Treatment results: Parkinson's disease
Identifieur interne : 000B38 ( Main/Corpus ); précédent : 000B37; suivant : 000B39Treatment results: Parkinson's disease
Auteurs : Pierre Pollak ; Valérie Fraix ; Paul Krack ; Elena Moro ; Alexandre Mendes ; Stephan Chabardes ; Adnan Koudsie ; Alim-Louis BenabidSource :
- Movement Disorders [ 0885-3185 ] ; 2002-03.
English descriptors
Abstract
Deep brain stimulation (DBS) is a neurosurgical treatment of Parkinson's disease that is applied to three targets: the ventral intermediate nucleus of the thalamus (Vim), the globus pallidus internas (GPi) and the subthalamic nucleus (STN). Vim DBS mainly improves contralateral tremor and, therefore, is being supplanted by DBS of the two other targets, even in patients with tremor dominant disease. STN and GPi DBS improve off‐motor phases and dyskinesias. There is little comparative data between these procedures. The magnitude of the motor improvement seems more constant with STN than GPi DBS. STN DBS allows a decrease in antiparkinsonian drug doses and consumes moderate current. These advantages of STN over GPi DBS are offset by the need for more intensive postoperative management. The DBS procedure has the unique advantage of reversibility and adjustability over time. Patients with young‐onset Parkinson's disease suffering from levodopa‐induced motor complications but still responding well to levodopa and who exhibit no behavioral, mood, or cognitive impairment benefit the most from STN DBS. Adverse effects more specific of the DBS procedure are infection, cutaneous erosion, and lead breaking or disconnection. Intracranial electrode implantation can induce a hematoma or contusion. Most authors agree that the benefit to risk ratio of DBS is favorable. © 2002 Movement Disorder Society
Url:
DOI: 10.1002/mds.10146
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ISTEX:645ED79E4BFD3D4EFB435E1FA0EB6C59E408A351Le document en format XML
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Pollak</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Fraix, Valerie" sort="Fraix, Valerie" uniqKey="Fraix V" first="Valérie" last="Fraix">Valérie Fraix</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Mendes, Alexandre" sort="Mendes, Alexandre" uniqKey="Mendes A" first="Alexandre" 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sort="Koudsie, Adnan" uniqKey="Koudsie A" first="Adnan" last="Koudsie">Adnan Koudsie</name><affiliation><mods:affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France</mods:affiliation></affiliation></author><author><name sortKey="Benabid, Alim Ouis" sort="Benabid, Alim Ouis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name><affiliation><mods:affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, 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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>New York</pubPlace><date type="published" when="2002-03">2002-03</date><biblScope unit="volume">17</biblScope><biblScope unit="issue">S3</biblScope><biblScope unit="supplement">3</biblScope><biblScope unit="page" from="S75">S75</biblScope><biblScope unit="page" to="S83">S83</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">645ED79E4BFD3D4EFB435E1FA0EB6C59E408A351</idno><idno type="DOI">10.1002/mds.10146</idno><idno type="ArticleID">MDS10146</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>Vim</term><term>deep brain stimulation</term><term>globus pallidus</term><term>subthalamic nucleus</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Deep brain stimulation (DBS) is a neurosurgical treatment of Parkinson's disease that is applied to three targets: the ventral intermediate nucleus of the thalamus (Vim), the globus pallidus internas (GPi) and the subthalamic nucleus (STN). Vim DBS mainly improves contralateral tremor and, therefore, is being supplanted by DBS of the two other targets, even in patients with tremor dominant disease. STN and GPi DBS improve off‐motor phases and dyskinesias. There is little comparative data between these procedures. The magnitude of the motor improvement seems more constant with STN than GPi DBS. STN DBS allows a decrease in antiparkinsonian drug doses and consumes moderate current. These advantages of STN over GPi DBS are offset by the need for more intensive postoperative management. The DBS procedure has the unique advantage of reversibility and adjustability over time. Patients with young‐onset Parkinson's disease suffering from levodopa‐induced motor complications but still responding well to levodopa and who exhibit no behavioral, mood, or cognitive impairment benefit the most from STN DBS. Adverse effects more specific of the DBS procedure are infection, cutaneous erosion, and lead breaking or disconnection. Intracranial electrode implantation can induce a hematoma or contusion. Most authors agree that the benefit to risk ratio of DBS is favorable. © 2002 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Pierre Pollak MD</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</json:string><json:string>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</json:string></affiliations></json:item><json:item><name>Valérie Fraix MD</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</json:string><json:string>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</json:string></affiliations></json:item><json:item><name>Paul Krack MD</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</json:string><json:string>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</json:string></affiliations></json:item><json:item><name>Elena Moro MD, PhD</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</json:string><json:string>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</json:string></affiliations></json:item><json:item><name>Alexandre Mendes MD</name><affiliations><json:string>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</json:string><json:string>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</json:string></affiliations></json:item><json:item><name>Stephan Chabardes MD</name><affiliations><json:string>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</json:string><json:string>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France</json:string></affiliations></json:item><json:item><name>Adnan Koudsie MD</name><affiliations><json:string>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</json:string><json:string>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France</json:string></affiliations></json:item><json:item><name>Alim‐Louis Benabid MD, PhD</name><affiliations><json:string>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</json:string><json:string>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>subthalamic nucleus</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>globus pallidus</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Vim</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>deep brain stimulation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item></subject><articleId><json:string>MDS10146</json:string></articleId><language><json:string>eng</json:string></language><abstract>Deep brain stimulation (DBS) is a neurosurgical treatment of Parkinson's disease that is applied to three targets: the ventral intermediate nucleus of the thalamus (Vim), the globus pallidus internas (GPi) and the subthalamic nucleus (STN). Vim DBS mainly improves contralateral tremor and, therefore, is being supplanted by DBS of the two other targets, even in patients with tremor dominant disease. STN and GPi DBS improve off‐motor phases and dyskinesias. There is little comparative data between these procedures. The magnitude of the motor improvement seems more constant with STN than GPi DBS. STN DBS allows a decrease in antiparkinsonian drug doses and consumes moderate current. These advantages of STN over GPi DBS are offset by the need for more intensive postoperative management. The DBS procedure has the unique advantage of reversibility and adjustability over time. Patients with young‐onset Parkinson's disease suffering from levodopa‐induced motor complications but still responding well to levodopa and who exhibit no behavioral, mood, or cognitive impairment benefit the most from STN DBS. Adverse effects more specific of the DBS procedure are infection, cutaneous erosion, and lead breaking or disconnection. Intracranial electrode implantation can induce a hematoma or contusion. Most authors agree that the benefit to risk ratio of DBS is favorable. © 2002 Movement Disorder Society</abstract><qualityIndicators><score>8.008</score><pdfVersion>1.4</pdfVersion><pdfPageSize>612 x 792 pts (letter)</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>5</keywordCount><abstractCharCount>1407</abstractCharCount><pdfWordCount>6784</pdfWordCount><pdfCharCount>45974</pdfCharCount><pdfPageCount>9</pdfPageCount><abstractWordCount>209</abstractWordCount></qualityIndicators><title>Treatment results: Parkinson's disease</title><genre><json:string>article</json:string></genre><host><volume>17</volume><publisherId><json:string>MDS</json:string></publisherId><pages><total>9</total><last>S83</last><first>S75</first></pages><issn><json:string>0885-3185</json:string></issn><issue>S3</issue><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1531-8257</json:string></eissn><title>Movement 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type="degree">MD</roleName><affiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</affiliation><affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</affiliation></author><author><persName><forename type="first">Paul</forename><surname>Krack</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</affiliation><affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</affiliation></author><author><persName><forename type="first">Elena</forename><surname>Moro</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</affiliation><affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</affiliation></author><author><persName><forename type="first">Alexandre</forename><surname>Mendes</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</affiliation><affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</affiliation></author><author><persName><forename type="first">Stephan</forename><surname>Chabardes</surname></persName><roleName type="degree">MD</roleName><affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</affiliation><affiliation>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France</affiliation></author><author><persName><forename type="first">Adnan</forename><surname>Koudsie</surname></persName><roleName type="degree">MD</roleName><affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</affiliation><affiliation>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France</affiliation></author><author><persName><forename type="first">Alim‐Louis</forename><surname>Benabid</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</affiliation><affiliation>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</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>New York</pubPlace><date type="published" when="2002-03"></date><biblScope unit="volume">17</biblScope><biblScope unit="issue">S3</biblScope><biblScope unit="supplement">3</biblScope><biblScope unit="page" from="S75">S75</biblScope><biblScope unit="page" to="S83">S83</biblScope></imprint></monogr><idno type="istex">645ED79E4BFD3D4EFB435E1FA0EB6C59E408A351</idno><idno type="DOI">10.1002/mds.10146</idno><idno type="ArticleID">MDS10146</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2002</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Deep brain stimulation (DBS) is a neurosurgical treatment of Parkinson's disease that is applied to three targets: the ventral intermediate nucleus of the thalamus (Vim), the globus pallidus internas (GPi) and the subthalamic nucleus (STN). Vim DBS mainly improves contralateral tremor and, therefore, is being supplanted by DBS of the two other targets, even in patients with tremor dominant disease. STN and GPi DBS improve off‐motor phases and dyskinesias. There is little comparative data between these procedures. The magnitude of the motor improvement seems more constant with STN than GPi DBS. STN DBS allows a decrease in antiparkinsonian drug doses and consumes moderate current. These advantages of STN over GPi DBS are offset by the need for more intensive postoperative management. The DBS procedure has the unique advantage of reversibility and adjustability over time. Patients with young‐onset Parkinson's disease suffering from levodopa‐induced motor complications but still responding well to levodopa and who exhibit no behavioral, mood, or cognitive impairment benefit the most from STN DBS. Adverse effects more specific of the DBS procedure are infection, cutaneous erosion, and lead breaking or disconnection. Intracranial electrode implantation can induce a hematoma or contusion. Most authors agree that the benefit to risk ratio of DBS is favorable. © 2002 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>subthalamic nucleus</term></item><item><term>globus pallidus</term></item><item><term>Vim</term></item><item><term>deep brain stimulation</term></item><item><term>Parkinson's disease</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2002-03">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/645ED79E4BFD3D4EFB435E1FA0EB6C59E408A351/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>New York</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="subtitle">Official Journal of the Movement Disorder Society</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="35"><doi origin="wiley" registered="yes">10.1002/mds.v17:3+</doi><titleGroup><title type="supplementTitle">Deep Brain Stimulation for Movement Disorders</title></titleGroup><numberingGroup><numbering type="journalVolume" number="17">17</numbering><numbering type="journalIssue">S3</numbering><numbering type="supplement" number="3">3</numbering></numberingGroup><coverDate startDate="2002-03">March/April 2002</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="12" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.10146</doi><idGroup><id type="unit" value="MDS10146"></id></idGroup><countGroup><count type="pageTotal" number="9"></count></countGroup><copyright ownership="thirdParty">Copyright © 2002 Movement Disorders Society</copyright><eventGroup><event type="firstOnline" date="2002-03-28"></event><event type="publishedOnlineFinalForm" date="2002-03-28"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.3.2 mode:FullText source:FullText result:FullText" date="2010-03-09"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-11-01"></event></eventGroup><numberingGroup><numbering type="pageFirst">S75</numbering><numbering type="pageLast">S83</numbering></numberingGroup><correspondenceTo>Department of Neurology, University of Grenoble, BP 217, 38043 Grenoble Cedex 9, France</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS10146.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="3"></count><count type="referenceTotal" number="117"></count><count type="wordTotal" number="6574"></count></countGroup><titleGroup><title type="main" xml:lang="en">Treatment results: Parkinson's disease</title><title type="short" xml:lang="en">Results of DBS in PD</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1 #af2" corresponding="yes"><personName><givenNames>Pierre</givenNames><familyName>Pollak</familyName><degrees>MD</degrees></personName><contactDetails><email normalForm="pierre.pollak@ujf-grenoble.fr">pierre.pollak@ujf‐grenoble.fr</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Valérie</givenNames><familyName>Fraix</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Paul</givenNames><familyName>Krack</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Elena</givenNames><familyName>Moro</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Alexandre</givenNames><familyName>Mendes</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af2 #af3"><personName><givenNames>Stephan</givenNames><familyName>Chabardes</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af2 #af3"><personName><givenNames>Adnan</givenNames><familyName>Koudsie</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af2 #af3"><personName><givenNames>Alim‐Louis</givenNames><familyName>Benabid</familyName><degrees>MD, PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="FR" type="organization"><unparsedAffiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="FR" type="organization"><unparsedAffiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="FR" type="organization"><unparsedAffiliation>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">subthalamic nucleus</keyword><keyword xml:id="kwd2">globus pallidus</keyword><keyword xml:id="kwd3">Vim</keyword><keyword xml:id="kwd4">deep brain stimulation</keyword><keyword xml:id="kwd5">Parkinson's disease</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Deep brain stimulation (DBS) is a neurosurgical treatment of Parkinson's disease that is applied to three targets: the ventral intermediate nucleus of the thalamus (Vim), the globus pallidus internas (GPi) and the subthalamic nucleus (STN). Vim DBS mainly improves contralateral tremor and, therefore, is being supplanted by DBS of the two other targets, even in patients with tremor dominant disease. STN and GPi DBS improve off‐motor phases and dyskinesias. There is little comparative data between these procedures. The magnitude of the motor improvement seems more constant with STN than GPi DBS. STN DBS allows a decrease in antiparkinsonian drug doses and consumes moderate current. These advantages of STN over GPi DBS are offset by the need for more intensive postoperative management. The DBS procedure has the unique advantage of reversibility and adjustability over time. Patients with young‐onset Parkinson's disease suffering from levodopa‐induced motor complications but still responding well to levodopa and who exhibit no behavioral, mood, or cognitive impairment benefit the most from STN DBS. Adverse effects more specific of the DBS procedure are infection, cutaneous erosion, and lead breaking or disconnection. Intracranial electrode implantation can induce a hematoma or contusion. Most authors agree that the benefit to risk ratio of DBS is favorable. © 2002 Movement Disorder Society</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Treatment results: Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Results of DBS in PD</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Treatment results: Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Pierre</namePart><namePart type="family">Pollak</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</affiliation><affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</affiliation><description>Correspondence: Department of Neurology, University of Grenoble, BP 217, 38043 Grenoble Cedex 9, France</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Valérie</namePart><namePart type="family">Fraix</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</affiliation><affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Paul</namePart><namePart type="family">Krack</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</affiliation><affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Elena</namePart><namePart type="family">Moro</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</affiliation><affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alexandre</namePart><namePart type="family">Mendes</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</affiliation><affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Stephan</namePart><namePart type="family">Chabardes</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</affiliation><affiliation>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Adnan</namePart><namePart type="family">Koudsie</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</affiliation><affiliation>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Alim‐Louis</namePart><namePart type="family">Benabid</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</affiliation><affiliation>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France</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">New York</placeTerm></place><dateIssued encoding="w3cdtf">2002-03</dateIssued><copyrightDate encoding="w3cdtf">2002</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="tables">3</extent><extent unit="references">117</extent><extent unit="words">6574</extent></physicalDescription><abstract lang="en">Deep brain stimulation (DBS) is a neurosurgical treatment of Parkinson's disease that is applied to three targets: the ventral intermediate nucleus of the thalamus (Vim), the globus pallidus internas (GPi) and the subthalamic nucleus (STN). Vim DBS mainly improves contralateral tremor and, therefore, is being supplanted by DBS of the two other targets, even in patients with tremor dominant disease. STN and GPi DBS improve off‐motor phases and dyskinesias. There is little comparative data between these procedures. The magnitude of the motor improvement seems more constant with STN than GPi DBS. STN DBS allows a decrease in antiparkinsonian drug doses and consumes moderate current. These advantages of STN over GPi DBS are offset by the need for more intensive postoperative management. The DBS procedure has the unique advantage of reversibility and adjustability over time. Patients with young‐onset Parkinson's disease suffering from levodopa‐induced motor complications but still responding well to levodopa and who exhibit no behavioral, mood, or cognitive impairment benefit the most from STN DBS. Adverse effects more specific of the DBS procedure are infection, cutaneous erosion, and lead breaking or disconnection. Intracranial electrode implantation can induce a hematoma or contusion. Most authors agree that the benefit to risk ratio of DBS is favorable. © 2002 Movement Disorder Society</abstract><subject lang="en"><genre>Keywords</genre><topic>subthalamic nucleus</topic><topic>globus pallidus</topic><topic>Vim</topic><topic>deep brain stimulation</topic><topic>Parkinson's disease</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title><subTitle>Official Journal of the Movement Disorder Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Mov. 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