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

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[Deep brain stimulation and gait disorders in Parkinson disease].

Identifieur interne : 000A74 ( PubMed/Curation ); précédent : 000A73; suivant : 000A75

[Deep brain stimulation and gait disorders in Parkinson disease].

Auteurs : M-U Ferraye [France] ; B. Debû ; P. Pollak

Source :

RBID : pubmed:19815246

English descriptors

Abstract

Gait disorders and freezing of gait (FOG) are seen in most patients with advanced Parkinson disease. Response to levodopa and deep brain stimulation is variable across patients.

DOI: 10.1016/j.neurol.2009.07.018
PubMed: 19815246

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pubmed:19815246

Le document en format XML

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<title xml:lang="en">[Deep brain stimulation and gait disorders in Parkinson disease].</title>
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<name sortKey="Ferraye, M U" sort="Ferraye, M U" uniqKey="Ferraye M" first="M-U" last="Ferraye">M-U Ferraye</name>
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<nlm:affiliation>Inserm, U836, université de Grenoble, CHU de Grenoble, pavillon de neurologie, BP 217, 38043 Grenoble cedex 9, France. Murielle.Ferraye@e.ujf-grenoble.fr</nlm:affiliation>
<country xml:lang="fr">France</country>
<wicri:regionArea>Inserm, U836, université de Grenoble, CHU de Grenoble, pavillon de neurologie, BP 217, 38043 Grenoble cedex 9</wicri:regionArea>
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<term>Deep Brain Stimulation (adverse effects)</term>
<term>Deep Brain Stimulation (methods)</term>
<term>Disease Progression</term>
<term>Gait (physiology)</term>
<term>Gait Disorders, Neurologic (etiology)</term>
<term>Gait Disorders, Neurologic (therapy)</term>
<term>Globus Pallidus (physiopathology)</term>
<term>Humans</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Parkinson Disease (therapy)</term>
<term>Subthalamic Nucleus (physiopathology)</term>
<term>Treatment Outcome</term>
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<term>Deep Brain Stimulation</term>
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<term>Gait Disorders, Neurologic</term>
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<term>Deep Brain Stimulation</term>
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<term>Gait</term>
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<term>Globus Pallidus</term>
<term>Parkinson Disease</term>
<term>Subthalamic Nucleus</term>
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<term>Gait Disorders, Neurologic</term>
<term>Parkinson Disease</term>
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<div type="abstract" xml:lang="en">Gait disorders and freezing of gait (FOG) are seen in most patients with advanced Parkinson disease. Response to levodopa and deep brain stimulation is variable across patients.</div>
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<AbstractText Label="INTRODUCTION" NlmCategory="BACKGROUND">Gait disorders and freezing of gait (FOG) are seen in most patients with advanced Parkinson disease. Response to levodopa and deep brain stimulation is variable across patients.</AbstractText>
<AbstractText Label="STATE OF ART" NlmCategory="BACKGROUND">Thalamic stimulation is ineffective on gait and can even worsen balance when bilaterally applied. Pallidal stimulation moderately improves gait disorders and FOG although this effect tends to wane after three to five years. Stimulation of the subthalamic nucleus (STN) improves levodopa-responsive gait disorders and FOG. However, some patients worsen after STN stimulation and others are better improved under levodopa than under STN stimulation. Synergistic effects of the two treatments have been reported. As for pallidal stimulation, there is a failure of long-term STN stimulation to improve gait, probably due to the involvement of non-dopaminergic pathways as the disease progresses. Levodopa-resistant gait disorders and FOG do not usually benefit from STN stimulation. In the rare cases of levodopa-induced FOG, STN stimulation may be indirectly effective, as it enables reduction or arrest of the levodopa treatment.</AbstractText>
<AbstractText Label="PERSPECTIVES" NlmCategory="CONCLUSIONS">Pedunculopontine nucleus stimulation has recently been performed in small groups of patients with disabling gait disorders and FOG. Although encouraging, the first results need to be confirmed by controlled studies involving larger series of patients.</AbstractText>
<AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Overall, gait disorders remain a motor PD symptom that is little improved, or only temporarily, by current pharmacological and surgical treatments. Patient management is complex.</AbstractText>
<CopyrightInformation>Copyright 2009 Elsevier Masson SAS. All rights reserved.</CopyrightInformation>
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