Pallidal stimulation in advanced Parkinson's patients with contraindications for subthalamic stimulation
Identifieur interne : 000605 ( Main/Exploration ); précédent : 000604; suivant : 000606Pallidal stimulation in advanced Parkinson's patients with contraindications for subthalamic stimulation
Auteurs : Tiphaine Rouaud [France] ; Thibaut Dondaine [France] ; Sophie Drapier [France] ; Claire Haegelen [France] ; François Lallement [France] ; Julie Péron [France] ; Sylvie Raoul [France] ; Paul Sauleau [France] ; Marc Vérin [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2010-09-15.
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Abstract
The aim of this study was to evaluate the efficacy and safety of bilateral pallidal (GPi) deep brain stimulation (DBS) 6 months after surgery in advanced parkinsonian patients whose dopa‐resistant axial motor signs or cognitive decline constituted contraindications for subthalamic nucleus (STN) DBS. Seventeen patients with a mean age of 59.3 ± 7.1 years (range, 45–70), mean disease duration of 12.5 ± 4.3 years (range, 7–20), and contraindications for STN DBS, underwent bilateral GPi DBS. They were evaluated before surgery and 6 months afterward, in accordance with Core Assessment Program for Intracerebral Transplantation recommendations. There were mean improvements of 41.1% in the UPDRS III motor score in the off‐dopa condition and 20.3% in the activities of daily living score. Motor fluctuations were reduced by 22.9% and dyskinesias by 68.6%. Axial motor signs improved in the off‐dopa condition by 34.2%. Neuropsychological performances remained unchanged at the 6‐month assessment. Bilateral GPi DBS is both safe and effective in advanced parkinsonian patients with untreatable motor fluctuations, for whom STN DBS is contraindicated due to dopa‐resistant axial motor signs or cognitive decline. As such, it should be regarded as a viable option for these patients. © 2010 Movement Disorder Society
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DOI: 10.1002/mds.23171
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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>Hoboken</pubPlace><date type="published" when="2010-09-15">2010-09-15</date><biblScope unit="volume">25</biblScope><biblScope unit="issue">12</biblScope><biblScope unit="page" from="1839">1839</biblScope><biblScope unit="page" to="1846">1846</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">FE2CEE72D1A106C8CBBB7DAA6BE20BCD0BDEFEAA</idno><idno type="DOI">10.1002/mds.23171</idno><idno type="ArticleID">MDS23171</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>axial motor symptoms</term><term>deep brain stimulation</term><term>neuropsychological outcome</term><term>pallidal stimulation</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The aim of this study was to evaluate the efficacy and safety of bilateral pallidal (GPi) deep brain stimulation (DBS) 6 months after surgery in advanced parkinsonian patients whose dopa‐resistant axial motor signs or cognitive decline constituted contraindications for subthalamic nucleus (STN) DBS. Seventeen patients with a mean age of 59.3 ± 7.1 years (range, 45–70), mean disease duration of 12.5 ± 4.3 years (range, 7–20), and contraindications for STN DBS, underwent bilateral GPi DBS. They were evaluated before surgery and 6 months afterward, in accordance with Core Assessment Program for Intracerebral Transplantation recommendations. There were mean improvements of 41.1% in the UPDRS III motor score in the off‐dopa condition and 20.3% in the activities of daily living score. Motor fluctuations were reduced by 22.9% and dyskinesias by 68.6%. Axial motor signs improved in the off‐dopa condition by 34.2%. Neuropsychological performances remained unchanged at the 6‐month assessment. Bilateral GPi DBS is both safe and effective in advanced parkinsonian patients with untreatable motor fluctuations, for whom STN DBS is contraindicated due to dopa‐resistant axial motor signs or cognitive decline. As such, it should be regarded as a viable option for these patients. © 2010 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>France</li></country><settlement><li>Nantes</li><li>Rennes</li></settlement></list><tree><country name="France"><noRegion><name sortKey="Rouaud, Tiphaine" sort="Rouaud, Tiphaine" uniqKey="Rouaud T" first="Tiphaine" last="Rouaud">Tiphaine Rouaud</name></noRegion><name sortKey="Dondaine, Thibaut" sort="Dondaine, Thibaut" uniqKey="Dondaine T" first="Thibaut" last="Dondaine">Thibaut Dondaine</name><name sortKey="Drapier, Sophie" sort="Drapier, Sophie" uniqKey="Drapier S" first="Sophie" last="Drapier">Sophie Drapier</name><name sortKey="Haegelen, Claire" sort="Haegelen, Claire" uniqKey="Haegelen C" first="Claire" last="Haegelen">Claire Haegelen</name><name sortKey="Lallement, Francois" sort="Lallement, Francois" uniqKey="Lallement F" first="François" last="Lallement">François Lallement</name><name sortKey="Peron, Julie" sort="Peron, Julie" uniqKey="Peron J" first="Julie" last="Péron">Julie Péron</name><name sortKey="Raoul, Sylvie" sort="Raoul, Sylvie" uniqKey="Raoul S" first="Sylvie" last="Raoul">Sylvie Raoul</name><name sortKey="Sauleau, Paul" sort="Sauleau, Paul" uniqKey="Sauleau P" first="Paul" last="Sauleau">Paul Sauleau</name><name sortKey="Verin, Marc" sort="Verin, Marc" uniqKey="Verin M" first="Marc" last="Vérin">Marc Vérin</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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