Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease.
Identifieur interne : 001412 ( PubMed/Curation ); précédent : 001411; suivant : 001413Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease.
Auteurs : P. Limousin [France] ; P. Krack ; P. Pollak ; A. Benazzouz ; C. Ardouin ; D. Hoffmann ; A L BenabidSource :
- The New England journal of medicine [ 0028-4793 ] ; 1998.
English descriptors
- KwdEn :
- Activities of Daily Living, Antiparkinson Agents (therapeutic use), Combined Modality Therapy, Dyskinesia, Drug-Induced (etiology), Electric Stimulation Therapy, Electrodes, Implanted, Female, Follow-Up Studies, Humans, Levodopa (therapeutic use), Male, Middle Aged, Parkinson Disease (classification), Parkinson Disease (drug therapy), Parkinson Disease (therapy), Severity of Illness Index, Thalamic Nuclei.
- MESH :
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- classification : Parkinson Disease.
- drug therapy : Parkinson Disease.
- etiology : Dyskinesia, Drug-Induced.
- therapy : Parkinson Disease.
- Activities of Daily Living, Combined Modality Therapy, Electric Stimulation Therapy, Electrodes, Implanted, Female, Follow-Up Studies, Humans, Male, Middle Aged, Severity of Illness Index, Thalamic Nuclei.
Abstract
In many patients with idiopathic Parkinson's disease, treatment with levodopa is complicated by fluctuations between an "off" period, when the medication is not working and the motor symptoms of parkinsonism are present, and an "on" period, when the medication is causing improved mobility, often accompanied by debilitating dyskinesias. In animal models of Parkinson's disease, there is overactivity in the subthalamic nucleus, and electrical stimulation of the subthalamic nucleus improves parkinsonism. We therefore sought to determine the efficacy and safety of electrical stimulation of the subthalamic nucleus in patients with Parkinson's disease.
DOI: 10.1056/NEJM199810153391603
PubMed: 9770557
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Benazzouz</name></author><author><name sortKey="Ardouin, C" sort="Ardouin, C" uniqKey="Ardouin C" first="C" last="Ardouin">C. Ardouin</name></author><author><name sortKey="Hoffmann, D" sort="Hoffmann, D" uniqKey="Hoffmann D" first="D" last="Hoffmann">D. Hoffmann</name></author><author><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A L" last="Benabid">A L Benabid</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="1998">1998</date><idno type="RBID">pubmed:9770557</idno><idno type="pmid">9770557</idno><idno type="doi">10.1056/NEJM199810153391603</idno><idno type="wicri:Area/PubMed/Corpus">001453</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001453</idno><idno type="wicri:Area/PubMed/Curation">001412</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001412</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease.</title><author><name sortKey="Limousin, P" sort="Limousin, P" uniqKey="Limousin P" first="P" last="Limousin">P. Limousin</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical and Biologic Neurosciences, Joseph Fourier University, Grenoble, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biologic Neurosciences, Joseph Fourier University, Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Krack, P" sort="Krack, P" uniqKey="Krack P" first="P" last="Krack">P. Krack</name></author><author><name sortKey="Pollak, P" sort="Pollak, P" uniqKey="Pollak P" first="P" last="Pollak">P. Pollak</name></author><author><name sortKey="Benazzouz, A" sort="Benazzouz, A" uniqKey="Benazzouz A" first="A" last="Benazzouz">A. Benazzouz</name></author><author><name sortKey="Ardouin, C" sort="Ardouin, C" uniqKey="Ardouin C" first="C" last="Ardouin">C. Ardouin</name></author><author><name sortKey="Hoffmann, D" sort="Hoffmann, D" uniqKey="Hoffmann D" first="D" last="Hoffmann">D. Hoffmann</name></author><author><name sortKey="Benabid, A L" sort="Benabid, A L" uniqKey="Benabid A" first="A L" last="Benabid">A L Benabid</name></author></analytic><series><title level="j">The New England journal of medicine</title><idno type="ISSN">0028-4793</idno><imprint><date when="1998" type="published">1998</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activities of Daily Living</term><term>Antiparkinson Agents (therapeutic use)</term><term>Combined Modality Therapy</term><term>Dyskinesia, Drug-Induced (etiology)</term><term>Electric Stimulation Therapy</term><term>Electrodes, Implanted</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Levodopa (therapeutic use)</term><term>Male</term><term>Middle Aged</term><term>Parkinson Disease (classification)</term><term>Parkinson Disease (drug therapy)</term><term>Parkinson Disease (therapy)</term><term>Severity of Illness Index</term><term>Thalamic Nuclei</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="classification" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Dyskinesia, Drug-Induced</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Activities of Daily Living</term><term>Combined Modality Therapy</term><term>Electric Stimulation Therapy</term><term>Electrodes, Implanted</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Severity of Illness Index</term><term>Thalamic Nuclei</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In many patients with idiopathic Parkinson's disease, treatment with levodopa is complicated by fluctuations between an "off" period, when the medication is not working and the motor symptoms of parkinsonism are present, and an "on" period, when the medication is causing improved mobility, often accompanied by debilitating dyskinesias. In animal models of Parkinson's disease, there is overactivity in the subthalamic nucleus, and electrical stimulation of the subthalamic nucleus improves parkinsonism. We therefore sought to determine the efficacy and safety of electrical stimulation of the subthalamic nucleus in patients with Parkinson's disease.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">9770557</PMID><DateCreated><Year>1998</Year><Month>10</Month><Day>15</Day></DateCreated><DateCompleted><Year>1998</Year><Month>10</Month><Day>15</Day></DateCompleted><DateRevised><Year>2013</Year><Month>11</Month><Day>21</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0028-4793</ISSN><JournalIssue CitedMedium="Print"><Volume>339</Volume><Issue>16</Issue><PubDate><Year>1998</Year><Month>Oct</Month><Day>15</Day></PubDate></JournalIssue><Title>The New England journal of medicine</Title><ISOAbbreviation>N. Engl. J. Med.</ISOAbbreviation></Journal><ArticleTitle>Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease.</ArticleTitle><Pagination><MedlinePgn>1105-11</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">In many patients with idiopathic Parkinson's disease, treatment with levodopa is complicated by fluctuations between an "off" period, when the medication is not working and the motor symptoms of parkinsonism are present, and an "on" period, when the medication is causing improved mobility, often accompanied by debilitating dyskinesias. In animal models of Parkinson's disease, there is overactivity in the subthalamic nucleus, and electrical stimulation of the subthalamic nucleus improves parkinsonism. We therefore sought to determine the efficacy and safety of electrical stimulation of the subthalamic nucleus in patients with Parkinson's disease.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">We studied 24 patients with idiopathic Parkinson's disease in whom electrodes were implanted bilaterally in the subthalamic nucleus under stereotactic guidance with imaging and electrophysiologic testing of the location. Twenty were followed for at least 12 months. Clinical evaluations included the Unified Parkinson's Disease Rating Scale, a dyskinesia scale, and timed tests conducted before and after surgery, when patients were off and on medications.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">After one year of electrical stimulation of the subthalamic nucleus, the patients' scores for activities of daily living and motor examination scores (Unified Parkinson's Disease Rating Scale parts II and III, respectively) off medication improved by 60 percent (P<0.001). The subscores improved for limb akinesia, rigidity, tremor, and gait. In the testing done on medication, the scores on part III improved by 10 percent (P<0.005). The mean dose of dopaminergic drugs was reduced by half. The cognitive-performance scores remained unchanged, but one patient had paralysis and aphasia after an intracerebral hematoma during the implantation procedure.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Electrical stimulation of the subthalamic nucleus is an effective treatment for advanced Parkinson's disease. The severity of symptoms off medication decreases, and the dose of levodopa can be reduced with consequent reduction in dyskinesias.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Limousin</LastName><ForeName>P</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Department of Clinical and Biologic Neurosciences, Joseph Fourier University, Grenoble, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Krack</LastName><ForeName>P</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Pollak</LastName><ForeName>P</ForeName><Initials>P</Initials></Author><Author ValidYN="Y"><LastName>Benazzouz</LastName><ForeName>A</ForeName><Initials>A</Initials></Author><Author ValidYN="Y"><LastName>Ardouin</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>Benabid</LastName><ForeName>A L</ForeName><Initials>AL</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>N Engl J Med</MedlineTA><NlmUniqueID>0255562</NlmUniqueID><ISSNLinking>0028-4793</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000978">Antiparkinson Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>46627O600J</RegistryNumber><NameOfSubstance UI="D007980">Levodopa</NameOfSubstance></Chemical></ChemicalList><CitationSubset>AIM</CitationSubset><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000203" MajorTopicYN="N">Activities of Daily Living</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000978" MajorTopicYN="N">Antiparkinson Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003131" MajorTopicYN="N">Combined Modality Therapy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004409" MajorTopicYN="N">Dyskinesia, Drug-Induced</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004599" MajorTopicYN="Y">Electric Stimulation Therapy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D004567" MajorTopicYN="N">Electrodes, Implanted</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</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="D007980" MajorTopicYN="N">Levodopa</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010300" MajorTopicYN="N">Parkinson Disease</DescriptorName><QualifierName UI="Q000145" MajorTopicYN="N">classification</QualifierName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013787" MajorTopicYN="N">Thalamic Nuclei</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>1998</Year><Month>10</Month><Day>15</Day></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>1998</Year><Month>10</Month><Day>15</Day><Hour>0</Hour><Minute>1</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>1998</Year><Month>10</Month><Day>15</Day><Hour>0</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">9770557</ArticleId><ArticleId IdType="doi">10.1056/NEJM199810153391603</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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