Pallidal stimulation in advanced Parkinson's patients with contraindications for subthalamic stimulation
Identifieur interne : 001B01 ( Main/Corpus ); précédent : 001B00; suivant : 001B02Pallidal stimulation in advanced Parkinson's patients with contraindications for subthalamic stimulation
Auteurs : Tiphaine Rouaud ; Thibaut Dondaine ; Sophie Drapier ; Claire Haegelen ; François Lallement ; Julie Péron ; Sylvie Raoul ; Paul Sauleau ; Marc VérinSource :
- Movement Disorders [ 0885-3185 ] ; 2010-09-15.
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Abstract
The aim of this study was to evaluate the efficacy and safety of bilateral pallidal (GPi) deep brain stimulation (DBS) 6 months after surgery in advanced parkinsonian patients whose dopa‐resistant axial motor signs or cognitive decline constituted contraindications for subthalamic nucleus (STN) DBS. Seventeen patients with a mean age of 59.3 ± 7.1 years (range, 45–70), mean disease duration of 12.5 ± 4.3 years (range, 7–20), and contraindications for STN DBS, underwent bilateral GPi DBS. They were evaluated before surgery and 6 months afterward, in accordance with Core Assessment Program for Intracerebral Transplantation recommendations. There were mean improvements of 41.1% in the UPDRS III motor score in the off‐dopa condition and 20.3% in the activities of daily living score. Motor fluctuations were reduced by 22.9% and dyskinesias by 68.6%. Axial motor signs improved in the off‐dopa condition by 34.2%. Neuropsychological performances remained unchanged at the 6‐month assessment. Bilateral GPi DBS is both safe and effective in advanced parkinsonian patients with untreatable motor fluctuations, for whom STN DBS is contraindicated due to dopa‐resistant axial motor signs or cognitive decline. As such, it should be regarded as a viable option for these patients. © 2010 Movement Disorder Society
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DOI: 10.1002/mds.23171
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Seventeen patients with a mean age of 59.3 ± 7.1 years (range, 45–70), mean disease duration of 12.5 ± 4.3 years (range, 7–20), and contraindications for STN DBS, underwent bilateral GPi DBS. They were evaluated before surgery and 6 months afterward, in accordance with Core Assessment Program for Intracerebral Transplantation recommendations. There were mean improvements of 41.1% in the UPDRS III motor score in the off‐dopa condition and 20.3% in the activities of daily living score. Motor fluctuations were reduced by 22.9% and dyskinesias by 68.6%. Axial motor signs improved in the off‐dopa condition by 34.2%. Neuropsychological performances remained unchanged at the 6‐month assessment. Bilateral GPi DBS is both safe and effective in advanced parkinsonian patients with untreatable motor fluctuations, for whom STN DBS is contraindicated due to dopa‐resistant axial motor signs or cognitive decline. As such, it should be regarded as a viable option for these patients. © 2010 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Tiphaine Rouaud MD</name><affiliations><json:string>Department of Neurology, University Hospital of Rennes, Rennes, France</json:string></affiliations></json:item><json:item><name>Thibaut Dondaine MSc</name><affiliations><json:string>Department of Neurology, University Hospital of Rennes, Rennes, France</json:string></affiliations></json:item><json:item><name>Sophie Drapier MD</name><affiliations><json:string>Department of Neurology, University Hospital of Rennes, Rennes, France</json:string></affiliations></json:item><json:item><name>Claire Haegelen MD</name><affiliations><json:string>Department of Neurosurgery, University Hospital of Rennes, Rennes, France</json:string></affiliations></json:item><json:item><name>François Lallement MD</name><affiliations><json:string>Department of Neurology, Hospital of Saint‐Brieuc, Saint‐Brieuc, France</json:string></affiliations></json:item><json:item><name>Julie Péron PhD</name><affiliations><json:string>Department of Neurology, University Hospital of Rennes, Rennes, France</json:string></affiliations></json:item><json:item><name>Sylvie Raoul MD, PhD</name><affiliations><json:string>Department of Neurosurgery, University Hospital of Nantes, Nantes, France</json:string></affiliations></json:item><json:item><name>Paul Sauleau MD, PhD</name><affiliations><json:string>Department of Neurophysiology, University Hospital of Rennes, Rennes, France</json:string></affiliations></json:item><json:item><name>Marc Vérin MD, PhD</name><affiliations><json:string>Department of Neurology, University Hospital of Rennes, Rennes, France</json:string></affiliations></json:item></author><subject><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>pallidal stimulation</value></json:item><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>neuropsychological outcome</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>axial motor symptoms</value></json:item></subject><articleId><json:string>MDS23171</json:string></articleId><language><json:string>eng</json:string></language><abstract>The aim of this study was to evaluate the efficacy and safety of bilateral pallidal (GPi) deep brain stimulation (DBS) 6 months after surgery in advanced parkinsonian patients whose dopa‐resistant axial motor signs or cognitive decline constituted contraindications for subthalamic nucleus (STN) DBS. Seventeen patients with a mean age of 59.3 ± 7.1 years (range, 45–70), mean disease duration of 12.5 ± 4.3 years (range, 7–20), and contraindications for STN DBS, underwent bilateral GPi DBS. They were evaluated before surgery and 6 months afterward, in accordance with Core Assessment Program for Intracerebral Transplantation recommendations. There were mean improvements of 41.1% in the UPDRS III motor score in the off‐dopa condition and 20.3% in the activities of daily living score. Motor fluctuations were reduced by 22.9% and dyskinesias by 68.6%. Axial motor signs improved in the off‐dopa condition by 34.2%. Neuropsychological performances remained unchanged at the 6‐month assessment. Bilateral GPi DBS is both safe and effective in advanced parkinsonian patients with untreatable motor fluctuations, for whom STN DBS is contraindicated due to dopa‐resistant axial motor signs or cognitive decline. 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Seventeen patients with a mean age of 59.3 ± 7.1 years (range, 45–70), mean disease duration of 12.5 ± 4.3 years (range, 7–20), and contraindications for STN DBS, underwent bilateral GPi DBS. They were evaluated before surgery and 6 months afterward, in accordance with Core Assessment Program for Intracerebral Transplantation recommendations. There were mean improvements of 41.1% in the UPDRS III motor score in the off‐dopa condition and 20.3% in the activities of daily living score. Motor fluctuations were reduced by 22.9% and dyskinesias by 68.6%. Axial motor signs improved in the off‐dopa condition by 34.2%. Neuropsychological performances remained unchanged at the 6‐month assessment. Bilateral GPi DBS is both safe and effective in advanced parkinsonian patients with untreatable motor fluctuations, for whom STN DBS is contraindicated due to dopa‐resistant axial motor signs or cognitive decline. 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xml:id="au3" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Sophie</givenNames><familyName>Drapier</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Claire</givenNames><familyName>Haegelen</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af3"><personName><givenNames>François</givenNames><familyName>Lallement</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Julie</givenNames><familyName>Péron</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Sylvie</givenNames><familyName>Raoul</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af5"><personName><givenNames>Paul</givenNames><familyName>Sauleau</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Marc</givenNames><familyName>Vérin</familyName><degrees>MD, PhD</degrees></personName><contactDetails><email normalForm="marc.verin@chu-rennes.fr">marc.verin@chu‐rennes.fr</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="FR" type="organization"><unparsedAffiliation>Department of Neurology, University Hospital of Rennes, Rennes, France</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="FR" type="organization"><unparsedAffiliation>Department of Neurosurgery, University Hospital of Rennes, Rennes, France</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="FR" type="organization"><unparsedAffiliation>Department of Neurology, Hospital of Saint‐Brieuc, Saint‐Brieuc, France</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="FR" type="organization"><unparsedAffiliation>Department of Neurosurgery, University Hospital of Nantes, Nantes, France</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="FR" type="organization"><unparsedAffiliation>Department of Neurophysiology, University Hospital of Rennes, Rennes, France</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">deep brain stimulation</keyword><keyword xml:id="kwd2">pallidal stimulation</keyword><keyword xml:id="kwd3">Parkinson's disease</keyword><keyword xml:id="kwd4">neuropsychological outcome</keyword><keyword xml:id="kwd5">axial motor symptoms</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>The aim of this study was to evaluate the efficacy and safety of bilateral pallidal (GPi) deep brain stimulation (DBS) 6 months after surgery in advanced parkinsonian patients whose dopa‐resistant axial motor signs or cognitive decline constituted contraindications for subthalamic nucleus (STN) DBS. Seventeen patients with a mean age of 59.3 ± 7.1 years (range, 45–70), mean disease duration of 12.5 ± 4.3 years (range, 7–20), and contraindications for STN DBS, underwent bilateral GPi DBS. They were evaluated before surgery and 6 months afterward, in accordance with Core Assessment Program for Intracerebral Transplantation recommendations. There were mean improvements of 41.1% in the UPDRS III motor score in the off‐dopa condition and 20.3% in the activities of daily living score. Motor fluctuations were reduced by 22.9% and dyskinesias by 68.6%. Axial motor signs improved in the off‐dopa condition by 34.2%. Neuropsychological performances remained unchanged at the 6‐month assessment. Bilateral GPi DBS is both safe and effective in advanced parkinsonian patients with untreatable motor fluctuations, for whom STN DBS is contraindicated due to dopa‐resistant axial motor signs or cognitive decline. As such, it should be regarded as a viable option for these patients. © 2010 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn2"><p>Potential conflict of interest: Nothing to report.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Pallidal stimulation in advanced Parkinson's patients with contraindications for subthalamic stimulation</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Pallidal Stimulation in Advanced Parkinson's Patients</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Pallidal stimulation in advanced Parkinson's patients with contraindications for subthalamic stimulation</title></titleInfo><name type="personal"><namePart type="given">Tiphaine</namePart><namePart type="family">Rouaud</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University Hospital of Rennes, Rennes, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Thibaut</namePart><namePart type="family">Dondaine</namePart><namePart type="termsOfAddress">MSc</namePart><affiliation>Department of Neurology, University Hospital of Rennes, Rennes, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sophie</namePart><namePart type="family">Drapier</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University Hospital of Rennes, Rennes, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Claire</namePart><namePart type="family">Haegelen</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurosurgery, University Hospital of Rennes, Rennes, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">François</namePart><namePart type="family">Lallement</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Hospital of Saint‐Brieuc, Saint‐Brieuc, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Julie</namePart><namePart type="family">Péron</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Neurology, University Hospital of Rennes, Rennes, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sylvie</namePart><namePart type="family">Raoul</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurosurgery, University Hospital of Nantes, Nantes, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Paul</namePart><namePart type="family">Sauleau</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurophysiology, University Hospital of Rennes, Rennes, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Marc</namePart><namePart type="family">Vérin</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, University Hospital of Rennes, Rennes, France</affiliation><description>Correspondence: Service de Neurologie, Centre Hospitalier Universitaire de Rennes, 35033 Rennes, France</description><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">2010-09-15</dateIssued><dateCaptured encoding="w3cdtf">2009-10-20</dateCaptured><dateValid encoding="w3cdtf">2010-03-18</dateValid><copyrightDate encoding="w3cdtf">2010</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">7</extent><extent unit="references">41</extent><extent unit="words">9827</extent></physicalDescription><abstract lang="en">The aim of this study was to evaluate the efficacy and safety of bilateral pallidal (GPi) deep brain stimulation (DBS) 6 months after surgery in advanced parkinsonian patients whose dopa‐resistant axial motor signs or cognitive decline constituted contraindications for subthalamic nucleus (STN) DBS. Seventeen patients with a mean age of 59.3 ± 7.1 years (range, 45–70), mean disease duration of 12.5 ± 4.3 years (range, 7–20), and contraindications for STN DBS, underwent bilateral GPi DBS. They were evaluated before surgery and 6 months afterward, in accordance with Core Assessment Program for Intracerebral Transplantation recommendations. There were mean improvements of 41.1% in the UPDRS III motor score in the off‐dopa condition and 20.3% in the activities of daily living score. Motor fluctuations were reduced by 22.9% and dyskinesias by 68.6%. Axial motor signs improved in the off‐dopa condition by 34.2%. Neuropsychological performances remained unchanged at the 6‐month assessment. Bilateral GPi DBS is both safe and effective in advanced parkinsonian patients with untreatable motor fluctuations, for whom STN DBS is contraindicated due to dopa‐resistant axial motor signs or cognitive decline. As such, it should be regarded as a viable option for these patients. © 2010 Movement Disorder Society</abstract><note type="content">*Potential conflict of interest: Nothing to report.</note><subject lang="en"><genre>Keywords</genre><topic>deep brain stimulation</topic><topic>pallidal stimulation</topic><topic>Parkinson's disease</topic><topic>neuropsychological outcome</topic><topic>axial motor symptoms</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>2010</date><detail type="volume"><caption>vol.</caption><number>25</number></detail><detail type="issue"><caption>no.</caption><number>12</number></detail><extent unit="pages"><start>1839</start><end>1846</end><total>8</total></extent></part></relatedItem><identifier type="istex">FE2CEE72D1A106C8CBBB7DAA6BE20BCD0BDEFEAA</identifier><identifier type="DOI">10.1002/mds.23171</identifier><identifier type="ArticleID">MDS23171</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2010 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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