Deep Brain Stimulation for Early‐Stage Parkinson's Disease: An Illustrative Case
Identifieur interne : 000344 ( Main/Exploration ); précédent : 000343; suivant : 000345Deep Brain Stimulation for Early‐Stage Parkinson's Disease: An Illustrative Case
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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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><affiliations><list><country><li>États-Unis</li></country><region><li>Tennessee</li></region></list><tree><noCountry><name sortKey="Finder, Stuart G" sort="Finder, Stuart G" uniqKey="Finder S" first="Stuart G." last="Finder">Stuart G. Finder</name><name sortKey="Gill, Chandler E" sort="Gill, Chandler E" uniqKey="Gill C" first="Chandler E." last="Gill">Chandler E. Gill</name></noCountry><country name="États-Unis"><region name="Tennessee"><name sortKey="Allen, Laura A" sort="Allen, Laura A" uniqKey="Allen L" first="Laura A." last="Allen">Laura A. Allen</name></region><name sortKey="Bliton, Mark J" sort="Bliton, Mark J" uniqKey="Bliton M" first="Mark J." last="Bliton">Mark J. Bliton</name><name sortKey="Bradenham, Courtney H" sort="Bradenham, Courtney H" uniqKey="Bradenham C" first="Courtney H." last="Bradenham">Courtney H. Bradenham</name><name sortKey="Charles, P David" sort="Charles, P David" uniqKey="Charles P" first="P. David" last="Charles">P. David Charles</name><name sortKey="Davis, Thomas L" sort="Davis, Thomas L" uniqKey="Davis T" first="Thomas L." last="Davis">Thomas L. Davis</name><name sortKey="Davis, Thomas L" sort="Davis, Thomas L" uniqKey="Davis T" first="Thomas L." last="Davis">Thomas L. Davis</name><name sortKey="Kao, C Chris" sort="Kao, C Chris" uniqKey="Kao C" first="C. Chris" last="Kao">C. Chris Kao</name><name sortKey="Konrad, Peter E" sort="Konrad, Peter E" uniqKey="Konrad P" first="Peter E." last="Konrad">Peter E. Konrad</name><name sortKey="Remple, Michael S" sort="Remple, Michael S" uniqKey="Remple M" first="Michael S." last="Remple">Michael S. Remple</name><name sortKey="Tramontana, Michael G" sort="Tramontana, Michael G" uniqKey="Tramontana M" first="Michael G." last="Tramontana">Michael G. Tramontana</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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