Beyond nine years of continuous subthalamic nucleus deep brain stimulation in Parkinson's disease
Identifieur interne : 001822 ( Main/Corpus ); précédent : 001821; suivant : 001823Beyond nine years of continuous subthalamic nucleus deep brain stimulation in Parkinson's disease
Auteurs : Maurizio Zibetti ; Aristide Merola ; Laura Rizzi ; Valeria Ricchi ; Serena Angrisano ; Corrado Azzaro ; Carlo Alberto Artusi ; Nichy Arduino ; Alice Marchisio ; Michele Lanotte ; Mario Rizzone ; Leonardo LopianoSource :
- Movement Disorders [ 0885-3185 ] ; 2011-11.
English descriptors
Abstract
Deep brain stimulation of the subthalamic nucleus is an effective treatment for advanced Parkinson's disease. The benefits of bilateral subthalamic stimulation are well documented, and some studies reported outcomes with a follow‐up of 5 to 6 years; nevertheless, few data are available beyond 5 years. We report a long‐term prospective evaluation of 14 consecutive parkinsonian patients, treated by bilateral subthalamic stimulation for at least 9 years. Motor symptoms, activity of daily living, and motor complications were evaluated by means of the Unified Parkinson's Disease Rating Scale, while cognition and mood were assessed with a specific neuropsychological test battery; medication intake, stimulation parameters, comorbidity, and adverse events were also recorded. Patients were evaluated before surgery and at 1, 5, and ≥9 years after surgery. At last follow‐up, deep brain stimulation significantly improved the motor score by 42% compared to baseline, whereas activities of daily living were no longer improved; there was a 39% reduction in the dosage of dopaminergic drugs and a 59% improvement of L‐dopa–related motor complications. The neuropsychological assessment showed that 4 patients (29%) developed a significant cognitive decline over the follow‐up period. These results indicate a persistent effect of deep brain stimulation of the subthalamic nucleus on the cardinal motor symptoms in advanced Parkinson's disease patients in the long‐term; however, a worsening of patients' disability, mainly due to disease progression, was observed. © 2011 Movement Disorder Society
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DOI: 10.1002/mds.23903
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The benefits of bilateral subthalamic stimulation are well documented, and some studies reported outcomes with a follow‐up of 5 to 6 years; nevertheless, few data are available beyond 5 years. We report a long‐term prospective evaluation of 14 consecutive parkinsonian patients, treated by bilateral subthalamic stimulation for at least 9 years. Motor symptoms, activity of daily living, and motor complications were evaluated by means of the Unified Parkinson's Disease Rating Scale, while cognition and mood were assessed with a specific neuropsychological test battery; medication intake, stimulation parameters, comorbidity, and adverse events were also recorded. Patients were evaluated before surgery and at 1, 5, and ≥9 years after surgery. At last follow‐up, deep brain stimulation significantly improved the motor score by 42% compared to baseline, whereas activities of daily living were no longer improved; there was a 39% reduction in the dosage of dopaminergic drugs and a 59% improvement of L‐dopa–related motor complications. The neuropsychological assessment showed that 4 patients (29%) developed a significant cognitive decline over the follow‐up period. These results indicate a persistent effect of deep brain stimulation of the subthalamic nucleus on the cardinal motor symptoms in advanced Parkinson's disease patients in the long‐term; however, a worsening of patients' disability, mainly due to disease progression, was observed. © 2011 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><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>Aristide Merola 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>Valeria Ricchi MD</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>Corrado Azzaro MD</name><affiliations><json:string>Department of Neuroscience, University of Torino, Torino, Italy</json:string></affiliations></json:item><json:item><name>Carlo Alberto Artusi</name><affiliations><json:string>Department of Neuroscience, University of Torino, Torino, Italy</json:string></affiliations></json:item><json:item><name>Nichy Arduino</name><affiliations><json:string>Department of Neuroscience, University of Torino, Torino, Italy</json:string></affiliations></json:item><json:item><name>Alice Marchisio</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>Mario Rizzone 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>deep brain stimulation</value></json:item><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>long‐term follow‐up</value></json:item></subject><articleId><json:string>MDS23903</json:string></articleId><language><json:string>eng</json:string></language><abstract>Deep brain stimulation of the subthalamic nucleus is an effective treatment for advanced Parkinson's disease. The benefits of bilateral subthalamic stimulation are well documented, and some studies reported outcomes with a follow‐up of 5 to 6 years; nevertheless, few data are available beyond 5 years. We report a long‐term prospective evaluation of 14 consecutive parkinsonian patients, treated by bilateral subthalamic stimulation for at least 9 years. Motor symptoms, activity of daily living, and motor complications were evaluated by means of the Unified Parkinson's Disease Rating Scale, while cognition and mood were assessed with a specific neuropsychological test battery; medication intake, stimulation parameters, comorbidity, and adverse events were also recorded. Patients were evaluated before surgery and at 1, 5, and ≥9 years after surgery. At last follow‐up, deep brain stimulation significantly improved the motor score by 42% compared to baseline, whereas activities of daily living were no longer improved; there was a 39% reduction in the dosage of dopaminergic drugs and a 59% improvement of L‐dopa–related motor complications. The neuropsychological assessment showed that 4 patients (29%) developed a significant cognitive decline over the follow‐up period. 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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: None to declare.</note><note type="content">*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">Beyond nine years of continuous subthalamic nucleus deep brain stimulation in Parkinson's disease</title><author><persName><forename type="first">Maurizio</forename><surname>Zibetti</surname></persName><roleName type="degree">MD, PhD</roleName><note type="correspondence"><p>Correspondence: 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">Aristide</forename><surname>Merola</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">Valeria</forename><surname>Ricchi</surname></persName><roleName type="degree">MD</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, 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The benefits of bilateral subthalamic stimulation are well documented, and some studies reported outcomes with a follow‐up of 5 to 6 years; nevertheless, few data are available beyond 5 years. We report a long‐term prospective evaluation of 14 consecutive parkinsonian patients, treated by bilateral subthalamic stimulation for at least 9 years. Motor symptoms, activity of daily living, and motor complications were evaluated by means of the Unified Parkinson's Disease Rating Scale, while cognition and mood were assessed with a specific neuropsychological test battery; medication intake, stimulation parameters, comorbidity, and adverse events were also recorded. Patients were evaluated before surgery and at 1, 5, and ≥9 years after surgery. At last follow‐up, deep brain stimulation significantly improved the motor score by 42% compared to baseline, whereas activities of daily living were no longer improved; there was a 39% reduction in the dosage of dopaminergic drugs and a 59% improvement of L‐dopa–related motor complications. The neuropsychological assessment showed that 4 patients (29%) developed a significant cognitive decline over the follow‐up period. These results indicate a persistent effect of deep brain stimulation of the subthalamic nucleus on the cardinal motor symptoms in advanced Parkinson's disease patients in the long‐term; however, a worsening of patients' disability, mainly due to disease progression, was observed. © 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>deep brain stimulation</term></item><item><term>subthalamic nucleus</term></item><item><term>long‐term follow‐up</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="2011-04-12">Received</change><change when="2011-07-15">Registration</change><change when="2011-11">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/86BC223EC673155C439086073CC3FAB44D244F98/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. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="130"><doi origin="wiley" registered="yes">10.1002/mds.v26.13</doi><numberingGroup><numbering type="journalVolume" number="26">26</numbering><numbering type="journalIssue">13</numbering></numberingGroup><coverDate startDate="2011-11">November 2011</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="60" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.23903</doi><idGroup><id type="unit" value="MDS23903"></id></idGroup><countGroup><count type="pageTotal" number="8"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2011 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2011-04-12"></event><event type="manuscriptRevised" date="2011-07-01"></event><event 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type="figureTotal" number="1"></count><count type="tableTotal" number="4"></count><count type="referenceTotal" number="43"></count><count type="wordTotal" number="6815"></count></countGroup><titleGroup><title type="main" xml:lang="en">Beyond nine years of continuous subthalamic nucleus deep brain stimulation in Parkinson's disease<link href="#fn1"></link><link href="#fn2"></link></title><title type="short" xml:lang="en">9 Years of STN‐DBS in PD</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Maurizio</givenNames><familyName>Zibetti</familyName><degrees>MD, PhD</degrees></personName><contactDetails><email>maurizio.zibetti@gmail.com</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Aristide</givenNames><familyName>Merola</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Laura</givenNames><familyName>Rizzi</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Valeria</givenNames><familyName>Ricchi</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Serena</givenNames><familyName>Angrisano</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Corrado</givenNames><familyName>Azzaro</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Carlo Alberto</givenNames><familyName>Artusi</familyName></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Nichy</givenNames><familyName>Arduino</familyName></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Alice</givenNames><familyName>Marchisio</familyName></personName></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Michele</givenNames><familyName>Lanotte</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au11" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Mario</givenNames><familyName>Rizzone</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au12" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Leonardo</givenNames><familyName>Lopiano</familyName><degrees>MD, PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="IT" type="organization"><unparsedAffiliation>Department of Neuroscience, University of Torino, Torino, Italy</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword><keyword xml:id="kwd2">deep brain stimulation</keyword><keyword xml:id="kwd3">subthalamic nucleus</keyword><keyword xml:id="kwd4">long‐term follow‐up</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Deep brain stimulation of the subthalamic nucleus is an effective treatment for advanced Parkinson's disease. The benefits of bilateral subthalamic stimulation are well documented, and some studies reported outcomes with a follow‐up of 5 to 6 years; nevertheless, few data are available beyond 5 years. We report a long‐term prospective evaluation of 14 consecutive parkinsonian patients, treated by bilateral subthalamic stimulation for at least 9 years. Motor symptoms, activity of daily living, and motor complications were evaluated by means of the Unified Parkinson's Disease Rating Scale, while cognition and mood were assessed with a specific neuropsychological test battery; medication intake, stimulation parameters, comorbidity, and adverse events were also recorded. Patients were evaluated before surgery and at 1, 5, and ≥9 years after surgery. At last follow‐up, deep brain stimulation significantly improved the motor score by 42% compared to baseline, whereas activities of daily living were no longer improved; there was a 39% reduction in the dosage of dopaminergic drugs and a 59% improvement of <sc>L</sc>‐dopa–related motor complications. The neuropsychological assessment showed that 4 patients (29%) developed a significant cognitive decline over the follow‐up period. These results indicate a persistent effect of deep brain stimulation of the subthalamic nucleus on the cardinal motor symptoms in advanced Parkinson's disease patients in the long‐term; however, a worsening of patients' disability, mainly due to disease progression, was observed. © 2011 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p><b>Relevant conflicts of interest/financial disclosures:</b> None to declare.</p></note><note xml:id="fn2"><p>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>Beyond nine years of continuous subthalamic nucleus deep brain stimulation in Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>9 Years of STN‐DBS in PD</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Beyond nine years of continuous subthalamic nucleus deep brain stimulation in Parkinson's disease</title></titleInfo><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><description>Correspondence: 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">Aristide</namePart><namePart type="family">Merola</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">Valeria</namePart><namePart type="family">Ricchi</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">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">Corrado</namePart><namePart type="family">Azzaro</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">Carlo Alberto</namePart><namePart type="family">Artusi</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">Nichy</namePart><namePart type="family">Arduino</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">Alice</namePart><namePart type="family">Marchisio</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">Mario</namePart><namePart type="family">Rizzone</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">2011-11</dateIssued><dateCaptured encoding="w3cdtf">2011-04-12</dateCaptured><dateValid encoding="w3cdtf">2011-07-15</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">1</extent><extent unit="tables">4</extent><extent unit="references">43</extent><extent unit="words">6815</extent></physicalDescription><abstract lang="en">Deep brain stimulation of the subthalamic nucleus is an effective treatment for advanced Parkinson's disease. The benefits of bilateral subthalamic stimulation are well documented, and some studies reported outcomes with a follow‐up of 5 to 6 years; nevertheless, few data are available beyond 5 years. We report a long‐term prospective evaluation of 14 consecutive parkinsonian patients, treated by bilateral subthalamic stimulation for at least 9 years. Motor symptoms, activity of daily living, and motor complications were evaluated by means of the Unified Parkinson's Disease Rating Scale, while cognition and mood were assessed with a specific neuropsychological test battery; medication intake, stimulation parameters, comorbidity, and adverse events were also recorded. Patients were evaluated before surgery and at 1, 5, and ≥9 years after surgery. At last follow‐up, deep brain stimulation significantly improved the motor score by 42% compared to baseline, whereas activities of daily living were no longer improved; there was a 39% reduction in the dosage of dopaminergic drugs and a 59% improvement of L‐dopa–related motor complications. The neuropsychological assessment showed that 4 patients (29%) developed a significant cognitive decline over the follow‐up period. These results indicate a persistent effect of deep brain stimulation of the subthalamic nucleus on the cardinal motor symptoms in advanced Parkinson's disease patients in the long‐term; however, a worsening of patients' disability, mainly due to disease progression, was observed. © 2011 Movement Disorder Society</abstract><note type="content">*Relevant conflicts of interest/financial disclosures: None to declare.</note><note type="content">*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>deep brain stimulation</topic><topic>subthalamic nucleus</topic><topic>long‐term follow‐up</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>13</number></detail><extent unit="pages"><start>2327</start><end>2334</end><total>8</total></extent></part></relatedItem><identifier type="istex">86BC223EC673155C439086073CC3FAB44D244F98</identifier><identifier type="DOI">10.1002/mds.23903</identifier><identifier type="ArticleID">MDS23903</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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