Deep Brain Stimulation for Early‐Stage Parkinson's Disease: An Illustrative Case
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Auteurs : Chandler E. Gill ; Laura A. Allen [États-Unis] ; Peter E. Konrad [États-Unis] ; Thomas L. Davis [États-Unis] ; Mark J. Bliton [États-Unis] ; Stuart G. Finder ; Michael G. Tramontana [États-Unis] ; C. Chris Kao [États-Unis] ; Michael S. Remple [États-Unis] ; Courtney H. Bradenham [États-Unis] ; P. David Charles [États-Unis]Source :
- Neuromodulation: Technology at the Neural Interface [ 1094-7159 ] ; 2011-11.
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Abstract
Objectives: Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective intervention in advanced Parkinson's disease (PD), but its efficacy and safety in early PD are unknown. We are conducting a randomized pilot trial investigating DBS in early PD. This report describes one participant who received bilateral STN‐DBS. Materials and Methods: Thirty subjects have been randomized to either optimal drug therapy (ODT) or DBS + ODT. Microelectrode recordings from the STN and substantia nigra are collected at implantation. The Unified Parkinson's Disease Rating Scale Motor Subscale (UPDRS‐III) is administered in the ON and OFF states semi‐annually and neuropsychological function and quality of life are assessed annually. We describe a 54‐year‐old man with a two‐year history of PD who was randomized to DBS + ODT and followed for two years. Results: The subject showed a lower STN to substantia nigra ratio of neuronal activity than advanced PD patients, and higher firing rate than non‐PD patients. The subject's total UPDRS and UPDRS‐III scores improved during the two‐year follow‐up, while his OFF UPDRS‐III score and levodopa equivalent daily dose increased. Quality of life, verbal fluency, and verbal learning improved. He did not experience any serious adverse events. Conclusions: This report details the first successful application of bilateral STN‐DBS for early‐stage PD during a clinical trial.
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DOI: 10.1111/j.1525-1403.2011.00391.x
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Chandler E. Gill<affiliation><mods:affiliation>Stritch School of Medicine, Loyola University, Maywood, IL;</mods:affiliation><wicri:noCountry code="subField">IL;</wicri:noCountry></affiliation><affiliation><mods:affiliation>Center for Healthcare Ethics, Cedars‐Sinai Medical Center, Los Angeles, California, USA; and</mods:affiliation><wicri:noCountry code="subField">USA; and</wicri:noCountry></affiliation>Le document en format XML
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David Charles</name><affiliation wicri:level="1"><mods:affiliation>Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA;</mods:affiliation><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:945D02E936B1F38F036959687AF2CFD8D1F08212</idno><date when="2011" year="2011">2011</date><idno type="doi">10.1111/j.1525-1403.2011.00391.x</idno><idno type="url">https://api.istex.fr/document/945D02E936B1F38F036959687AF2CFD8D1F08212/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000245</idno><idno type="wicri:Area/Main/Curation">000203</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Deep Brain Stimulation for Early‐Stage Parkinson's Disease: An Illustrative Case</title><author><name sortKey="Gill, Chandler E" sort="Gill, Chandler E" uniqKey="Gill C" first="Chandler E." last="Gill">Chandler E. Gill</name><affiliation><mods:affiliation>Stritch School of Medicine, Loyola University, Maywood, IL;</mods:affiliation><wicri:noCountry code="subField">IL;</wicri:noCountry></affiliation></author><author><name sortKey="Allen, Laura A" sort="Allen, Laura A" uniqKey="Allen L" first="Laura A." last="Allen">Laura A. Allen</name><affiliation wicri:level="1"><mods:affiliation>Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA;</mods:affiliation><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee</wicri:regionArea></affiliation></author><author><name sortKey="Konrad, Peter E" sort="Konrad, Peter E" uniqKey="Konrad P" first="Peter E." last="Konrad">Peter E. Konrad</name><affiliation wicri:level="1"><mods:affiliation>Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA;</mods:affiliation><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee</wicri:regionArea></affiliation></author><author><name sortKey="Davis, Thomas L" sort="Davis, Thomas L" uniqKey="Davis T" first="Thomas L." last="Davis">Thomas L. Davis</name><affiliation wicri:level="1"><mods:affiliation>Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA;</mods:affiliation><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Department of Neurology, Tennessee Valley VA Healthcare System, Nashville, Tennessee, USA;</mods:affiliation><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Department of Neurology, Tennessee Valley VA Healthcare System, Nashville, Tennessee</wicri:regionArea></affiliation></author><author><name sortKey="Bliton, Mark J" sort="Bliton, Mark J" uniqKey="Bliton M" first="Mark J." last="Bliton">Mark J. Bliton</name><affiliation wicri:level="1"><mods:affiliation>Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, Tennessee, USA;</mods:affiliation><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, Tennessee</wicri:regionArea></affiliation></author><author><name sortKey="Finder, Stuart G" sort="Finder, Stuart G" uniqKey="Finder S" first="Stuart G." last="Finder">Stuart G. Finder</name><affiliation><mods:affiliation>Center for Healthcare Ethics, Cedars‐Sinai Medical Center, Los Angeles, California, USA; and</mods:affiliation><wicri:noCountry code="subField">USA; and</wicri:noCountry></affiliation></author><author><name sortKey="Tramontana, Michael G" sort="Tramontana, Michael G" uniqKey="Tramontana M" first="Michael G." last="Tramontana">Michael G. Tramontana</name><affiliation wicri:level="1"><mods:affiliation>Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee, USA</mods:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee</wicri:regionArea></affiliation></author><author><name sortKey="Kao, C Chris" sort="Kao, C Chris" uniqKey="Kao C" first="C. Chris" last="Kao">C. Chris Kao</name><affiliation wicri:level="1"><mods:affiliation>Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA;</mods:affiliation><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee</wicri:regionArea></affiliation></author><author><name sortKey="Remple, Michael S" sort="Remple, Michael S" uniqKey="Remple M" first="Michael S." last="Remple">Michael S. Remple</name><affiliation wicri:level="1"><mods:affiliation>Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA;</mods:affiliation><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee</wicri:regionArea></affiliation></author><author><name sortKey="Bradenham, Courtney H" sort="Bradenham, Courtney H" uniqKey="Bradenham C" first="Courtney H." last="Bradenham">Courtney H. Bradenham</name><affiliation wicri:level="1"><mods:affiliation>Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA;</mods:affiliation><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee</wicri:regionArea></affiliation></author><author><name sortKey="Charles, P David" sort="Charles, P David" uniqKey="Charles P" first="P. David" last="Charles">P. David Charles</name><affiliation wicri:level="1"><mods:affiliation>Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA;</mods:affiliation><country xml:lang="fr" wicri:curation="lc">États-Unis</country><wicri:regionArea>Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j">Neuromodulation: Technology at the Neural Interface</title><idno type="ISSN">1094-7159</idno><idno type="eISSN">1525-1403</idno><imprint><publisher>Blackwell Publishing Inc</publisher><pubPlace>Malden, USA</pubPlace><date type="published" when="2011-11">2011-11</date><biblScope unit="volume">14</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="515">515</biblScope><biblScope unit="page" to="522">522</biblScope></imprint><idno type="ISSN">1094-7159</idno></series><idno type="istex">945D02E936B1F38F036959687AF2CFD8D1F08212</idno><idno type="DOI">10.1111/j.1525-1403.2011.00391.x</idno><idno type="ArticleID">NER391</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1094-7159</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Deep brain stimulation (DBS)</term><term>Parkinson's Disease (PD)</term><term>Unified Parkinson's Disease Rating Scale Motor Subscale (UPDRS‐III)</term><term>early stage</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objectives: Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective intervention in advanced Parkinson's disease (PD), but its efficacy and safety in early PD are unknown. We are conducting a randomized pilot trial investigating DBS in early PD. This report describes one participant who received bilateral STN‐DBS. Materials and Methods: Thirty subjects have been randomized to either optimal drug therapy (ODT) or DBS + ODT. Microelectrode recordings from the STN and substantia nigra are collected at implantation. The Unified Parkinson's Disease Rating Scale Motor Subscale (UPDRS‐III) is administered in the ON and OFF states semi‐annually and neuropsychological function and quality of life are assessed annually. We describe a 54‐year‐old man with a two‐year history of PD who was randomized to DBS + ODT and followed for two years. Results: The subject showed a lower STN to substantia nigra ratio of neuronal activity than advanced PD patients, and higher firing rate than non‐PD patients. The subject's total UPDRS and UPDRS‐III scores improved during the two‐year follow‐up, while his OFF UPDRS‐III score and levodopa equivalent daily dose increased. Quality of life, verbal fluency, and verbal learning improved. He did not experience any serious adverse events. Conclusions: This report details the first successful application of bilateral STN‐DBS for early‐stage PD during a clinical trial.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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