Side‐effects of subthalamic stimulation in Parkinson's disease: clinical evolution and predictive factors
Identifieur interne : 002601 ( Main/Corpus ); précédent : 002600; suivant : 002602Side‐effects of subthalamic stimulation in Parkinson's disease: clinical evolution and predictive factors
Auteurs : D. Guehl ; E. Cuny ; A. Benazzouz ; A. Rougier ; F. Tison ; S. Machado ; D. Grabot ; C. Gross ; B. Bioulac ; P. BurbaudSource :
- European Journal of Neurology [ 1351-5101 ] ; 2006-09.
English descriptors
Abstract
Chronic bilateral high‐frequency stimulation of the subthalamic nucleus (STN) is an alternative treatment for disabling forms of Parkinson's disease when on–off fluctuations and levodopa‐induced dyskinesias compromise patients’ quality of life. The aim of this study was to assess the evolution of side‐effects during the first year of follow‐up and search for clinical predictive factors accounting for their occurrence. We compared the frequency of side‐effects at 3 and 12 months after surgery in a cohort of 44 patients. The off‐medication scores of Unified Parkinson's Disease Rating Scale (UPDRS) II, III, axial symptoms, disease duration and age at surgery were retained for correlation analysis. Dysarthria/hypophonia, weight gain and postural instability were the most frequent chronic side‐effects. Whereas dysarthria/hypophonia remained stable over time, weight gain and postural instability increased during the first year post‐op. High axial and UPDRS II scores at surgery were predictive of dysarthria/hypophonia. Age and axial score at surgery were positively correlated with postural instability. Despite the occurrence of side‐effects, the benefit/side‐effects ratio of STN stimulation was largely positive during the first year of follow‐up. Age, intensity of axial symptoms and UDPRS II off‐medication score before surgery are predictive factors of dysarthria/hypophonia and postural instability after surgery.
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DOI: 10.1111/j.1468-1331.2006.01405.x
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The aim of this study was to assess the evolution of side‐effects during the first year of follow‐up and search for clinical predictive factors accounting for their occurrence. We compared the frequency of side‐effects at 3 and 12 months after surgery in a cohort of 44 patients. The off‐medication scores of Unified Parkinson's Disease Rating Scale (UPDRS) II, III, axial symptoms, disease duration and age at surgery were retained for correlation analysis. Dysarthria/hypophonia, weight gain and postural instability were the most frequent chronic side‐effects. Whereas dysarthria/hypophonia remained stable over time, weight gain and postural instability increased during the first year post‐op. High axial and UPDRS II scores at surgery were predictive of dysarthria/hypophonia. Age and axial score at surgery were positively correlated with postural instability. Despite the occurrence of side‐effects, the benefit/side‐effects ratio of STN stimulation was largely positive during the first year of follow‐up. Age, intensity of axial symptoms and UDPRS II off‐medication score before surgery are predictive factors of dysarthria/hypophonia and postural instability after surgery.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>D. Guehl</name><affiliations><json:string>Service de Neurophysiologie Clinique, Hôpital Pellegrin, Place Amélie‐Rabat Léon, Bordeaux, France</json:string></affiliations></json:item><json:item><name>E. Cuny</name><affiliations><json:string>Service de Neurochirurgie, Hôpital Pellegrin, Place Amélie‐Rabat Léon, Bordeaux, France</json:string></affiliations></json:item><json:item><name>A. Benazzouz</name><affiliations><json:string>Service de Neurophysiologie Clinique, Hôpital Pellegrin, Place Amélie‐Rabat Léon, Bordeaux, France</json:string></affiliations></json:item><json:item><name>A. 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The aim of this study was to assess the evolution of side‐effects during the first year of follow‐up and search for clinical predictive factors accounting for their occurrence. We compared the frequency of side‐effects at 3 and 12 months after surgery in a cohort of 44 patients. The off‐medication scores of Unified Parkinson's Disease Rating Scale (UPDRS) II, III, axial symptoms, disease duration and age at surgery were retained for correlation analysis. Dysarthria/hypophonia, weight gain and postural instability were the most frequent chronic side‐effects. Whereas dysarthria/hypophonia remained stable over time, weight gain and postural instability increased during the first year post‐op. High axial and UPDRS II scores at surgery were predictive of dysarthria/hypophonia. Age and axial score at surgery were positively correlated with postural instability. Despite the occurrence of side‐effects, the benefit/side‐effects ratio of STN stimulation was largely positive during the first year of follow‐up. 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The aim of this study was to assess the evolution of side‐effects during the first year of follow‐up and search for clinical predictive factors accounting for their occurrence. We compared the frequency of side‐effects at 3 and 12 months after surgery in a cohort of 44 patients. The off‐medication scores of Unified Parkinson's Disease Rating Scale (UPDRS) II, III, axial symptoms, disease duration and age at surgery were retained for correlation analysis. Dysarthria/hypophonia, weight gain and postural instability were the most frequent chronic side‐effects. Whereas dysarthria/hypophonia remained stable over time, weight gain and postural instability increased during the first year post‐op. High axial and UPDRS II scores at surgery were predictive of dysarthria/hypophonia. Age and axial score at surgery were positively correlated with postural instability. Despite the occurrence of side‐effects, the benefit/side‐effects ratio of STN stimulation was largely positive during the first year of follow‐up. Age, intensity of axial symptoms and UDPRS II off‐medication score before surgery are predictive factors of dysarthria/hypophonia and postural instability after surgery.</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>deep brain stimulation</term></item><item><term>Parkinson's disease</term></item><item><term>side‐effects</term></item><item><term>subthalamic nucleus</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2006-09">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/73C381B921DCD78DFE3B78E78B650E19CA51C3C7/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>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1468-1331</doi><issn type="print">1351-5101</issn><issn type="electronic">1468-1331</issn><idGroup><id type="product" value="ENE"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="EUROPEAN JOURNAL OF NEUROLOGY">European Journal of Neurology</title></titleGroup></publicationMeta><publicationMeta level="part" position="09009"><doi origin="wiley">10.1111/ene.2006.13.issue-9</doi><numberingGroup><numbering type="journalVolume" number="13">13</numbering><numbering type="journalIssue" number="9">9</numbering></numberingGroup><coverDate startDate="2006-09">September 2006</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="9" status="forIssue"><doi origin="wiley">10.1111/j.1468-1331.2006.01405.x</doi><idGroup><id type="unit" value="ENE1405"></id></idGroup><countGroup><count type="pageTotal" number="9"></count></countGroup><titleGroup><title type="tocHeading1">Original Articles</title></titleGroup><eventGroup><event type="firstOnline" date="2006-05-26"></event><event type="publishedOnlineFinalForm" date="2006-08-23"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.5 mode:FullText source:FullText result:FullText" date="2010-04-07"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-24"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-16"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="963">963</numbering><numbering type="pageLast" number="971">971</numbering></numberingGroup><correspondenceTo>Dr Dominique Guehl, Service de Neurophysiologie Clinique, Hôpital Pellegrin, Place Amélie‐Rabat Léon, 33076 Bordeaux, France (tel.: 33‐557571551; fax: 33‐556901421; e‐mail: <email normalForm="dominique.guehl@umr5543.u-bordeaux2.fr">dominique.guehl@umr5543.u‐bordeaux2.fr</email>).</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:ENE.ENE1405.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Received 11 May 2005 Accepted 2 October 2005</unparsedEditorialHistory><countGroup><count type="figureTotal" number="3"></count><count type="tableTotal" number="4"></count></countGroup><titleGroup><title type="main">Side‐effects of subthalamic stimulation in Parkinson's disease: clinical evolution and predictive factors</title><title type="shortAuthors">D. Guehl <i>et al.</i></title><title type="short">Side‐effects of STN stimulation and their clinical predictors</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>D.</givenNames><familyName>Guehl</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a2"><personName><givenNames>E.</givenNames><familyName>Cuny</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1"><personName><givenNames>A.</givenNames><familyName>Benazzouz</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a2"><personName><givenNames>A.</givenNames><familyName>Rougier</familyName></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a3"><personName><givenNames>F.</givenNames><familyName>Tison</familyName></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a3"><personName><givenNames>S.</givenNames><familyName>Machado</familyName></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a4"><personName><givenNames>D.</givenNames><familyName>Grabot</familyName></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a1"><personName><givenNames>C.</givenNames><familyName>Gross</familyName></personName></creator><creator creatorRole="author" xml:id="cr9" affiliationRef="#a1"><personName><givenNames>B.</givenNames><familyName>Bioulac</familyName></personName></creator><creator creatorRole="author" xml:id="cr10" affiliationRef="#a1"><personName><givenNames>P.</givenNames><familyName>Burbaud</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="FR"><unparsedAffiliation>Service de Neurophysiologie Clinique, Hôpital Pellegrin, Place Amélie‐Rabat Léon, Bordeaux, France</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="FR"><unparsedAffiliation>Service de Neurochirurgie, Hôpital Pellegrin, Place Amélie‐Rabat Léon, Bordeaux, France</unparsedAffiliation></affiliation><affiliation xml:id="a3" countryCode="FR"><unparsedAffiliation>Service de Neurologie, Hôpital Pellegrin, Place Amélie‐Rabat Léon, Bordeaux, France</unparsedAffiliation></affiliation><affiliation xml:id="a4"><unparsedAffiliation>Service de Psychiatrie Adulte, Hôpital Charles Perrens, Rue de la Béchade, Bordeaux, France</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">deep brain stimulation</keyword><keyword xml:id="k2">Parkinson's disease</keyword><keyword xml:id="k3">side‐effects</keyword><keyword xml:id="k4">subthalamic nucleus</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p>Chronic bilateral high‐frequency stimulation of the subthalamic nucleus (STN) is an alternative treatment for disabling forms of Parkinson's disease when on–off fluctuations and levodopa‐induced dyskinesias compromise patients’ quality of life. The aim of this study was to assess the evolution of side‐effects during the first year of follow‐up and search for clinical predictive factors accounting for their occurrence. We compared the frequency of side‐effects at 3 and 12 months after surgery in a cohort of 44 patients. The off‐medication scores of Unified Parkinson's Disease Rating Scale (UPDRS) II, III, axial symptoms, disease duration and age at surgery were retained for correlation analysis. Dysarthria/hypophonia, weight gain and postural instability were the most frequent chronic side‐effects. Whereas dysarthria/hypophonia remained stable over time, weight gain and postural instability increased during the first year post‐op. High axial and UPDRS II scores at surgery were predictive of dysarthria/hypophonia. Age and axial score at surgery were positively correlated with postural instability. Despite the occurrence of side‐effects, the benefit/side‐effects ratio of STN stimulation was largely positive during the first year of follow‐up. Age, intensity of axial symptoms and UDPRS II off‐medication score before surgery are predictive factors of dysarthria/hypophonia and postural instability after surgery.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Side‐effects of subthalamic stimulation in Parkinson's disease: clinical evolution and predictive factors</title></titleInfo><titleInfo type="abbreviated"><title>Side‐effects of STN stimulation and their clinical predictors</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Side‐effects of subthalamic stimulation in Parkinson's disease: clinical evolution and predictive factors</title></titleInfo><name type="personal"><namePart type="given">D.</namePart><namePart type="family">Guehl</namePart><affiliation>Service de Neurophysiologie Clinique, Hôpital Pellegrin, Place Amélie‐Rabat Léon, Bordeaux, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">E.</namePart><namePart type="family">Cuny</namePart><affiliation>Service de Neurochirurgie, Hôpital Pellegrin, Place Amélie‐Rabat Léon, Bordeaux, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A.</namePart><namePart type="family">Benazzouz</namePart><affiliation>Service de Neurophysiologie Clinique, Hôpital Pellegrin, Place Amélie‐Rabat Léon, Bordeaux, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">A.</namePart><namePart type="family">Rougier</namePart><affiliation>Service de Neurochirurgie, Hôpital Pellegrin, Place Amélie‐Rabat Léon, Bordeaux, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">F.</namePart><namePart type="family">Tison</namePart><affiliation>Service de Neurologie, Hôpital Pellegrin, Place Amélie‐Rabat Léon, Bordeaux, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">S.</namePart><namePart type="family">Machado</namePart><affiliation>Service de Neurologie, Hôpital Pellegrin, Place Amélie‐Rabat Léon, Bordeaux, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">D.</namePart><namePart type="family">Grabot</namePart><affiliation>Service de Psychiatrie Adulte, Hôpital Charles Perrens, Rue de la Béchade, Bordeaux, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C.</namePart><namePart type="family">Gross</namePart><affiliation>Service de Neurophysiologie Clinique, Hôpital Pellegrin, Place Amélie‐Rabat Léon, Bordeaux, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">B.</namePart><namePart type="family">Bioulac</namePart><affiliation>Service de Neurophysiologie Clinique, Hôpital Pellegrin, Place Amélie‐Rabat Léon, Bordeaux, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">P.</namePart><namePart type="family">Burbaud</namePart><affiliation>Service de Neurophysiologie Clinique, Hôpital Pellegrin, Place Amélie‐Rabat Léon, Bordeaux, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2006-09</dateIssued><edition>Received 11 May 2005 Accepted 2 October 2005</edition><copyrightDate encoding="w3cdtf">2006</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">3</extent><extent unit="tables">4</extent></physicalDescription><abstract lang="en">Chronic bilateral high‐frequency stimulation of the subthalamic nucleus (STN) is an alternative treatment for disabling forms of Parkinson's disease when on–off fluctuations and levodopa‐induced dyskinesias compromise patients’ quality of life. The aim of this study was to assess the evolution of side‐effects during the first year of follow‐up and search for clinical predictive factors accounting for their occurrence. We compared the frequency of side‐effects at 3 and 12 months after surgery in a cohort of 44 patients. The off‐medication scores of Unified Parkinson's Disease Rating Scale (UPDRS) II, III, axial symptoms, disease duration and age at surgery were retained for correlation analysis. Dysarthria/hypophonia, weight gain and postural instability were the most frequent chronic side‐effects. Whereas dysarthria/hypophonia remained stable over time, weight gain and postural instability increased during the first year post‐op. High axial and UPDRS II scores at surgery were predictive of dysarthria/hypophonia. Age and axial score at surgery were positively correlated with postural instability. Despite the occurrence of side‐effects, the benefit/side‐effects ratio of STN stimulation was largely positive during the first year of follow‐up. Age, intensity of axial symptoms and UDPRS II off‐medication score before surgery are predictive factors of dysarthria/hypophonia and postural instability after surgery.</abstract><subject lang="en"><genre>Keywords</genre><topic>deep brain stimulation</topic><topic>Parkinson's disease</topic><topic>side‐effects</topic><topic>subthalamic nucleus</topic></subject><relatedItem type="host"><titleInfo><title>European Journal of Neurology</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">1351-5101</identifier><identifier type="eISSN">1468-1331</identifier><identifier type="DOI">10.1111/(ISSN)1468-1331</identifier><identifier type="PublisherID">ENE</identifier><part><date>2006</date><detail type="volume"><caption>vol.</caption><number>13</number></detail><detail type="issue"><caption>no.</caption><number>9</number></detail><extent unit="pages"><start>963</start><end>971</end><total>9</total></extent></part></relatedItem><identifier type="istex">73C381B921DCD78DFE3B78E78B650E19CA51C3C7</identifier><identifier type="DOI">10.1111/j.1468-1331.2006.01405.x</identifier><identifier type="ArticleID">ENE1405</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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