Long‐term follow‐up of thalamic stimulation versus thalamotomy for tremor suppression
Identifieur interne : 001E86 ( Main/Corpus ); précédent : 001E85; suivant : 001E87Long‐term follow‐up of thalamic stimulation versus thalamotomy for tremor suppression
Auteurs : P. Richard Schuurman ; D. Andries Bosch ; Maruschka P. Merkus ; Johannes D. SpeelmanSource :
- Movement Disorders [ 0885-3185 ] ; 2008-06-15.
English descriptors
Abstract
Thalamic stimulation and thalamotomy for treatment of tremor due to Parkinson's disease, essential tremor, and multiple sclerosis were compared in a randomized trial. The symptomatic and functional outcome was studied after 5 years of follow‐up. Sixty‐eight patients were treated (45 Parkinson's disease, 13 essential tremor, 10 multiple sclerosis) by thalamotomy (n = 34) or thalamic stimulation (n = 34). After 5 years, 48 patients were available for follow‐up. The primary outcome measure was change in functional status measured by the Frenchay Activities Index (FAI), scores ranging from 0 to 60. Secondary outcome measures were tremor severity, frequency of complications, and patients' assessment of the outcome. The mean difference in FAI scores between thalamic stimulation and thalamotomy was 4.4 (95% CI: 1.1–7.7) after 6 months, 3.3 (95% CI: −0.03–6.6) after 2 years and 4.0 (95% CI: 0.3–7.7) after 5 years in favor of stimulation. Tremor suppression was equally effective after both procedures, and stable in Parkinson patients. In ET and multiple sclerosis, a diminished effect of stimulation was observed in half of the patients. There were six stimulation equipment‐related complications, but neurological side effects of surgery were higher after thalamotomy. Subjective outcome‐assessment by the patients was more favorable in the stimulation group. © 2008 Movement Disorder Society.
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DOI: 10.1002/mds.22059
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ISTEX:BEBAD44BDCC45A1BCD703EB8DE8673BA8742C25BLe document en format XML
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The symptomatic and functional outcome was studied after 5 years of follow‐up. Sixty‐eight patients were treated (45 Parkinson's disease, 13 essential tremor, 10 multiple sclerosis) by thalamotomy (n = 34) or thalamic stimulation (n = 34). After 5 years, 48 patients were available for follow‐up. The primary outcome measure was change in functional status measured by the Frenchay Activities Index (FAI), scores ranging from 0 to 60. Secondary outcome measures were tremor severity, frequency of complications, and patients' assessment of the outcome. The mean difference in FAI scores between thalamic stimulation and thalamotomy was 4.4 (95% CI: 1.1–7.7) after 6 months, 3.3 (95% CI: −0.03–6.6) after 2 years and 4.0 (95% CI: 0.3–7.7) after 5 years in favor of stimulation. Tremor suppression was equally effective after both procedures, and stable in Parkinson patients. In ET and multiple sclerosis, a diminished effect of stimulation was observed in half of the patients. 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The symptomatic and functional outcome was studied after 5 years of follow‐up. Sixty‐eight patients were treated (45 Parkinson's disease, 13 essential tremor, 10 multiple sclerosis) by thalamotomy (n = 34) or thalamic stimulation (n = 34). After 5 years, 48 patients were available for follow‐up. The primary outcome measure was change in functional status measured by the Frenchay Activities Index (FAI), scores ranging from 0 to 60. Secondary outcome measures were tremor severity, frequency of complications, and patients' assessment of the outcome. The mean difference in FAI scores between thalamic stimulation and thalamotomy was 4.4 (95% CI: 1.1–7.7) after 6 months, 3.3 (95% CI: −0.03–6.6) after 2 years and 4.0 (95% CI: 0.3–7.7) after 5 years in favor of stimulation. Tremor suppression was equally effective after both procedures, and stable in Parkinson patients. In ET and multiple sclerosis, a diminished effect of stimulation was observed in half of the patients. There were six stimulation equipment‐related complications, but neurological side effects of surgery were higher after thalamotomy. Subjective outcome‐assessment by the patients was more favorable in the stimulation group. © 2008 Movement Disorder Society.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Long‐term follow‐up of thalamic stimulation versus thalamotomy for tremor suppression</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Thalamic Stimulation and Thalamotomy: 5 Years</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Long‐term follow‐up of thalamic stimulation versus thalamotomy for tremor suppression</title></titleInfo><name type="personal"><namePart type="given">P. Richard</namePart><namePart type="family">Schuurman</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurosurgery, Academic Medical Center, Amsterdam, The Netherlands</affiliation><description>Correspondence: Department of Neurosurgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">D. Andries</namePart><namePart type="family">Bosch</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurosurgery, Academic Medical Center, Amsterdam, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Maruschka P.</namePart><namePart type="family">Merkus</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Clinical Epidemiology and Biostatistics, Academic Medical Center, Amsterdam, The Netherlands</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Johannes D.</namePart><namePart type="family">Speelman</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands</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">2008-06-15</dateIssued><dateCaptured encoding="w3cdtf">2006-07-27</dateCaptured><dateValid encoding="w3cdtf">2008-03-01</dateValid><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="tables">4</extent><extent unit="references">19</extent><extent unit="words">5267</extent></physicalDescription><abstract lang="fr">Thalamic stimulation and thalamotomy for treatment of tremor due to Parkinson's disease, essential tremor, and multiple sclerosis were compared in a randomized trial. The symptomatic and functional outcome was studied after 5 years of follow‐up. Sixty‐eight patients were treated (45 Parkinson's disease, 13 essential tremor, 10 multiple sclerosis) by thalamotomy (n = 34) or thalamic stimulation (n = 34). After 5 years, 48 patients were available for follow‐up. The primary outcome measure was change in functional status measured by the Frenchay Activities Index (FAI), scores ranging from 0 to 60. Secondary outcome measures were tremor severity, frequency of complications, and patients' assessment of the outcome. The mean difference in FAI scores between thalamic stimulation and thalamotomy was 4.4 (95% CI: 1.1–7.7) after 6 months, 3.3 (95% CI: −0.03–6.6) after 2 years and 4.0 (95% CI: 0.3–7.7) after 5 years in favor of stimulation. Tremor suppression was equally effective after both procedures, and stable in Parkinson patients. In ET and multiple sclerosis, a diminished effect of stimulation was observed in half of the patients. There were six stimulation equipment‐related complications, but neurological side effects of surgery were higher after thalamotomy. Subjective outcome‐assessment by the patients was more favorable in the stimulation group. © 2008 Movement Disorder Society.</abstract><subject lang="en"><genre>Keywords</genre><topic>thalamic stimulation</topic><topic>thalamotomy</topic><topic>tremor</topic><topic>Parkinson</topic><topic>essential tremor</topic><topic>multiple sclerosis</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title><subTitle>Official Journal of the Movement Disorder Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Mov. 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>2008</date><detail type="volume"><caption>vol.</caption><number>23</number></detail><detail type="issue"><caption>no.</caption><number>8</number></detail><extent unit="pages"><start>1146</start><end>1153</end><total>8</total></extent></part></relatedItem><identifier type="istex">BEBAD44BDCC45A1BCD703EB8DE8673BA8742C25B</identifier><identifier type="DOI">10.1002/mds.22059</identifier><identifier type="ArticleID">MDS22059</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2008 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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