Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment of movement disorders.
Identifieur interne : 001594 ( PubMed/Corpus ); précédent : 001593; suivant : 001595Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment of movement disorders.
Auteurs : A L Benabid ; P. Pollak ; D. Gao ; D. Hoffmann ; P. Limousin ; E. Gay ; I. Payen ; A. BenazzouzSource :
- Journal of neurosurgery [ 0022-3085 ] ; 1996.
English descriptors
- KwdEn :
- Electric Stimulation Therapy (adverse effects), Extracellular Space (physiology), Follow-Up Studies, Humans, Intraoperative Period, Movement Disorders (physiopathology), Movement Disorders (therapy), Neurons (physiology), Parkinson Disease (physiopathology), Parkinson Disease (therapy), Postoperative Complications, Stereotaxic Techniques, Thalamic Nuclei (physiopathology), Treatment Outcome, Tremor (physiopathology), Tremor (therapy).
- MESH :
- adverse effects : Electric Stimulation Therapy.
- physiology : Extracellular Space, Neurons.
- physiopathology : Movement Disorders, Parkinson Disease, Thalamic Nuclei, Tremor.
- therapy : Movement Disorders, Parkinson Disease, Tremor.
- Follow-Up Studies, Humans, Intraoperative Period, Postoperative Complications, Stereotaxic Techniques, Treatment Outcome.
Abstract
Tremor was suppressed by test stimulation of the thalamic ventralis intermedius (VIM) nucleus at high frequency (130 Hz) during stereotaxy in nonanesthetized patients suffering from Parkinson's disease or essential tremor. Ventralis intermedius stimulation has since been used by the authors over the last 8 years as a treatment in 117 patients with movement disorders (80 cases of Parkinson's disease, 20 cases of essential tremor, and 17 cases of various dyskinesias and dystonias including four multiple sclerosis). Chronic electrodes were stereotactically implanted in the VIM and connected to a programmable stimulator. Results depend on the indication. In Parkinson's disease patients, tremor, but not bradykinesia and rigidity, was selectively suppressed for as long as 8 years. Administration of L-Dopa was decreased by more than 30% in 40 Parkinson's disease patients. In essential tremor patients, results were satisfactory but deteriorated with time in 18.5% of cases, mainly for patients who presented an action component of their but deteriorated with time in 18.5% of cases, mainly for patients who presented an action component of their tremor. In other types of dyskinesias (except multiple sclerosis), results were much less favorable. Fifty-nine patients underwent bilateral implantation and 14 other patients received implantation contralateral to a previous thalamotomy. Thirty-seven patients (31.6%) experienced minor side effects, which were always well tolerated and immediately reversible. Three secondary scalp infections led to temporary removal of the implanted material. There was no permanent morbidity. This tremor suppression effect could be due to the inhibition or jamming of a retroactive loop. Chronic VIM stimulation, which is reversible, adaptable, and well tolerated even by patients undergoing bilateral surgery (74 of 117 patients) and by elderly patients, should replace thalamotomy in the regular surgical treatment of parkinsonian and essential tremors.
DOI: 10.3171/jns.1996.84.2.0203
PubMed: 8592222
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment of movement disorders.</title><author><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A L" last="Benabid">A L Benabid</name><affiliation><nlm:affiliation>Department of Clinical and Biological Neurosciences, INSERM Preclinical Neurobiology, Joseph Fourier University of Grenoble, Hôpital A. Michallon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P" last="Pollak">P. Pollak</name></author><author><name sortKey="Gao, D" sort="Gao, D" uniqKey="Gao D" first="D" last="Gao">D. Gao</name></author><author><name sortKey="Hoffmann, D" sort="Hoffmann, D" uniqKey="Hoffmann D" first="D" last="Hoffmann">D. Hoffmann</name></author><author><name sortKey="Limousin, P" sort="Limousin, P" uniqKey="Limousin P" first="P" last="Limousin">P. Limousin</name></author><author><name sortKey="Gay, E" sort="Gay, E" uniqKey="Gay E" first="E" last="Gay">E. Gay</name></author><author><name sortKey="Payen, I" sort="Payen, I" uniqKey="Payen I" first="I" last="Payen">I. Payen</name></author><author><name sortKey="Benazzouz, A" sort="Benazzouz, A" uniqKey="Benazzouz A" first="A" last="Benazzouz">A. Benazzouz</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1996">1996</date><idno type="RBID">pubmed:8592222</idno><idno type="pmid">8592222</idno><idno type="doi">10.3171/jns.1996.84.2.0203</idno><idno type="wicri:Area/PubMed/Corpus">001594</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001594</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment of movement disorders.</title><author><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A L" last="Benabid">A L Benabid</name><affiliation><nlm:affiliation>Department of Clinical and Biological Neurosciences, INSERM Preclinical Neurobiology, Joseph Fourier University of Grenoble, Hôpital A. Michallon, France.</nlm:affiliation></affiliation></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P" last="Pollak">P. Pollak</name></author><author><name sortKey="Gao, D" sort="Gao, D" uniqKey="Gao D" first="D" last="Gao">D. Gao</name></author><author><name sortKey="Hoffmann, D" sort="Hoffmann, D" uniqKey="Hoffmann D" first="D" last="Hoffmann">D. Hoffmann</name></author><author><name sortKey="Limousin, P" sort="Limousin, P" uniqKey="Limousin P" first="P" last="Limousin">P. Limousin</name></author><author><name sortKey="Gay, E" sort="Gay, E" uniqKey="Gay E" first="E" last="Gay">E. Gay</name></author><author><name sortKey="Payen, I" sort="Payen, I" uniqKey="Payen I" first="I" last="Payen">I. Payen</name></author><author><name sortKey="Benazzouz, A" sort="Benazzouz, A" uniqKey="Benazzouz A" first="A" last="Benazzouz">A. Benazzouz</name></author></analytic><series><title level="j">Journal of neurosurgery</title><idno type="ISSN">0022-3085</idno><imprint><date when="1996" type="published">1996</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Electric Stimulation Therapy (adverse effects)</term><term>Extracellular Space (physiology)</term><term>Follow-Up Studies</term><term>Humans</term><term>Intraoperative Period</term><term>Movement Disorders (physiopathology)</term><term>Movement Disorders (therapy)</term><term>Neurons (physiology)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (therapy)</term><term>Postoperative Complications</term><term>Stereotaxic Techniques</term><term>Thalamic Nuclei (physiopathology)</term><term>Treatment Outcome</term><term>Tremor (physiopathology)</term><term>Tremor (therapy)</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Electric Stimulation Therapy</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Extracellular Space</term><term>Neurons</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Movement Disorders</term><term>Parkinson Disease</term><term>Thalamic Nuclei</term><term>Tremor</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Movement Disorders</term><term>Parkinson Disease</term><term>Tremor</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Follow-Up Studies</term><term>Humans</term><term>Intraoperative Period</term><term>Postoperative Complications</term><term>Stereotaxic Techniques</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Tremor was suppressed by test stimulation of the thalamic ventralis intermedius (VIM) nucleus at high frequency (130 Hz) during stereotaxy in nonanesthetized patients suffering from Parkinson's disease or essential tremor. Ventralis intermedius stimulation has since been used by the authors over the last 8 years as a treatment in 117 patients with movement disorders (80 cases of Parkinson's disease, 20 cases of essential tremor, and 17 cases of various dyskinesias and dystonias including four multiple sclerosis). Chronic electrodes were stereotactically implanted in the VIM and connected to a programmable stimulator. Results depend on the indication. In Parkinson's disease patients, tremor, but not bradykinesia and rigidity, was selectively suppressed for as long as 8 years. Administration of L-Dopa was decreased by more than 30% in 40 Parkinson's disease patients. In essential tremor patients, results were satisfactory but deteriorated with time in 18.5% of cases, mainly for patients who presented an action component of their but deteriorated with time in 18.5% of cases, mainly for patients who presented an action component of their tremor. In other types of dyskinesias (except multiple sclerosis), results were much less favorable. Fifty-nine patients underwent bilateral implantation and 14 other patients received implantation contralateral to a previous thalamotomy. Thirty-seven patients (31.6%) experienced minor side effects, which were always well tolerated and immediately reversible. Three secondary scalp infections led to temporary removal of the implanted material. There was no permanent morbidity. This tremor suppression effect could be due to the inhibition or jamming of a retroactive loop. Chronic VIM stimulation, which is reversible, adaptable, and well tolerated even by patients undergoing bilateral surgery (74 of 117 patients) and by elderly patients, should replace thalamotomy in the regular surgical treatment of parkinsonian and essential tremors.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">8592222</PMID><DateCreated><Year>1996</Year><Month>04</Month><Day>01</Day></DateCreated><DateCompleted><Year>1996</Year><Month>04</Month><Day>01</Day></DateCompleted><DateRevised><Year>2006</Year><Month>11</Month><Day>15</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0022-3085</ISSN><JournalIssue CitedMedium="Print"><Volume>84</Volume><Issue>2</Issue><PubDate><Year>1996</Year><Month>Feb</Month></PubDate></JournalIssue><Title>Journal of neurosurgery</Title><ISOAbbreviation>J. Neurosurg.</ISOAbbreviation></Journal><ArticleTitle>Chronic electrical stimulation of the ventralis intermedius nucleus of the thalamus as a treatment of movement disorders.</ArticleTitle><Pagination><MedlinePgn>203-14</MedlinePgn></Pagination><Abstract><AbstractText>Tremor was suppressed by test stimulation of the thalamic ventralis intermedius (VIM) nucleus at high frequency (130 Hz) during stereotaxy in nonanesthetized patients suffering from Parkinson's disease or essential tremor. Ventralis intermedius stimulation has since been used by the authors over the last 8 years as a treatment in 117 patients with movement disorders (80 cases of Parkinson's disease, 20 cases of essential tremor, and 17 cases of various dyskinesias and dystonias including four multiple sclerosis). Chronic electrodes were stereotactically implanted in the VIM and connected to a programmable stimulator. Results depend on the indication. In Parkinson's disease patients, tremor, but not bradykinesia and rigidity, was selectively suppressed for as long as 8 years. Administration of L-Dopa was decreased by more than 30% in 40 Parkinson's disease patients. In essential tremor patients, results were satisfactory but deteriorated with time in 18.5% of cases, mainly for patients who presented an action component of their but deteriorated with time in 18.5% of cases, mainly for patients who presented an action component of their tremor. In other types of dyskinesias (except multiple sclerosis), results were much less favorable. Fifty-nine patients underwent bilateral implantation and 14 other patients received implantation contralateral to a previous thalamotomy. Thirty-seven patients (31.6%) experienced minor side effects, which were always well tolerated and immediately reversible. Three secondary scalp infections led to temporary removal of the implanted material. There was no permanent morbidity. This tremor suppression effect could be due to the inhibition or jamming of a retroactive loop. Chronic VIM stimulation, which is reversible, adaptable, and well tolerated even by patients undergoing bilateral surgery (74 of 117 patients) and by elderly patients, should replace thalamotomy in the regular surgical treatment of parkinsonian and essential tremors.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Benabid</LastName><ForeName>A L</ForeName><Initials>AL</Initials><AffiliationInfo><Affiliation>Department of Clinical and Biological Neurosciences, INSERM Preclinical Neurobiology, Joseph Fourier University of Grenoble, Hôpital A. Michallon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pollak</LastName><ForeName>P</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Gao</LastName><ForeName>D</ForeName><Initials>D</Initials></Author><Author ValidYN="Y"><LastName>Hoffmann</LastName><ForeName>D</ForeName><Initials>D</Initials></Author><Author ValidYN="Y"><LastName>Limousin</LastName><ForeName>P</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Gay</LastName><ForeName>E</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Payen</LastName><ForeName>I</ForeName><Initials>I</Initials></Author><Author ValidYN="Y"><LastName>Benazzouz</LastName><ForeName>A</ForeName><Initials>A</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Neurosurg</MedlineTA><NlmUniqueID>0253357</NlmUniqueID><ISSNLinking>0022-3085</ISSNLinking></MedlineJournalInfo><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>J Neurosurg. 1997 Apr;86(4):737</RefSource><PMID Version="1">9120645</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D004599" MajorTopicYN="Y">Electric Stimulation Therapy</DescriptorName><QualifierName UI="Q000009" MajorTopicYN="N">adverse effects</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005110" MajorTopicYN="N">Extracellular Space</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007432" MajorTopicYN="N">Intraoperative Period</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009069" MajorTopicYN="N">Movement Disorders</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D009474" MajorTopicYN="N">Neurons</DescriptorName><QualifierName UI="Q000502" MajorTopicYN="N">physiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010300" MajorTopicYN="N">Parkinson Disease</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011183" MajorTopicYN="N">Postoperative Complications</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013238" MajorTopicYN="N">Stereotaxic Techniques</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013787" MajorTopicYN="N">Thalamic Nuclei</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="Y">physiopathology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014202" MajorTopicYN="N">Tremor</DescriptorName><QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1996</Year><Month>2</Month><Day>1</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1996</Year><Month>2</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1996</Year><Month>2</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">8592222</ArticleId><ArticleId IdType="doi">10.3171/jns.1996.84.2.0203</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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