Acute and long-term effects of subthalamic nucleus stimulation in Parkinson's disease.
Identifieur interne : 001696 ( PubMed/Corpus ); précédent : 001695; suivant : 001697Acute and long-term effects of subthalamic nucleus stimulation in Parkinson's disease.
Auteurs : A L Benabid ; P. Pollak ; C. Gross ; D. Hoffmann ; A. Benazzouz ; D M Gao ; A. Laurent ; M. Gentil ; J. PerretSource :
- Stereotactic and functional neurosurgery [ 1011-6125 ] ; 1994.
English descriptors
- KwdEn :
- Electric Stimulation Therapy, Electrodes, Implanted, Follow-Up Studies, Humans, Hypokinesia (etiology), Hypokinesia (therapy), Middle Aged, Monitoring, Intraoperative, Parkinson Disease (complications), Parkinson Disease (therapy), Postoperative Period, Stereotaxic Techniques, Thalamic Nuclei (physiopathology), Time Factors.
- MESH :
- complications : Parkinson Disease.
- etiology : Hypokinesia.
- physiopathology : Thalamic Nuclei.
- therapy : Hypokinesia, Parkinson Disease.
- Electric Stimulation Therapy, Electrodes, Implanted, Follow-Up Studies, Humans, Middle Aged, Monitoring, Intraoperative, Postoperative Period, Stereotaxic Techniques, Time Factors.
Abstract
In animal models of Parkinson's disease (PD), it is postulated that the excessive output from the subthalamic nucleus (STN) plays a critical role. Selective lesions or high frequency electrical stimulation of the STN can alleviate parkinsonian symptoms in MPTP-treated monkeys. We decided to carry out STN stimulation in patients suffering from severe akinetic forms of PD. After approval of the institutional ethical committee, we operated on a parkinsonian patient aged 51, suffering for 8 years from a strongly disabling akinetorigid form of PD, complicated by an on-off effect (Hoehn and Yahr stage 5 in the worst-off motor phase). Stereotactic surgery was done on one side under local anesthesia. The theoretical target was chosen according to stereotactic atlases, based on ventriculographic landmarks such as anterior and posterior commissures (AC and PC). The final position of the chronic electrodes was optimized using electrophysiological recording and stimulation along with clinical assessment and surface EMG of agonist and antagonist muscles of the examined limbs. A spontaneous increase in neuronal activity was recorded in an area located 2-4 mm under the level of the intercommissural plane, 10 mm from the midline, at mid-distance between AC and PC. Within the same place, a 130-Hz stimulation induced acute and reversible akinesia alleviation mainly on the contralateral limbs, comparable to that obtained with dopaminergic drugs. No dyskinesia, such as hemiballism, was induced by introduction of electrodes or by stimulation. Then a long-term quadripolar DBS Medtronic electrode was inserted in this area. Studies of the effects of chronic stimulation were extensively performed to determine the best spatiotemporal and electrical stimulation variables.(ABSTRACT TRUNCATED AT 250 WORDS)
PubMed: 7631092
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Benazzouz</name></author><author><name sortKey="Gao, D M" sort="Gao, D M" uniqKey="Gao D" first="D M" last="Gao">D M Gao</name></author><author><name sortKey="Laurent, A" sort="Laurent, A" uniqKey="Laurent A" first="A" last="Laurent">A. Laurent</name></author><author><name sortKey="Gentil, M" sort="Gentil, M" uniqKey="Gentil M" first="M" last="Gentil">M. Gentil</name></author><author><name sortKey="Perret, J" sort="Perret, J" uniqKey="Perret J" first="J" last="Perret">J. 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Gross</name></author><author><name sortKey="Hoffmann, D" sort="Hoffmann, D" uniqKey="Hoffmann D" first="D" last="Hoffmann">D. Hoffmann</name></author><author><name sortKey="Benazzouz, A" sort="Benazzouz, A" uniqKey="Benazzouz A" first="A" last="Benazzouz">A. Benazzouz</name></author><author><name sortKey="Gao, D M" sort="Gao, D M" uniqKey="Gao D" first="D M" last="Gao">D M Gao</name></author><author><name sortKey="Laurent, A" sort="Laurent, A" uniqKey="Laurent A" first="A" last="Laurent">A. Laurent</name></author><author><name sortKey="Gentil, M" sort="Gentil, M" uniqKey="Gentil M" first="M" last="Gentil">M. Gentil</name></author><author><name sortKey="Perret, J" sort="Perret, J" uniqKey="Perret J" first="J" last="Perret">J. Perret</name></author></analytic><series><title level="j">Stereotactic and functional neurosurgery</title><idno type="ISSN">1011-6125</idno><imprint><date when="1994" type="published">1994</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Electric Stimulation Therapy</term><term>Electrodes, Implanted</term><term>Follow-Up Studies</term><term>Humans</term><term>Hypokinesia (etiology)</term><term>Hypokinesia (therapy)</term><term>Middle Aged</term><term>Monitoring, Intraoperative</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (therapy)</term><term>Postoperative Period</term><term>Stereotaxic Techniques</term><term>Thalamic Nuclei (physiopathology)</term><term>Time Factors</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Hypokinesia</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Thalamic Nuclei</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Hypokinesia</term><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Electric Stimulation Therapy</term><term>Electrodes, Implanted</term><term>Follow-Up Studies</term><term>Humans</term><term>Middle Aged</term><term>Monitoring, Intraoperative</term><term>Postoperative Period</term><term>Stereotaxic Techniques</term><term>Time Factors</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In animal models of Parkinson's disease (PD), it is postulated that the excessive output from the subthalamic nucleus (STN) plays a critical role. Selective lesions or high frequency electrical stimulation of the STN can alleviate parkinsonian symptoms in MPTP-treated monkeys. We decided to carry out STN stimulation in patients suffering from severe akinetic forms of PD. After approval of the institutional ethical committee, we operated on a parkinsonian patient aged 51, suffering for 8 years from a strongly disabling akinetorigid form of PD, complicated by an on-off effect (Hoehn and Yahr stage 5 in the worst-off motor phase). Stereotactic surgery was done on one side under local anesthesia. The theoretical target was chosen according to stereotactic atlases, based on ventriculographic landmarks such as anterior and posterior commissures (AC and PC). The final position of the chronic electrodes was optimized using electrophysiological recording and stimulation along with clinical assessment and surface EMG of agonist and antagonist muscles of the examined limbs. A spontaneous increase in neuronal activity was recorded in an area located 2-4 mm under the level of the intercommissural plane, 10 mm from the midline, at mid-distance between AC and PC. Within the same place, a 130-Hz stimulation induced acute and reversible akinesia alleviation mainly on the contralateral limbs, comparable to that obtained with dopaminergic drugs. No dyskinesia, such as hemiballism, was induced by introduction of electrodes or by stimulation. Then a long-term quadripolar DBS Medtronic electrode was inserted in this area. Studies of the effects of chronic stimulation were extensively performed to determine the best spatiotemporal and electrical stimulation variables.(ABSTRACT TRUNCATED AT 250 WORDS)</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">7631092</PMID><DateCreated><Year>1995</Year><Month>09</Month><Day>07</Day></DateCreated><DateCompleted><Year>1995</Year><Month>09</Month><Day>07</Day></DateCompleted><DateRevised><Year>2004</Year><Month>11</Month><Day>17</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">1011-6125</ISSN><JournalIssue CitedMedium="Print"><Volume>62</Volume><Issue>1-4</Issue><PubDate><Year>1994</Year></PubDate></JournalIssue><Title>Stereotactic and functional neurosurgery</Title><ISOAbbreviation>Stereotact Funct Neurosurg</ISOAbbreviation></Journal><ArticleTitle>Acute and long-term effects of subthalamic nucleus stimulation in Parkinson's disease.</ArticleTitle><Pagination><MedlinePgn>76-84</MedlinePgn></Pagination><Abstract><AbstractText>In animal models of Parkinson's disease (PD), it is postulated that the excessive output from the subthalamic nucleus (STN) plays a critical role. Selective lesions or high frequency electrical stimulation of the STN can alleviate parkinsonian symptoms in MPTP-treated monkeys. We decided to carry out STN stimulation in patients suffering from severe akinetic forms of PD. After approval of the institutional ethical committee, we operated on a parkinsonian patient aged 51, suffering for 8 years from a strongly disabling akinetorigid form of PD, complicated by an on-off effect (Hoehn and Yahr stage 5 in the worst-off motor phase). Stereotactic surgery was done on one side under local anesthesia. The theoretical target was chosen according to stereotactic atlases, based on ventriculographic landmarks such as anterior and posterior commissures (AC and PC). The final position of the chronic electrodes was optimized using electrophysiological recording and stimulation along with clinical assessment and surface EMG of agonist and antagonist muscles of the examined limbs. A spontaneous increase in neuronal activity was recorded in an area located 2-4 mm under the level of the intercommissural plane, 10 mm from the midline, at mid-distance between AC and PC. Within the same place, a 130-Hz stimulation induced acute and reversible akinesia alleviation mainly on the contralateral limbs, comparable to that obtained with dopaminergic drugs. No dyskinesia, such as hemiballism, was induced by introduction of electrodes or by stimulation. Then a long-term quadripolar DBS Medtronic electrode was inserted in this area. Studies of the effects of chronic stimulation were extensively performed to determine the best spatiotemporal and electrical stimulation variables.(ABSTRACT TRUNCATED AT 250 WORDS)</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Benabid</LastName><ForeName>A L</ForeName><Initials>AL</Initials><AffiliationInfo><Affiliation>Department of Neurosciences, University Hospital, Grenoble, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pollak</LastName><ForeName>P</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Gross</LastName><ForeName>C</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Hoffmann</LastName><ForeName>D</ForeName><Initials>D</Initials></Author><Author ValidYN="Y"><LastName>Benazzouz</LastName><ForeName>A</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Gao</LastName><ForeName>D M</ForeName><Initials>DM</Initials></Author><Author ValidYN="Y"><LastName>Laurent</LastName><ForeName>A</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Gentil</LastName><ForeName>M</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Perret</LastName><ForeName>J</ForeName><Initials>J</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Switzerland</Country><MedlineTA>Stereotact Funct Neurosurg</MedlineTA><NlmUniqueID>8902881</NlmUniqueID><ISSNLinking>1011-6125</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D004599" MajorTopicYN="Y">Electric Stimulation Therapy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004567" MajorTopicYN="N">Electrodes, Implanted</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005500" MajorTopicYN="N">Follow-Up Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018476" MajorTopicYN="N">Hypokinesia</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016343" MajorTopicYN="N">Monitoring, Intraoperative</DescriptorName></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="D011184" MajorTopicYN="N">Postoperative Period</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="D013997" MajorTopicYN="N">Time Factors</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1994</Year><Month>1</Month><Day>1</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1994</Year><Month>1</Month><Day>1</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1994</Year><Month>1</Month><Day>1</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">7631092</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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