Comparison of subthalamic nucleus deep brain stimulation and Duodopa in the treatment of advanced Parkinson's disease
Identifieur interne : 000937 ( Main/Corpus ); précédent : 000936; suivant : 000938Comparison of subthalamic nucleus deep brain stimulation and Duodopa in the treatment of advanced Parkinson's disease
Auteurs : Aristide Merola ; Maurizio Zibetti ; Serena Angrisano ; Laura Rizzi ; Michele Lanotte ; Leonardo LopianoSource :
- Movement Disorders [ 0885-3185 ] ; 2011-03.
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Abstract
Background:: Subthalamic nucleus deep brain stimulation (STN‐DBS) and levodopa/carbidopa enteral (Duodopa) infusion are two effective therapeutic options for the treatment of advanced Parkinson's disease (PD). Methods:: Retrospectively, this study compared the two procedures, evaluating 40 PD patients who underwent either STN‐DBS or a percutaneous gastrostomy (PEG) for Duodopa infusion. Duodopa group comprised 20 patients, with a mean follow‐up of ∼15 months, treated by Duodopa infusion rather than STN‐DBS because of the presence of neurosurgical contraindications, age > 70 years‐old, moderate cognitive impairment or patient's unwillingness to undergo neurosurgery. The STN‐DBS group comprised 20 consecutive patients similar to the patients of the Duodopa group for age at the disease onset, age at the procedure, follow‐up, and duration of motor complications. The only difference concerned neuropsychological functions, which were more impaired in the group of Duodopa patients. Clinical and neuropsychological data were compared at baseline and at follow‐up for the two procedures. Results:: Both procedures showed a significant improvement in UPDRS‐II, UPDRS‐III, and UPDRS‐IV and a considerable reduction in the percentage of waking day spent in “off,” whereas only the STN‐DBS group showed a significant improvement in dyskinesias duration and disability. STN‐DBS was associated to a significant drop in the phonemic verbal fluency score, whereas Duodopa patients showed a milder worsening in this task. The procedure‐related complications occurred more frequently with Duodopa. Conclusion:: STN‐DBS and Duodopa showed a significant efficacy on motor symptoms, activities of daily living, and motor complications. The group of Duodopa‐treated patients developed more procedure‐related complications. © 2011 Movement Disorder Society
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DOI: 10.1002/mds.23524
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Comparison of subthalamic nucleus deep brain stimulation and Duodopa in the treatment of advanced Parkinson's disease</title><author><name sortKey="Merola, Aristide" sort="Merola, Aristide" uniqKey="Merola A" first="Aristide" last="Merola">Aristide Merola</name><affiliation><mods:affiliation>Department of Neuroscience, University of Torino, Torino, Italy</mods:affiliation></affiliation></author><author><name sortKey="Zibetti, Maurizio" sort="Zibetti, Maurizio" uniqKey="Zibetti M" first="Maurizio" last="Zibetti">Maurizio Zibetti</name><affiliation><mods:affiliation>Department of Neuroscience, University of Torino, Torino, Italy</mods:affiliation></affiliation></author><author><name sortKey="Angrisano, Serena" sort="Angrisano, Serena" uniqKey="Angrisano S" first="Serena" last="Angrisano">Serena Angrisano</name><affiliation><mods:affiliation>Department of Neuroscience, University of Torino, Torino, Italy</mods:affiliation></affiliation></author><author><name sortKey="Rizzi, Laura" sort="Rizzi, Laura" uniqKey="Rizzi L" first="Laura" last="Rizzi">Laura Rizzi</name><affiliation><mods:affiliation>Department of Neuroscience, University of Torino, Torino, Italy</mods:affiliation></affiliation></author><author><name sortKey="Lanotte, Michele" sort="Lanotte, Michele" uniqKey="Lanotte M" first="Michele" last="Lanotte">Michele Lanotte</name><affiliation><mods:affiliation>Department of Neuroscience, University of Torino, Torino, Italy</mods:affiliation></affiliation></author><author><name sortKey="Lopiano, Leonardo" sort="Lopiano, Leonardo" uniqKey="Lopiano L" first="Leonardo" last="Lopiano">Leonardo Lopiano</name><affiliation><mods:affiliation>Department of Neuroscience, University of Torino, Torino, Italy</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:422E8EB64C0EBEFEF8F11E8B5368498D8E74BAD0</idno><date when="2011" year="2011">2011</date><idno type="doi">10.1002/mds.23524</idno><idno type="url">https://api.istex.fr/document/422E8EB64C0EBEFEF8F11E8B5368498D8E74BAD0/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000937</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Comparison of subthalamic nucleus deep brain stimulation and Duodopa in the treatment of advanced Parkinson's disease</title><author><name sortKey="Merola, Aristide" sort="Merola, Aristide" uniqKey="Merola A" first="Aristide" last="Merola">Aristide Merola</name><affiliation><mods:affiliation>Department of Neuroscience, University of Torino, Torino, Italy</mods:affiliation></affiliation></author><author><name sortKey="Zibetti, Maurizio" sort="Zibetti, Maurizio" uniqKey="Zibetti M" first="Maurizio" last="Zibetti">Maurizio Zibetti</name><affiliation><mods:affiliation>Department of Neuroscience, University of Torino, Torino, Italy</mods:affiliation></affiliation></author><author><name sortKey="Angrisano, Serena" sort="Angrisano, Serena" uniqKey="Angrisano S" first="Serena" last="Angrisano">Serena Angrisano</name><affiliation><mods:affiliation>Department of Neuroscience, University of Torino, Torino, Italy</mods:affiliation></affiliation></author><author><name sortKey="Rizzi, Laura" sort="Rizzi, Laura" uniqKey="Rizzi L" first="Laura" last="Rizzi">Laura Rizzi</name><affiliation><mods:affiliation>Department of Neuroscience, University of Torino, Torino, Italy</mods:affiliation></affiliation></author><author><name sortKey="Lanotte, Michele" sort="Lanotte, Michele" uniqKey="Lanotte M" first="Michele" last="Lanotte">Michele Lanotte</name><affiliation><mods:affiliation>Department of Neuroscience, University of Torino, Torino, Italy</mods:affiliation></affiliation></author><author><name sortKey="Lopiano, Leonardo" sort="Lopiano, Leonardo" uniqKey="Lopiano L" first="Leonardo" last="Lopiano">Leonardo Lopiano</name><affiliation><mods:affiliation>Department of Neuroscience, University of Torino, Torino, Italy</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-03">2011-03</date><biblScope unit="volume">26</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="664">664</biblScope><biblScope unit="page" to="670">670</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">422E8EB64C0EBEFEF8F11E8B5368498D8E74BAD0</idno><idno type="DOI">10.1002/mds.23524</idno><idno type="ArticleID">MDS23524</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Levodopa/carbidopa enteral infusion</term><term>Parkinson's disease</term><term>subthalamic nucleus deep brain stimulation</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background:: Subthalamic nucleus deep brain stimulation (STN‐DBS) and levodopa/carbidopa enteral (Duodopa) infusion are two effective therapeutic options for the treatment of advanced Parkinson's disease (PD). Methods:: Retrospectively, this study compared the two procedures, evaluating 40 PD patients who underwent either STN‐DBS or a percutaneous gastrostomy (PEG) for Duodopa infusion. Duodopa group comprised 20 patients, with a mean follow‐up of ∼15 months, treated by Duodopa infusion rather than STN‐DBS because of the presence of neurosurgical contraindications, age > 70 years‐old, moderate cognitive impairment or patient's unwillingness to undergo neurosurgery. The STN‐DBS group comprised 20 consecutive patients similar to the patients of the Duodopa group for age at the disease onset, age at the procedure, follow‐up, and duration of motor complications. The only difference concerned neuropsychological functions, which were more impaired in the group of Duodopa patients. Clinical and neuropsychological data were compared at baseline and at follow‐up for the two procedures. Results:: Both procedures showed a significant improvement in UPDRS‐II, UPDRS‐III, and UPDRS‐IV and a considerable reduction in the percentage of waking day spent in “off,” whereas only the STN‐DBS group showed a significant improvement in dyskinesias duration and disability. STN‐DBS was associated to a significant drop in the phonemic verbal fluency score, whereas Duodopa patients showed a milder worsening in this task. The procedure‐related complications occurred more frequently with Duodopa. Conclusion:: STN‐DBS and Duodopa showed a significant efficacy on motor symptoms, activities of daily living, and motor complications. The group of Duodopa‐treated patients developed more procedure‐related complications. © 2011 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Aristide Merola MD</name><affiliations><json:string>Department of Neuroscience, University of Torino, Torino, Italy</json:string></affiliations></json:item><json:item><name>Maurizio Zibetti MD, PhD</name><affiliations><json:string>Department of Neuroscience, University of Torino, Torino, Italy</json:string></affiliations></json:item><json:item><name>Serena Angrisano MD</name><affiliations><json:string>Department of Neuroscience, University of Torino, Torino, Italy</json:string></affiliations></json:item><json:item><name>Laura Rizzi PhD</name><affiliations><json:string>Department of Neuroscience, University of Torino, Torino, Italy</json:string></affiliations></json:item><json:item><name>Michele Lanotte MD</name><affiliations><json:string>Department of Neuroscience, University of Torino, Torino, Italy</json:string></affiliations></json:item><json:item><name>Leonardo Lopiano MD, PhD</name><affiliations><json:string>Department of Neuroscience, University of Torino, Torino, Italy</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>subthalamic nucleus deep brain stimulation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Levodopa/carbidopa enteral infusion</value></json:item></subject><articleId><json:string>MDS23524</json:string></articleId><language><json:string>eng</json:string></language><abstract>Background:: Subthalamic nucleus deep brain stimulation (STN‐DBS) and levodopa/carbidopa enteral (Duodopa) infusion are two effective therapeutic options for the treatment of advanced Parkinson's disease (PD). Methods:: Retrospectively, this study compared the two procedures, evaluating 40 PD patients who underwent either STN‐DBS or a percutaneous gastrostomy (PEG) for Duodopa infusion. Duodopa group comprised 20 patients, with a mean follow‐up of ∼15 months, treated by Duodopa infusion rather than STN‐DBS because of the presence of neurosurgical contraindications, age > 70 years‐old, moderate cognitive impairment or patient's unwillingness to undergo neurosurgery. The STN‐DBS group comprised 20 consecutive patients similar to the patients of the Duodopa group for age at the disease onset, age at the procedure, follow‐up, and duration of motor complications. The only difference concerned neuropsychological functions, which were more impaired in the group of Duodopa patients. Clinical and neuropsychological data were compared at baseline and at follow‐up for the two procedures. Results:: Both procedures showed a significant improvement in UPDRS‐II, UPDRS‐III, and UPDRS‐IV and a considerable reduction in the percentage of waking day spent in “off,” whereas only the STN‐DBS group showed a significant improvement in dyskinesias duration and disability. STN‐DBS was associated to a significant drop in the phonemic verbal fluency score, whereas Duodopa patients showed a milder worsening in this task. The procedure‐related complications occurred more frequently with Duodopa. Conclusion:: STN‐DBS and Duodopa showed a significant efficacy on motor symptoms, activities of daily living, and motor complications. The group of Duodopa‐treated patients developed more procedure‐related complications. © 2011 Movement Disorder Society</abstract><qualityIndicators><score>7.07</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 810 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>3</keywordCount><abstractCharCount>1847</abstractCharCount><pdfWordCount>4070</pdfWordCount><pdfCharCount>26528</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>252</abstractWordCount></qualityIndicators><title>Comparison of subthalamic nucleus deep brain stimulation and Duodopa in the treatment of advanced Parkinson's disease</title><genre><json:string>article</json:string></genre><host><volume>26</volume><publisherId><json:string>MDS</json:string></publisherId><pages><total>7</total><last>670</last><first>664</first></pages><issn><json:string>0885-3185</json:string></issn><issue>4</issue><subject><json:item><value>Research Article</value></json:item></subject><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1531-8257</json:string></eissn><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2011</publicationDate><copyrightDate>2011</copyrightDate><doi><json:string>10.1002/mds.23524</json:string></doi><id>422E8EB64C0EBEFEF8F11E8B5368498D8E74BAD0</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/422E8EB64C0EBEFEF8F11E8B5368498D8E74BAD0/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/422E8EB64C0EBEFEF8F11E8B5368498D8E74BAD0/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/422E8EB64C0EBEFEF8F11E8B5368498D8E74BAD0/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Comparison of subthalamic nucleus deep brain stimulation and Duodopa in the treatment of advanced Parkinson's disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2011</date></publicationStmt><notesStmt><note type="content">*Relevant conflicts of interest/financial disclosures: Nothing to report. Full financial disclosures and author roles may be found in the online version of this article.</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Comparison of subthalamic nucleus deep brain stimulation and Duodopa in the treatment of advanced Parkinson's disease</title><author><persName><forename type="first">Aristide</forename><surname>Merola</surname></persName><roleName type="degree">MD</roleName><note type="correspondence"><p>Correspondence: Aristide Merola, Department of Neuroscience, University of Torino, Via Cherasco 15, 10126 Torino, Italy</p></note><affiliation>Department of Neuroscience, University of Torino, Torino, Italy</affiliation></author><author><persName><forename type="first">Maurizio</forename><surname>Zibetti</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neuroscience, University of Torino, Torino, Italy</affiliation></author><author><persName><forename type="first">Serena</forename><surname>Angrisano</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neuroscience, University of Torino, Torino, Italy</affiliation></author><author><persName><forename type="first">Laura</forename><surname>Rizzi</surname></persName><roleName type="degree">PhD</roleName><affiliation>Department of Neuroscience, University of Torino, Torino, Italy</affiliation></author><author><persName><forename type="first">Michele</forename><surname>Lanotte</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neuroscience, University of Torino, Torino, Italy</affiliation></author><author><persName><forename type="first">Leonardo</forename><surname>Lopiano</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neuroscience, University of Torino, Torino, Italy</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-03"></date><biblScope unit="volume">26</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="664">664</biblScope><biblScope unit="page" to="670">670</biblScope></imprint></monogr><idno type="istex">422E8EB64C0EBEFEF8F11E8B5368498D8E74BAD0</idno><idno type="DOI">10.1002/mds.23524</idno><idno type="ArticleID">MDS23524</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2011</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Background:: Subthalamic nucleus deep brain stimulation (STN‐DBS) and levodopa/carbidopa enteral (Duodopa) infusion are two effective therapeutic options for the treatment of advanced Parkinson's disease (PD). Methods:: Retrospectively, this study compared the two procedures, evaluating 40 PD patients who underwent either STN‐DBS or a percutaneous gastrostomy (PEG) for Duodopa infusion. Duodopa group comprised 20 patients, with a mean follow‐up of ∼15 months, treated by Duodopa infusion rather than STN‐DBS because of the presence of neurosurgical contraindications, age > 70 years‐old, moderate cognitive impairment or patient's unwillingness to undergo neurosurgery. The STN‐DBS group comprised 20 consecutive patients similar to the patients of the Duodopa group for age at the disease onset, age at the procedure, follow‐up, and duration of motor complications. The only difference concerned neuropsychological functions, which were more impaired in the group of Duodopa patients. Clinical and neuropsychological data were compared at baseline and at follow‐up for the two procedures. Results:: Both procedures showed a significant improvement in UPDRS‐II, UPDRS‐III, and UPDRS‐IV and a considerable reduction in the percentage of waking day spent in “off,” whereas only the STN‐DBS group showed a significant improvement in dyskinesias duration and disability. STN‐DBS was associated to a significant drop in the phonemic verbal fluency score, whereas Duodopa patients showed a milder worsening in this task. The procedure‐related complications occurred more frequently with Duodopa. Conclusion:: STN‐DBS and Duodopa showed a significant efficacy on motor symptoms, activities of daily living, and motor complications. The group of Duodopa‐treated patients developed more procedure‐related complications. © 2011 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>subthalamic nucleus deep brain stimulation</term></item><item><term>Levodopa/carbidopa enteral infusion</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-07-17">Received</change><change when="2010-10-18">Registration</change><change when="2011-03">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/422E8EB64C0EBEFEF8F11E8B5368498D8E74BAD0/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. 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Duodopa group comprised 20 patients, with a mean follow‐up of ∼15 months, treated by Duodopa infusion rather than STN‐DBS because of the presence of neurosurgical contraindications, age > 70 years‐old, moderate cognitive impairment or patient's unwillingness to undergo neurosurgery. The STN‐DBS group comprised 20 consecutive patients similar to the patients of the Duodopa group for age at the disease onset, age at the procedure, follow‐up, and duration of motor complications. The only difference concerned neuropsychological functions, which were more impaired in the group of Duodopa patients. Clinical and neuropsychological data were compared at baseline and at follow‐up for the two procedures.</p></section><section xml:id="abs1-3"><title type="main">Results:</title><p>Both procedures showed a significant improvement in UPDRS‐II, UPDRS‐III, and UPDRS‐IV and a considerable reduction in the percentage of waking day spent in “off,” whereas only the STN‐DBS group showed a significant improvement in dyskinesias duration and disability. STN‐DBS was associated to a significant drop in the phonemic verbal fluency score, whereas Duodopa patients showed a milder worsening in this task. The procedure‐related complications occurred more frequently with Duodopa.</p></section><section xml:id="abs1-4"><title type="main">Conclusion:</title><p>STN‐DBS and Duodopa showed a significant efficacy on motor symptoms, activities of daily living, and motor complications. The group of Duodopa‐treated patients developed more procedure‐related complications. © 2011 Movement Disorder Society</p></section></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p><b>Relevant conflicts of interest/financial disclosures</b>: Nothing to report. Full financial disclosures and author roles may be found in the online version of this article.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Comparison of subthalamic nucleus deep brain stimulation and Duodopa in the treatment of advanced Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Comparison OF STN‐DBS and Duodopa</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Comparison of subthalamic nucleus deep brain stimulation and Duodopa in the treatment of advanced Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Aristide</namePart><namePart type="family">Merola</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neuroscience, University of Torino, Torino, Italy</affiliation><description>Correspondence: Aristide Merola, Department of Neuroscience, University of Torino, Via Cherasco 15, 10126 Torino, Italy</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Maurizio</namePart><namePart type="family">Zibetti</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neuroscience, University of Torino, Torino, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Serena</namePart><namePart type="family">Angrisano</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neuroscience, University of Torino, Torino, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Laura</namePart><namePart type="family">Rizzi</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Neuroscience, University of Torino, Torino, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michele</namePart><namePart type="family">Lanotte</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neuroscience, University of Torino, Torino, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Leonardo</namePart><namePart type="family">Lopiano</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neuroscience, University of Torino, Torino, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2011-03</dateIssued><dateCaptured encoding="w3cdtf">2010-07-17</dateCaptured><dateValid encoding="w3cdtf">2010-10-18</dateValid><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="tables">3</extent><extent unit="references">33</extent><extent unit="words">5874</extent></physicalDescription><abstract lang="en">Background:: Subthalamic nucleus deep brain stimulation (STN‐DBS) and levodopa/carbidopa enteral (Duodopa) infusion are two effective therapeutic options for the treatment of advanced Parkinson's disease (PD). Methods:: Retrospectively, this study compared the two procedures, evaluating 40 PD patients who underwent either STN‐DBS or a percutaneous gastrostomy (PEG) for Duodopa infusion. Duodopa group comprised 20 patients, with a mean follow‐up of ∼15 months, treated by Duodopa infusion rather than STN‐DBS because of the presence of neurosurgical contraindications, age > 70 years‐old, moderate cognitive impairment or patient's unwillingness to undergo neurosurgery. The STN‐DBS group comprised 20 consecutive patients similar to the patients of the Duodopa group for age at the disease onset, age at the procedure, follow‐up, and duration of motor complications. The only difference concerned neuropsychological functions, which were more impaired in the group of Duodopa patients. Clinical and neuropsychological data were compared at baseline and at follow‐up for the two procedures. Results:: Both procedures showed a significant improvement in UPDRS‐II, UPDRS‐III, and UPDRS‐IV and a considerable reduction in the percentage of waking day spent in “off,” whereas only the STN‐DBS group showed a significant improvement in dyskinesias duration and disability. STN‐DBS was associated to a significant drop in the phonemic verbal fluency score, whereas Duodopa patients showed a milder worsening in this task. The procedure‐related complications occurred more frequently with Duodopa. Conclusion:: STN‐DBS and Duodopa showed a significant efficacy on motor symptoms, activities of daily living, and motor complications. The group of Duodopa‐treated patients developed more procedure‐related complications. © 2011 Movement Disorder Society</abstract><note type="content">*Relevant conflicts of interest/financial disclosures: Nothing to report. Full financial disclosures and author roles may be found in the online version of this article.</note><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>subthalamic nucleus deep brain stimulation</topic><topic>Levodopa/carbidopa enteral infusion</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2011</date><detail type="volume"><caption>vol.</caption><number>26</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>664</start><end>670</end><total>7</total></extent></part></relatedItem><identifier type="istex">422E8EB64C0EBEFEF8F11E8B5368498D8E74BAD0</identifier><identifier type="DOI">10.1002/mds.23524</identifier><identifier type="ArticleID">MDS23524</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2011 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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