Inhibition of levodopa effects by internal pallidal stimulation.
Identifieur interne : 001424 ( PubMed/Curation ); précédent : 001423; suivant : 001425Inhibition of levodopa effects by internal pallidal stimulation.
Auteurs : P. Krack [France] ; P. Pollak ; P. Limousin ; D. Hoffmann ; A. Benazzouz ; A L BenabidSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1998.
English descriptors
- KwdEn :
- Antiparkinson Agents (administration & dosage), Antiparkinson Agents (adverse effects), Combined Modality Therapy, Dominance, Cerebral (drug effects), Dominance, Cerebral (physiology), Dyskinesia, Drug-Induced (diagnosis), Dyskinesia, Drug-Induced (physiopathology), Dyskinesia, Drug-Induced (therapy), Electric Stimulation Therapy, Electrodes, Implanted, Globus Pallidus (drug effects), Globus Pallidus (physiopathology), Humans, Levodopa (administration & dosage), Levodopa (adverse effects), Male, Middle Aged, Parkinson Disease (physiopathology), Parkinson Disease (therapy).
- MESH :
- chemical , administration & dosage : Antiparkinson Agents, Levodopa.
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- diagnosis : Dyskinesia, Drug-Induced.
- drug effects : Dominance, Cerebral, Globus Pallidus.
- physiology : Dominance, Cerebral.
- physiopathology : Dyskinesia, Drug-Induced, Globus Pallidus, Parkinson Disease.
- therapy : Dyskinesia, Drug-Induced, Parkinson Disease.
- Combined Modality Therapy, Electric Stimulation Therapy, Electrodes, Implanted, Humans, Male, Middle Aged.
Abstract
We report three patients with bilateral GPi stimulation for stage 4 Parkinson's disease (PD) with severe levodopa-induced dyskinesias (LID). In all three it was possible to completely inhibit LID using high-stimulation parameters. Parallel to complete inhibition of LID, an inhibition of the anti-akinetic effect of levodopa was observed, whereas, at the same time, rigidity was markedly improved. GPi stimulation is adaptable over time, and stimulation parameters have to be programmed according to off- and on-period motor symptoms. The main interest of stimulation is the possibility of finding a compromise between LID alleviation in on-phase without loss of the beneficial motor effects and improvement in parkinsonism in off-phase. In some patients, residual dyskinesias have to be accepted so as not to aggravate on-period motor symptoms by a presumed overinhibition of basal ganglia outflow.
DOI: 10.1002/mds.870130407
PubMed: 9686769
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pubmed:9686769Le document en format XML
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<term>Dominance, Cerebral (drug effects)</term>
<term>Dominance, Cerebral (physiology)</term>
<term>Dyskinesia, Drug-Induced (diagnosis)</term>
<term>Dyskinesia, Drug-Induced (physiopathology)</term>
<term>Dyskinesia, Drug-Induced (therapy)</term>
<term>Electric Stimulation Therapy</term>
<term>Electrodes, Implanted</term>
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<front><div type="abstract" xml:lang="en">We report three patients with bilateral GPi stimulation for stage 4 Parkinson's disease (PD) with severe levodopa-induced dyskinesias (LID). In all three it was possible to completely inhibit LID using high-stimulation parameters. Parallel to complete inhibition of LID, an inhibition of the anti-akinetic effect of levodopa was observed, whereas, at the same time, rigidity was markedly improved. GPi stimulation is adaptable over time, and stimulation parameters have to be programmed according to off- and on-period motor symptoms. The main interest of stimulation is the possibility of finding a compromise between LID alleviation in on-phase without loss of the beneficial motor effects and improvement in parkinsonism in off-phase. In some patients, residual dyskinesias have to be accepted so as not to aggravate on-period motor symptoms by a presumed overinhibition of basal ganglia outflow.</div>
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