Cognition and mood in Parkinson's disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: The COMPARE Trial
Identifieur interne : 000C73 ( Main/Corpus ); précédent : 000C72; suivant : 000C74Cognition and mood in Parkinson's disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: The COMPARE Trial
Auteurs : Michael S. Okun ; Hubert H. Fernandez ; Samuel S. Wu ; Lindsey Kirsch-Darrow ; Dawn Bowers ; Frank Bova ; Michele Suelter ; Charles E. Jacobson Iv ; Xinping Wang ; Clifford W. Gordon Jr. ; Pam Zeilman ; Janet Romrell ; Pam Martin ; Herbert Ward ; Ramon L. Rodriguez ; Kelly D. FooteSource :
- Annals of Neurology [ 0364-5134 ] ; 2009-05.
Abstract
Objective: Our aim was to compare in a prospective blinded study the cognitive and mood effects of subthalamic nucleus (STN) vs. globus pallidus interna (GPi) deep brain stimulation (DBS) in Parkinson disease. Methods: Fifty‐two subjects were randomized to unilateral STN or GPi DBS. The co‐primary outcome measures were the Visual Analog Mood Scale, and verbal fluency (semantic and letter) at 7 months post‐DBS in the optimal setting compared to pre‐DBS. At 7 months post‐DBS, subjects were tested in four randomized/counterbalanced conditions (optimal, ventral, dorsal, and off DBS). Results: Forty‐five subjects (23 GPi, 22 STN) completed the protocol. The study revealed no difference between STN and GPi DBS in the change of co‐primary mood and cognitive outcomes pre‐ to post‐DBS in the optimal setting (Hotelling's T2 test: p = 0.16 and 0.08 respectively). Subjects in both targets were less “happy”, less “energetic” and more “confused” when stimulated ventrally. Comparison of the other 3 DBS conditions to pre‐DBS showed a larger deterioration of letter verbal fluency in STN, especially when off DBS. There was no difference in UPDRS motor improvement between targets. Interpretation: There were no significant differences in the co‐primary outcome measures (mood and cognition) between STN and GPi in the optimal DBS state. Adverse mood effects occurred ventrally in both targets. A worsening of letter verbal fluency was seen in STN. The persistence of deterioration in verbal fluency in the off STN DBS state was suggestive of a surgical rather than a stimulation‐induced effect. Similar motor improvement were observed with both STN and GPi DBS. Ann Neurol 2009
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DOI: 10.1002/ana.21596
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Cognition and mood in Parkinson's disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: The COMPARE Trial</title><author><name sortKey="Okun, Michael S" sort="Okun, Michael S" uniqKey="Okun M" first="Michael S." last="Okun">Michael S. Okun</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Fernandez, Hubert H" sort="Fernandez, Hubert H" uniqKey="Fernandez H" first="Hubert H." last="Fernandez">Hubert H. 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Jacobson Iv</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Wang, Xinping" sort="Wang, Xinping" uniqKey="Wang X" first="Xinping" last="Wang">Xinping Wang</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Gordon Jr, Clifford W" sort="Gordon Jr, Clifford W" uniqKey="Gordon Jr C" first="Clifford W." last="Gordon Jr.">Clifford W. Gordon Jr.</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Zeilman, Pam" sort="Zeilman, Pam" uniqKey="Zeilman P" first="Pam" last="Zeilman">Pam Zeilman</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Romrell, Janet" sort="Romrell, Janet" uniqKey="Romrell J" first="Janet" last="Romrell">Janet Romrell</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Martin, Pam" sort="Martin, Pam" uniqKey="Martin P" first="Pam" last="Martin">Pam Martin</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Ward, Herbert" sort="Ward, Herbert" uniqKey="Ward H" first="Herbert" last="Ward">Herbert Ward</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Rodriguez, Ramon L" sort="Rodriguez, Ramon L" uniqKey="Rodriguez R" first="Ramon L." last="Rodriguez">Ramon L. Rodriguez</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Foote, Kelly D" sort="Foote, Kelly D" uniqKey="Foote K" first="Kelly D." last="Foote">Kelly D. Foote</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:2141B2BB9FCAC7CE59D2B44FB021AAA0FFC116FB</idno><date when="2009" year="2009">2009</date><idno type="doi">10.1002/ana.21596</idno><idno type="url">https://api.istex.fr/document/2141B2BB9FCAC7CE59D2B44FB021AAA0FFC116FB/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000C73</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Cognition and mood in Parkinson's disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: The COMPARE Trial</title><author><name sortKey="Okun, Michael S" sort="Okun, Michael S" uniqKey="Okun M" first="Michael S." last="Okun">Michael S. Okun</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Fernandez, Hubert H" sort="Fernandez, Hubert H" uniqKey="Fernandez H" first="Hubert H." last="Fernandez">Hubert H. Fernandez</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Wu, Samuel S" sort="Wu, Samuel S" uniqKey="Wu S" first="Samuel S." last="Wu">Samuel S. Wu</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Kirsch Arrow, Lindsey" sort="Kirsch Arrow, Lindsey" uniqKey="Kirsch Arrow L" first="Lindsey" last="Kirsch-Darrow">Lindsey Kirsch-Darrow</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Bowers, Dawn" sort="Bowers, Dawn" uniqKey="Bowers D" first="Dawn" last="Bowers">Dawn Bowers</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Bova, Frank" sort="Bova, Frank" uniqKey="Bova F" first="Frank" last="Bova">Frank Bova</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Suelter, Michele" sort="Suelter, Michele" uniqKey="Suelter M" first="Michele" last="Suelter">Michele Suelter</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Jacobson Iv, Charles E" sort="Jacobson Iv, Charles E" uniqKey="Jacobson Iv C" first="Charles E." last="Jacobson Iv">Charles E. Jacobson Iv</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Wang, Xinping" sort="Wang, Xinping" uniqKey="Wang X" first="Xinping" last="Wang">Xinping Wang</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Gordon Jr, Clifford W" sort="Gordon Jr, Clifford W" uniqKey="Gordon Jr C" first="Clifford W." last="Gordon Jr.">Clifford W. Gordon Jr.</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Zeilman, Pam" sort="Zeilman, Pam" uniqKey="Zeilman P" first="Pam" last="Zeilman">Pam Zeilman</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Romrell, Janet" sort="Romrell, Janet" uniqKey="Romrell J" first="Janet" last="Romrell">Janet Romrell</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Martin, Pam" sort="Martin, Pam" uniqKey="Martin P" first="Pam" last="Martin">Pam Martin</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Ward, Herbert" sort="Ward, Herbert" uniqKey="Ward H" first="Herbert" last="Ward">Herbert Ward</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Rodriguez, Ramon L" sort="Rodriguez, Ramon L" uniqKey="Rodriguez R" first="Ramon L." last="Rodriguez">Ramon L. Rodriguez</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author><author><name sortKey="Foote, Kelly D" sort="Foote, Kelly D" uniqKey="Foote K" first="Kelly D." last="Foote">Kelly D. Foote</name><affiliation><mods:affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Annals of Neurology</title><title level="j" type="sub">Official Journal of the American Neurological Association and the Child Neurology Society</title><title level="j" type="abbrev">Ann Neurol.</title><idno type="ISSN">0364-5134</idno><idno type="eISSN">1531-8249</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2009-05">2009-05</date><biblScope unit="volume">65</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="586">586</biblScope><biblScope unit="page" to="595">595</biblScope></imprint><idno type="ISSN">0364-5134</idno></series><idno type="istex">2141B2BB9FCAC7CE59D2B44FB021AAA0FFC116FB</idno><idno type="DOI">10.1002/ana.21596</idno><idno type="ArticleID">ANA21596</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0364-5134</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: Our aim was to compare in a prospective blinded study the cognitive and mood effects of subthalamic nucleus (STN) vs. globus pallidus interna (GPi) deep brain stimulation (DBS) in Parkinson disease. Methods: Fifty‐two subjects were randomized to unilateral STN or GPi DBS. The co‐primary outcome measures were the Visual Analog Mood Scale, and verbal fluency (semantic and letter) at 7 months post‐DBS in the optimal setting compared to pre‐DBS. At 7 months post‐DBS, subjects were tested in four randomized/counterbalanced conditions (optimal, ventral, dorsal, and off DBS). Results: Forty‐five subjects (23 GPi, 22 STN) completed the protocol. The study revealed no difference between STN and GPi DBS in the change of co‐primary mood and cognitive outcomes pre‐ to post‐DBS in the optimal setting (Hotelling's T2 test: p = 0.16 and 0.08 respectively). Subjects in both targets were less “happy”, less “energetic” and more “confused” when stimulated ventrally. Comparison of the other 3 DBS conditions to pre‐DBS showed a larger deterioration of letter verbal fluency in STN, especially when off DBS. There was no difference in UPDRS motor improvement between targets. Interpretation: There were no significant differences in the co‐primary outcome measures (mood and cognition) between STN and GPi in the optimal DBS state. Adverse mood effects occurred ventrally in both targets. A worsening of letter verbal fluency was seen in STN. The persistence of deterioration in verbal fluency in the off STN DBS state was suggestive of a surgical rather than a stimulation‐induced effect. Similar motor improvement were observed with both STN and GPi DBS. Ann Neurol 2009</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Michael S. Okun MD</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item><json:item><name>Hubert H. Fernandez MD</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item><json:item><name>Samuel S. Wu PhD</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item><json:item><name>Lindsey Kirsch‐Darrow MS</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item><json:item><name>Dawn Bowers PhD</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item><json:item><name>Frank Bova PhD</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item><json:item><name>Michele Suelter BS</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item><json:item><name>Charles E. Jacobson IV BS</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item><json:item><name>Xinping Wang PhD</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item><json:item><name>Clifford W. Gordon Jr. BS</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item><json:item><name>Pam Zeilman ARNP</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item><json:item><name>Janet Romrell PA‐C</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item><json:item><name>Pam Martin RN</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item><json:item><name>Herbert Ward MD</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item><json:item><name>Ramon L. Rodriguez MD</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item><json:item><name>Kelly D. Foote MD</name><affiliations><json:string>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</json:string></affiliations></json:item></author><articleId><json:string>ANA21596</json:string></articleId><language><json:string>eng</json:string></language><abstract>Objective: Our aim was to compare in a prospective blinded study the cognitive and mood effects of subthalamic nucleus (STN) vs. globus pallidus interna (GPi) deep brain stimulation (DBS) in Parkinson disease. Methods: Fifty‐two subjects were randomized to unilateral STN or GPi DBS. The co‐primary outcome measures were the Visual Analog Mood Scale, and verbal fluency (semantic and letter) at 7 months post‐DBS in the optimal setting compared to pre‐DBS. At 7 months post‐DBS, subjects were tested in four randomized/counterbalanced conditions (optimal, ventral, dorsal, and off DBS). Results: Forty‐five subjects (23 GPi, 22 STN) completed the protocol. The study revealed no difference between STN and GPi DBS in the change of co‐primary mood and cognitive outcomes pre‐ to post‐DBS in the optimal setting (Hotelling's T2 test: p = 0.16 and 0.08 respectively). Subjects in both targets were less “happy”, less “energetic” and more “confused” when stimulated ventrally. Comparison of the other 3 DBS conditions to pre‐DBS showed a larger deterioration of letter verbal fluency in STN, especially when off DBS. There was no difference in UPDRS motor improvement between targets. Interpretation: There were no significant differences in the co‐primary outcome measures (mood and cognition) between STN and GPi in the optimal DBS state. Adverse mood effects occurred ventrally in both targets. A worsening of letter verbal fluency was seen in STN. The persistence of deterioration in verbal fluency in the off STN DBS state was suggestive of a surgical rather than a stimulation‐induced effect. Similar motor improvement were observed with both STN and GPi DBS. 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M.S.O serves as a consultant to the National Parkinson Foundation (National Medical Director), and K.D.F. and M.S.O. receive honoraria for DBS fellows and for physician teaching from the Medtronic company.</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Cognition and mood in Parkinson's disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: The COMPARE Trial</title><author><persName><forename type="first">Michael S.</forename><surname>Okun</surname></persName><roleName type="degree">MD</roleName><note type="correspondence"><p>Correspondence: 100 South Newell Drive, Room L3‐101, Department of Neurology, Gainesville, FL 32611</p></note><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author><author><persName><forename type="first">Hubert H.</forename><surname>Fernandez</surname></persName><roleName type="degree">MD</roleName><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author><author><persName><forename type="first">Samuel S.</forename><surname>Wu</surname></persName><roleName type="degree">PhD</roleName><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author><author><persName><forename type="first">Lindsey</forename><surname>Kirsch‐Darrow</surname></persName><roleName type="degree">MS</roleName><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author><author><persName><forename type="first">Dawn</forename><surname>Bowers</surname></persName><roleName type="degree">PhD</roleName><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author><author><persName><forename type="first">Frank</forename><surname>Bova</surname></persName><roleName type="degree">PhD</roleName><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author><author><persName><forename type="first">Michele</forename><surname>Suelter</surname></persName><roleName type="degree">BS</roleName><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author><author><persName><forename type="first">Charles E.</forename><surname>Jacobson IV</surname></persName><roleName type="degree">BS</roleName><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author><author><persName><forename type="first">Xinping</forename><surname>Wang</surname></persName><roleName type="degree">PhD</roleName><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author><author><persName><forename type="first">Clifford W.</forename><surname>Gordon Jr.</surname></persName><roleName type="degree">BS</roleName><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author><author><persName><forename type="first">Pam</forename><surname>Zeilman</surname></persName><roleName type="degree">ARNP</roleName><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author><author><persName><forename type="first">Janet</forename><surname>Romrell</surname></persName><roleName type="degree">PA‐C</roleName><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author><author><persName><forename type="first">Pam</forename><surname>Martin</surname></persName><roleName type="degree">RN</roleName><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author><author><persName><forename type="first">Herbert</forename><surname>Ward</surname></persName><roleName type="degree">MD</roleName><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author><author><persName><forename type="first">Ramon L.</forename><surname>Rodriguez</surname></persName><roleName type="degree">MD</roleName><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author><author><persName><forename type="first">Kelly D.</forename><surname>Foote</surname></persName><roleName type="degree">MD</roleName><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation></author></analytic><monogr><title level="j">Annals of Neurology</title><title level="j" type="sub">Official Journal of the American Neurological Association and the Child Neurology Society</title><title level="j" type="abbrev">Ann Neurol.</title><idno type="pISSN">0364-5134</idno><idno type="eISSN">1531-8249</idno><idno type="DOI">10.1002/(ISSN)1531-8249</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2009-05"></date><biblScope unit="volume">65</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="586">586</biblScope><biblScope unit="page" to="595">595</biblScope></imprint></monogr><idno type="istex">2141B2BB9FCAC7CE59D2B44FB021AAA0FFC116FB</idno><idno type="DOI">10.1002/ana.21596</idno><idno 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Methods: Fifty‐two subjects were randomized to unilateral STN or GPi DBS. The co‐primary outcome measures were the Visual Analog Mood Scale, and verbal fluency (semantic and letter) at 7 months post‐DBS in the optimal setting compared to pre‐DBS. At 7 months post‐DBS, subjects were tested in four randomized/counterbalanced conditions (optimal, ventral, dorsal, and off DBS). Results: Forty‐five subjects (23 GPi, 22 STN) completed the protocol. The study revealed no difference between STN and GPi DBS in the change of co‐primary mood and cognitive outcomes pre‐ to post‐DBS in the optimal setting (Hotelling's T2 test: p = 0.16 and 0.08 respectively). Subjects in both targets were less “happy”, less “energetic” and more “confused” when stimulated ventrally. Comparison of the other 3 DBS conditions to pre‐DBS showed a larger deterioration of letter verbal fluency in STN, especially when off DBS. There was no difference in UPDRS motor improvement between targets. Interpretation: There were no significant differences in the co‐primary outcome measures (mood and cognition) between STN and GPi in the optimal DBS state. Adverse mood effects occurred ventrally in both targets. A worsening of letter verbal fluency was seen in STN. The persistence of deterioration in verbal fluency in the off STN DBS state was suggestive of a surgical rather than a stimulation‐induced effect. Similar motor improvement were observed with both STN and GPi DBS. Ann Neurol 2009</p></abstract><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Original Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2008-09-02">Received</change><change when="2008-10-31">Registration</change><change when="2009-05">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/2141B2BB9FCAC7CE59D2B44FB021AAA0FFC116FB/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 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registered="yes">10.1002/ana.21596</doi><idGroup><id type="unit" value="ANA21596"></id></idGroup><countGroup><count type="pageTotal" number="10"></count></countGroup><titleGroup><title type="articleCategory">Original Article</title><title type="tocHeading1">Original Article</title></titleGroup><copyright ownership="thirdParty">Copyright © 2009 American Neurological Association</copyright><eventGroup><event type="manuscriptReceived" date="2008-09-02"></event><event type="manuscriptRevised" date="2008-10-31"></event><event type="manuscriptAccepted" date="2008-10-31"></event><event type="publishedOnlineEarlyUnpaginated" date="2009-03-13"></event><event type="firstOnline" date="2009-03-13"></event><event type="publishedOnlineFinalForm" date="2009-06-11"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.3.1 mode:FullText source:FullText result:FullText" date="2010-02-23"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-03"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-14"></event></eventGroup><numberingGroup><numbering type="pageFirst">586</numbering><numbering type="pageLast">595</numbering></numberingGroup><correspondenceTo>100 South Newell Drive, Room L3‐101, Department of Neurology, Gainesville, FL 32611</correspondenceTo><objectNameGroup><objectName elementName="figure">Illustration</objectName></objectNameGroup><linkGroup><link type="toTypesetVersion" href="file:ANA.ANA21596.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="3"></count><count type="referenceTotal" number="40"></count><count type="wordTotal" number="7015"></count></countGroup><titleGroup><title type="main" xml:lang="en">Cognition and mood in Parkinson's disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: The COMPARE Trial<link href="#fn1"></link></title><title type="short" xml:lang="en">The COMPARE Trial</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Michael S.</givenNames><familyName>Okun</familyName><degrees>MD</degrees></personName><contactDetails><email>okun@neurology.ufl.edu</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Hubert H.</givenNames><familyName>Fernandez</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Samuel S.</givenNames><familyName>Wu</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Lindsey</givenNames><familyName>Kirsch‐Darrow</familyName><degrees>MS</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Dawn</givenNames><familyName>Bowers</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Frank</givenNames><familyName>Bova</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Michele</givenNames><familyName>Suelter</familyName><degrees>BS</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Charles E.</givenNames><familyName>Jacobson</familyName><nameSuffix>IV</nameSuffix><degrees>BS</degrees></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Xinping</givenNames><familyName>Wang</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Clifford W.</givenNames><familyName>Gordon</familyName><nameSuffix>Jr.</nameSuffix><degrees>BS</degrees></personName></creator><creator xml:id="au11" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Pam</givenNames><familyName>Zeilman</familyName><degrees>ARNP</degrees></personName></creator><creator xml:id="au12" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Janet</givenNames><familyName>Romrell</familyName><degrees>PA‐C</degrees></personName></creator><creator xml:id="au13" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Pam</givenNames><familyName>Martin</familyName><degrees>RN</degrees></personName></creator><creator xml:id="au14" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Herbert</givenNames><familyName>Ward</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au15" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Ramon L.</givenNames><familyName>Rodriguez</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au16" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Kelly D.</givenNames><familyName>Foote</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</unparsedAffiliation></affiliation></affiliationGroup><supportingInformation><p> Additional Supporting Information may be found in the online version of this article. </p><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:03645134:media:ana21596:ANA_21596_sm_SupTab1"></mediaResource><caption>Supplementary Table 1. Summary of the Primary and Secondary Outcome Variables</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:03645134:media:ana21596:ANA_21596_sm_SupTab2"></mediaResource><caption>Supplementary Table 2. GCRC Stimulation Setting Specific Adverse Events</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:03645134:media:ana21596:ANA_21596_sm_SupTab3"></mediaResource><caption>Supplementary Table 3. Post‐Surgical Mood and Cognitive Adverse Events</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:03645134:media:ana21596:ANA_21596_sm_SupTab4"></mediaResource><caption>Supplementary Table 4. General Post‐Surgical Adverse Events</caption></supportingInfoItem></supportingInformation><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><section xml:id="abs1-1"><title type="main">Objective</title><p>Our aim was to compare in a prospective blinded study the <i>cognitive</i> and <i>mood</i> effects of subthalamic nucleus (STN) vs. globus pallidus interna (GPi) deep brain stimulation (DBS) in Parkinson disease.</p></section><section xml:id="abs1-2"><title type="main">Methods</title><p>Fifty‐two subjects were randomized to unilateral STN or GPi DBS. The co‐primary outcome measures were the Visual Analog Mood Scale, and verbal fluency (semantic and letter) at 7 months post‐DBS in the <i>optimal</i> setting compared to pre‐DBS. At 7 months post‐DBS, subjects were tested in four randomized/counterbalanced conditions (<i>optimal, ventral, dorsal,</i> and <i>off</i> DBS).</p></section><section xml:id="abs1-3"><title type="main">Results</title><p>Forty‐five subjects (23 GPi, 22 STN) completed the protocol. The study revealed no difference between STN and GPi DBS in the change of co‐primary <i>mood</i> and <i>cognitive</i> outcomes pre‐ to post‐DBS in the <i>optimal</i> setting (Hotelling's T<sup>2</sup> test: p = 0.16 and 0.08 respectively). Subjects in both targets were less “happy”, less “energetic” and more “confused” when stimulated <i>ventrally.</i> Comparison of the other 3 DBS conditions to pre‐DBS showed a larger deterioration of letter verbal fluency in STN, especially when off DBS. There was no difference in UPDRS motor improvement between targets.</p></section><section xml:id="abs1-4"><title type="main">Interpretation</title><p>There were no significant differences in the co‐primary outcome measures (mood and cognition) between STN and GPi in the <i>optimal</i> DBS state. Adverse mood effects occurred <i>ventrally</i> in both targets. A worsening of letter verbal fluency was seen in STN. The persistence of deterioration in verbal fluency in the <i>off</i> STN DBS state was suggestive of a surgical rather than a stimulation‐induced effect. Similar motor improvement were observed with both STN and GPi DBS. Ann Neurol 2009</p></section></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Potential conflict of interest: This study was industry independent and completely supported by the NIH. M.S.O serves as a consultant to the National Parkinson Foundation (National Medical Director), and K.D.F. and M.S.O. receive honoraria for DBS fellows and for physician teaching from the Medtronic company.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Cognition and mood in Parkinson's disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: The COMPARE Trial</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>The COMPARE Trial</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Cognition and mood in Parkinson's disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: The COMPARE Trial</title></titleInfo><name type="personal"><namePart type="given">Michael S.</namePart><namePart type="family">Okun</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation><description>Correspondence: 100 South Newell Drive, Room L3‐101, Department of Neurology, Gainesville, FL 32611</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Hubert H.</namePart><namePart type="family">Fernandez</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Samuel S.</namePart><namePart type="family">Wu</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lindsey</namePart><namePart type="family">Kirsch‐Darrow</namePart><namePart type="termsOfAddress">MS</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Dawn</namePart><namePart type="family">Bowers</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Frank</namePart><namePart type="family">Bova</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michele</namePart><namePart type="family">Suelter</namePart><namePart type="termsOfAddress">BS</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Charles E.</namePart><namePart type="family">Jacobson IV</namePart><namePart type="termsOfAddress">BS</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Xinping</namePart><namePart type="family">Wang</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Clifford W.</namePart><namePart type="family">Gordon Jr.</namePart><namePart type="termsOfAddress">BS</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Pam</namePart><namePart type="family">Zeilman</namePart><namePart type="termsOfAddress">ARNP</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Janet</namePart><namePart type="family">Romrell</namePart><namePart type="termsOfAddress">PA‐C</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Pam</namePart><namePart type="family">Martin</namePart><namePart type="termsOfAddress">RN</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Herbert</namePart><namePart type="family">Ward</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ramon L.</namePart><namePart type="family">Rodriguez</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kelly D.</namePart><namePart type="family">Foote</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville, FL</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">2009-05</dateIssued><dateCaptured encoding="w3cdtf">2008-09-02</dateCaptured><dateValid encoding="w3cdtf">2008-10-31</dateValid><copyrightDate encoding="w3cdtf">2009</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">1</extent><extent unit="tables">3</extent><extent unit="references">40</extent><extent unit="words">7015</extent></physicalDescription><abstract lang="en">Objective: Our aim was to compare in a prospective blinded study the cognitive and mood effects of subthalamic nucleus (STN) vs. globus pallidus interna (GPi) deep brain stimulation (DBS) in Parkinson disease. Methods: Fifty‐two subjects were randomized to unilateral STN or GPi DBS. The co‐primary outcome measures were the Visual Analog Mood Scale, and verbal fluency (semantic and letter) at 7 months post‐DBS in the optimal setting compared to pre‐DBS. At 7 months post‐DBS, subjects were tested in four randomized/counterbalanced conditions (optimal, ventral, dorsal, and off DBS). Results: Forty‐five subjects (23 GPi, 22 STN) completed the protocol. The study revealed no difference between STN and GPi DBS in the change of co‐primary mood and cognitive outcomes pre‐ to post‐DBS in the optimal setting (Hotelling's T2 test: p = 0.16 and 0.08 respectively). Subjects in both targets were less “happy”, less “energetic” and more “confused” when stimulated ventrally. Comparison of the other 3 DBS conditions to pre‐DBS showed a larger deterioration of letter verbal fluency in STN, especially when off DBS. There was no difference in UPDRS motor improvement between targets. Interpretation: There were no significant differences in the co‐primary outcome measures (mood and cognition) between STN and GPi in the optimal DBS state. Adverse mood effects occurred ventrally in both targets. A worsening of letter verbal fluency was seen in STN. The persistence of deterioration in verbal fluency in the off STN DBS state was suggestive of a surgical rather than a stimulation‐induced effect. Similar motor improvement were observed with both STN and GPi DBS. Ann Neurol 2009</abstract><note type="content">*Potential conflict of interest: This study was industry independent and completely supported by the NIH. M.S.O serves as a consultant to the National Parkinson Foundation (National Medical Director), and K.D.F. and M.S.O. receive honoraria for DBS fellows and for physician teaching from the Medtronic company.</note><relatedItem type="host"><titleInfo><title>Annals of Neurology</title><subTitle>Official Journal of the American Neurological Association and the Child Neurology Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Ann Neurol.</title></titleInfo><genre type="Journal">journal</genre><note type="content"> Additional Supporting Information may be found in the online version of this article.Supporting Info Item: Supplementary Table 1. Summary of the Primary and Secondary Outcome Variables - Supplementary Table 2. GCRC Stimulation Setting Specific Adverse Events - Supplementary Table 3. Post‐Surgical Mood and Cognitive Adverse Events - Supplementary Table 4. General Post‐Surgical Adverse Events - </note><subject><genre>article category</genre><topic>Original Article</topic></subject><identifier type="ISSN">0364-5134</identifier><identifier type="eISSN">1531-8249</identifier><identifier type="DOI">10.1002/(ISSN)1531-8249</identifier><identifier type="PublisherID">ANA</identifier><part><date>2009</date><detail type="volume"><caption>vol.</caption><number>65</number></detail><detail type="issue"><caption>no.</caption><number>5</number></detail><extent unit="pages"><start>586</start><end>595</end><total>10</total></extent></part></relatedItem><identifier type="istex">2141B2BB9FCAC7CE59D2B44FB021AAA0FFC116FB</identifier><identifier type="DOI">10.1002/ana.21596</identifier><identifier type="ArticleID">ANA21596</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2009 American Neurological Association</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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