Treatment results: Parkinson's disease
Identifieur interne : 000996 ( Main/Curation ); précédent : 000995; suivant : 000997Treatment results: Parkinson's disease
Auteurs : Pierre Pollak [France] ; Valérie Fraix [France] ; Paul Krack [France] ; Elena Moro [France] ; Alexandre Mendes [France] ; Stephan Chabardes [France] ; Adnan Koudsie [France] ; Alim-Louis Benabid [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2002-03.
English descriptors
Abstract
Deep brain stimulation (DBS) is a neurosurgical treatment of Parkinson's disease that is applied to three targets: the ventral intermediate nucleus of the thalamus (Vim), the globus pallidus internas (GPi) and the subthalamic nucleus (STN). Vim DBS mainly improves contralateral tremor and, therefore, is being supplanted by DBS of the two other targets, even in patients with tremor dominant disease. STN and GPi DBS improve off‐motor phases and dyskinesias. There is little comparative data between these procedures. The magnitude of the motor improvement seems more constant with STN than GPi DBS. STN DBS allows a decrease in antiparkinsonian drug doses and consumes moderate current. These advantages of STN over GPi DBS are offset by the need for more intensive postoperative management. The DBS procedure has the unique advantage of reversibility and adjustability over time. Patients with young‐onset Parkinson's disease suffering from levodopa‐induced motor complications but still responding well to levodopa and who exhibit no behavioral, mood, or cognitive impairment benefit the most from STN DBS. Adverse effects more specific of the DBS procedure are infection, cutaneous erosion, and lead breaking or disconnection. Intracranial electrode implantation can induce a hematoma or contusion. Most authors agree that the benefit to risk ratio of DBS is favorable. © 2002 Movement Disorder Society
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DOI: 10.1002/mds.10146
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Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Moro, Elena" sort="Moro, Elena" uniqKey="Moro E" first="Elena" last="Moro">Elena Moro</name><affiliation wicri:level="1"><mods:affiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Mendes, Alexandre" sort="Mendes, Alexandre" uniqKey="Mendes A" first="Alexandre" last="Mendes">Alexandre Mendes</name><affiliation wicri:level="1"><mods:affiliation>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Service de Neurologie, Centre Hospitalier Universitaire de Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Chabardes, Stephan" sort="Chabardes, Stephan" uniqKey="Chabardes S" first="Stephan" last="Chabardes">Stephan Chabardes</name><affiliation wicri:level="1"><mods:affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Koudsie, Adnan" sort="Koudsie, Adnan" uniqKey="Koudsie A" first="Adnan" last="Koudsie">Adnan Koudsie</name><affiliation wicri:level="1"><mods:affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble</wicri:regionArea></affiliation></author><author><name sortKey="Benabid, Alim Ouis" sort="Benabid, Alim Ouis" uniqKey="Benabid A" first="Alim-Louis" last="Benabid">Alim-Louis Benabid</name><affiliation wicri:level="1"><mods:affiliation>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut National de la Santé et de la Recherche Médicale, Unit 318, Joseph Fourier University, Grenoble</wicri:regionArea></affiliation><affiliation wicri:level="1"><mods:affiliation>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble, France</mods:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Department of Clinical and Biological Neurosciences, Service de Neurochirurgie, Centre Hospitalier Universitaire de Grenoble, Grenoble</wicri:regionArea></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>New York</pubPlace><date type="published" when="2002-03">2002-03</date><biblScope unit="volume">17</biblScope><biblScope unit="issue">S3</biblScope><biblScope unit="supplement">3</biblScope><biblScope unit="page" from="S75">S75</biblScope><biblScope unit="page" to="S83">S83</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">645ED79E4BFD3D4EFB435E1FA0EB6C59E408A351</idno><idno type="DOI">10.1002/mds.10146</idno><idno type="ArticleID">MDS10146</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>Vim</term><term>deep brain stimulation</term><term>globus pallidus</term><term>subthalamic nucleus</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Deep brain stimulation (DBS) is a neurosurgical treatment of Parkinson's disease that is applied to three targets: the ventral intermediate nucleus of the thalamus (Vim), the globus pallidus internas (GPi) and the subthalamic nucleus (STN). Vim DBS mainly improves contralateral tremor and, therefore, is being supplanted by DBS of the two other targets, even in patients with tremor dominant disease. STN and GPi DBS improve off‐motor phases and dyskinesias. There is little comparative data between these procedures. The magnitude of the motor improvement seems more constant with STN than GPi DBS. STN DBS allows a decrease in antiparkinsonian drug doses and consumes moderate current. These advantages of STN over GPi DBS are offset by the need for more intensive postoperative management. The DBS procedure has the unique advantage of reversibility and adjustability over time. Patients with young‐onset Parkinson's disease suffering from levodopa‐induced motor complications but still responding well to levodopa and who exhibit no behavioral, mood, or cognitive impairment benefit the most from STN DBS. Adverse effects more specific of the DBS procedure are infection, cutaneous erosion, and lead breaking or disconnection. Intracranial electrode implantation can induce a hematoma or contusion. Most authors agree that the benefit to risk ratio of DBS is favorable. © 2002 Movement Disorder Society</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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