpus ); précédent : 001046; suivant : 001048Off-period dystonia in Parkinson's disease but not generalized dystonia is improved by high-frequency stimulation of the subthalamic nucleus.
Auteurs : Olivier Detante ; Laurent Vercueil ; Paul Krack ; Stéphan Chabardes ; Alim-Louis Benabid ; Pierre PollakSource :
- Advances in neurology [ 0091-3952 ] ; 2004.
English descriptors
- KwdEn :
- Adult, Age of Onset, Child, Dystonia (classification), Dystonia (complications), Dystonia (therapy), Electric Stimulation, Electric Stimulation Therapy (methods), Female, Humans, Male, Middle Aged, Pantothenate Kinase-Associated Neurodegeneration (therapy), Parkinson Disease (complications), Parkinson Disease (therapy), Severity of Illness Index, Stereotaxic Techniques, Subthalamic Nucleus, Surgical Procedures, Operative.
- MESH :
- classification : Dystonia.
- complications : Dystonia, Parkinson Disease.
- methods : Electric Stimulation Therapy.
- therapy : Dystonia, Pantothenate Kinase-Associated Neurodegeneration, Parkinson Disease.
- Adult, Age of Onset, Child, Electric Stimulation, Female, Humans, Male, Middle Aged, Severity of Illness Index, Stereotaxic Techniques, Subthalamic Nucleus, Surgical Procedures, Operative.
Abstract
STN-HFS is well known to improve patients with IPD. Because off-period dystonia mimics focal or generalized dystonia of other causes, we proposed bilateral STN-HFS to some patients with generalized dystonia. The aim of this study was to compare the efficacy of STN stimulation on off-period dystonia and generalized dystonia. From a larger series of patients with IPD, we selected 22 patients based on the presence of severe preoperative off-period dystonia rated > or = 3 in least one limb on a severity score ranging from 0 to 4. Four patients with generalized dystonia (Hallervorden-Spatz disease, n = 3; primary, n = 1) underwent bilateral STN-HFS. Dystonia of the four limbs was rated on video recordings in all patients before surgery and 3 months after surgery. In IPD, bilateral STN stimulation reduced the severity of off-period dystonia by 70% on the four limbs (preoperative mean severity score = 2.03 +/- 1.49; postoperative mean severity score = 0.60 +/- 0.78). In contrast, bilateral STN-HFS had no effect on generalized dystonia (preoperative mean severity score = 3.25 +/- 0.77; postoperative mean severity score = 3.12 +/- 0.62). Despite clinical similarities between off-period dystonia in Parkinson's disease and generalized dystonia in certain cases, the effect of chronic bilateral STN-HFS differs. STN stimulation is highly effective in off-period dystonia of IPD, whereas it does not improve generalized dystonia. The pathophysiologic mechanisms underlying dystonia in these two disorders are still unknown. Assuming that the mechanism of action of STN-HFS is similar regardless of the cause of dystonia, our findings suggest that the STN is not similarly involved in off-period dystonia of IPD and others dystonias.
PubMed: 14509688
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Off-period dystonia in Parkinson's disease but not generalized dystonia is improved by high-frequency stimulation of the subthalamic nucleus.</title><author><name sortKey="Detante, Olivier" sort="Detante, Olivier" uniqKey="Detante O" first="Olivier" last="Detante">Olivier Detante</name><affiliation><nlm:affiliation>Department of Biological and Clinical Neurosciences, INSERM, Joseph Fourier University, Department of Neurology, CHU Grenoble, Grenoble, France.</nlm:affiliation></affiliation></author><author><name sortKey="Vercueil, Laurent" sort="Vercueil, Laurent" uniqKey="Vercueil L" first="Laurent" last="Vercueil">Laurent Vercueil</name></author><author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name></author><author><name sortKey="Chabardes, Stephan" sort="Chabardes, Stephan" uniqKey="Chabardes S" first="Stéphan" last="Chabardes">Stéphan Chabardes</name></author><author><name sortKey="Benabid, Alim Louis" sort="Benabid, Alim Louis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name></author><author><name sortKey="Pollak, Pierre" sort="Pollak, Pierre" uniqKey="Pollak P" first="Pierre" last="Pollak">Pierre Pollak</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2004">2004</date><idno type="RBID">pubmed:14509688</idno><idno type="pmid">14509688</idno><idno type="wicri:Area/PubMed/Corpus">001047</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001047</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Off-period dystonia in Parkinson's disease but not generalized dystonia is improved by high-frequency stimulation of the subthalamic nucleus.</title><author><name sortKey="Detante, Olivier" sort="Detante, Olivier" uniqKey="Detante O" first="Olivier" last="Detante">Olivier Detante</name><affiliation><nlm:affiliation>Department of Biological and Clinical Neurosciences, INSERM, Joseph Fourier University, Department of Neurology, CHU Grenoble, Grenoble, France.</nlm:affiliation></affiliation></author><author><name sortKey="Vercueil, Laurent" sort="Vercueil, Laurent" uniqKey="Vercueil L" first="Laurent" last="Vercueil">Laurent Vercueil</name></author><author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name></author><author><name sortKey="Chabardes, Stephan" sort="Chabardes, Stephan" uniqKey="Chabardes S" first="Stéphan" last="Chabardes">Stéphan Chabardes</name></author><author><name sortKey="Benabid, Alim Louis" sort="Benabid, Alim Louis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name></author><author><name sortKey="Pollak, Pierre" sort="Pollak, Pierre" uniqKey="Pollak P" first="Pierre" last="Pollak">Pierre Pollak</name></author></analytic><series><title level="j">Advances in neurology</title><idno type="ISSN">0091-3952</idno><imprint><date when="2004" type="published">2004</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Age of Onset</term><term>Child</term><term>Dystonia (classification)</term><term>Dystonia (complications)</term><term>Dystonia (therapy)</term><term>Electric Stimulation</term><term>Electric Stimulation Therapy (methods)</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pantothenate Kinase-Associated Neurodegeneration (therapy)</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (therapy)</term><term>Severity of Illness Index</term><term>Stereotaxic Techniques</term><term>Subthalamic Nucleus</term><term>Surgical Procedures, Operative</term></keywords><keywords scheme="MESH" qualifier="classification" xml:lang="en"><term>Dystonia</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Dystonia</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Electric Stimulation Therapy</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Dystonia</term><term>Pantothenate Kinase-Associated Neurodegeneration</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Age of Onset</term><term>Child</term><term>Electric Stimulation</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Severity of Illness Index</term><term>Stereotaxic Techniques</term><term>Subthalamic Nucleus</term><term>Surgical Procedures, Operative</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">STN-HFS is well known to improve patients with IPD. Because off-period dystonia mimics focal or generalized dystonia of other causes, we proposed bilateral STN-HFS to some patients with generalized dystonia. The aim of this study was to compare the efficacy of STN stimulation on off-period dystonia and generalized dystonia. From a larger series of patients with IPD, we selected 22 patients based on the presence of severe preoperative off-period dystonia rated > or = 3 in least one limb on a severity score ranging from 0 to 4. Four patients with generalized dystonia (Hallervorden-Spatz disease, n = 3; primary, n = 1) underwent bilateral STN-HFS. Dystonia of the four limbs was rated on video recordings in all patients before surgery and 3 months after surgery. In IPD, bilateral STN stimulation reduced the severity of off-period dystonia by 70% on the four limbs (preoperative mean severity score = 2.03 +/- 1.49; postoperative mean severity score = 0.60 +/- 0.78). In contrast, bilateral STN-HFS had no effect on generalized dystonia (preoperative mean severity score = 3.25 +/- 0.77; postoperative mean severity score = 3.12 +/- 0.62). Despite clinical similarities between off-period dystonia in Parkinson's disease and generalized dystonia in certain cases, the effect of chronic bilateral STN-HFS differs. STN stimulation is highly effective in off-period dystonia of IPD, whereas it does not improve generalized dystonia. The pathophysiologic mechanisms underlying dystonia in these two disorders are still unknown. Assuming that the mechanism of action of STN-HFS is similar regardless of the cause of dystonia, our findings suggest that the STN is not similarly involved in off-period dystonia of IPD and others dystonias.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">14509688</PMID><DateCreated><Year>2003</Year><Month>09</Month><Day>26</Day></DateCreated><DateCompleted><Year>2003</Year><Month>10</Month><Day>23</Day></DateCompleted><DateRevised><Year>2007</Year><Month>11</Month><Day>15</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0091-3952</ISSN><JournalIssue CitedMedium="Print"><Volume>94</Volume><PubDate><Year>2004</Year></PubDate></JournalIssue><Title>Advances in neurology</Title><ISOAbbreviation>Adv Neurol</ISOAbbreviation></Journal><ArticleTitle>Off-period dystonia in Parkinson's disease but not generalized dystonia is improved by high-frequency stimulation of the subthalamic nucleus.</ArticleTitle><Pagination><MedlinePgn>309-14</MedlinePgn></Pagination><Abstract><AbstractText>STN-HFS is well known to improve patients with IPD. Because off-period dystonia mimics focal or generalized dystonia of other causes, we proposed bilateral STN-HFS to some patients with generalized dystonia. The aim of this study was to compare the efficacy of STN stimulation on off-period dystonia and generalized dystonia. From a larger series of patients with IPD, we selected 22 patients based on the presence of severe preoperative off-period dystonia rated > or = 3 in least one limb on a severity score ranging from 0 to 4. Four patients with generalized dystonia (Hallervorden-Spatz disease, n = 3; primary, n = 1) underwent bilateral STN-HFS. Dystonia of the four limbs was rated on video recordings in all patients before surgery and 3 months after surgery. In IPD, bilateral STN stimulation reduced the severity of off-period dystonia by 70% on the four limbs (preoperative mean severity score = 2.03 +/- 1.49; postoperative mean severity score = 0.60 +/- 0.78). In contrast, bilateral STN-HFS had no effect on generalized dystonia (preoperative mean severity score = 3.25 +/- 0.77; postoperative mean severity score = 3.12 +/- 0.62). Despite clinical similarities between off-period dystonia in Parkinson's disease and generalized dystonia in certain cases, the effect of chronic bilateral STN-HFS differs. STN stimulation is highly effective in off-period dystonia of IPD, whereas it does not improve generalized dystonia. The pathophysiologic mechanisms underlying dystonia in these two disorders are still unknown. Assuming that the mechanism of action of STN-HFS is similar regardless of the cause of dystonia, our findings suggest that the STN is not similarly involved in off-period dystonia of IPD and others dystonias.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Detante</LastName><ForeName>Olivier</ForeName><Initials>O</Initials><AffiliationInfo><Affiliation>Department of Biological and Clinical Neurosciences, INSERM, Joseph Fourier University, Department of Neurology, CHU Grenoble, Grenoble, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Vercueil</LastName><ForeName>Laurent</ForeName><Initials>L</Initials></Author><Author ValidYN="Y"><LastName>Krack</LastName><ForeName>Paul</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Chabardes</LastName><ForeName>Stéphan</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Benabid</LastName><ForeName>Alim-Louis</ForeName><Initials>AL</Initials></Author><Author ValidYN="Y"><LastName>Pollak</LastName><ForeName>Pierre</ForeName><Initials>P</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Adv Neurol</MedlineTA><NlmUniqueID>0367524</NlmUniqueID><ISSNLinking>0091-3952</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017668" MajorTopicYN="N">Age of Onset</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D002648" MajorTopicYN="N">Child</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004421" MajorTopicYN="N">Dystonia</DescriptorName><QualifierName UI="Q000145" MajorTopicYN="N">classification</QualifierName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004558" MajorTopicYN="Y">Electric Stimulation</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004599" MajorTopicYN="N">Electric Stimulation Therapy</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006211" MajorTopicYN="N">Pantothenate Kinase-Associated Neurodegeneration</DescriptorName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010300" MajorTopicYN="N">Parkinson Disease</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013238" MajorTopicYN="N">Stereotaxic Techniques</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D020531" MajorTopicYN="Y">Subthalamic Nucleus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013514" MajorTopicYN="N">Surgical Procedures, Operative</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2003</Year><Month>9</Month><Day>27</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2003</Year><Month>10</Month><Day>24</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2003</Year><Month>9</Month><Day>27</Day><Hour>5</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">14509688</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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