Cognition and mood in Parkinson's disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: The COMPARE Trial
Identifieur interne : 000B38 ( Main/Exploration ); précédent : 000B37; suivant : 000B39Cognition and mood in Parkinson's disease in subthalamic nucleus versus globus pallidus interna deep brain stimulation: The COMPARE Trial
Auteurs : Michael S. Okun [États-Unis] ; Hubert H. Fernandez [États-Unis] ; Samuel S. Wu [États-Unis] ; Lindsey Kirsch-Darrow [États-Unis] ; Dawn Bowers [États-Unis] ; Frank Bova [États-Unis] ; Michele Suelter [États-Unis] ; Charles E. Jacobson Iv [États-Unis] ; Xinping Wang [États-Unis] ; Clifford W. Gordon Jr. [États-Unis] ; Pam Zeilman [États-Unis] ; Janet Romrell [États-Unis] ; Pam Martin [États-Unis] ; Herbert Ward [États-Unis] ; Ramon L. Rodriguez [États-Unis] ; Kelly D. Foote [États-Unis]Source :
- Annals of Neurology [ 0364-5134 ] ; 2009-05.
Abstract
Objective: Our aim was to compare in a prospective blinded study the cognitive and mood effects of subthalamic nucleus (STN) vs. globus pallidus interna (GPi) deep brain stimulation (DBS) in Parkinson disease. Methods: Fifty‐two subjects were randomized to unilateral STN or GPi DBS. The co‐primary outcome measures were the Visual Analog Mood Scale, and verbal fluency (semantic and letter) at 7 months post‐DBS in the optimal setting compared to pre‐DBS. At 7 months post‐DBS, subjects were tested in four randomized/counterbalanced conditions (optimal, ventral, dorsal, and off DBS). Results: Forty‐five subjects (23 GPi, 22 STN) completed the protocol. The study revealed no difference between STN and GPi DBS in the change of co‐primary mood and cognitive outcomes pre‐ to post‐DBS in the optimal setting (Hotelling's T2 test: p = 0.16 and 0.08 respectively). Subjects in both targets were less “happy”, less “energetic” and more “confused” when stimulated ventrally. Comparison of the other 3 DBS conditions to pre‐DBS showed a larger deterioration of letter verbal fluency in STN, especially when off DBS. There was no difference in UPDRS motor improvement between targets. Interpretation: There were no significant differences in the co‐primary outcome measures (mood and cognition) between STN and GPi in the optimal DBS state. Adverse mood effects occurred ventrally in both targets. A worsening of letter verbal fluency was seen in STN. The persistence of deterioration in verbal fluency in the off STN DBS state was suggestive of a surgical rather than a stimulation‐induced effect. Similar motor improvement were observed with both STN and GPi DBS. Ann Neurol 2009
Url:
DOI: 10.1002/ana.21596
Affiliations:
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Jacobson Iv</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville</wicri:cityArea></affiliation></author><author><name sortKey="Wang, Xinping" sort="Wang, Xinping" uniqKey="Wang X" first="Xinping" last="Wang">Xinping Wang</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville</wicri:cityArea></affiliation></author><author><name sortKey="Gordon Jr, Clifford W" sort="Gordon Jr, Clifford W" uniqKey="Gordon Jr C" first="Clifford W." last="Gordon Jr.">Clifford W. Gordon Jr.</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville</wicri:cityArea></affiliation></author><author><name sortKey="Zeilman, Pam" sort="Zeilman, Pam" uniqKey="Zeilman P" first="Pam" last="Zeilman">Pam Zeilman</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville</wicri:cityArea></affiliation></author><author><name sortKey="Romrell, Janet" sort="Romrell, Janet" uniqKey="Romrell J" first="Janet" last="Romrell">Janet Romrell</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville</wicri:cityArea></affiliation></author><author><name sortKey="Martin, Pam" sort="Martin, Pam" uniqKey="Martin P" first="Pam" last="Martin">Pam Martin</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville</wicri:cityArea></affiliation></author><author><name sortKey="Ward, Herbert" sort="Ward, Herbert" uniqKey="Ward H" first="Herbert" last="Ward">Herbert Ward</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville</wicri:cityArea></affiliation></author><author><name sortKey="Rodriguez, Ramon L" sort="Rodriguez, Ramon L" uniqKey="Rodriguez R" first="Ramon L." last="Rodriguez">Ramon L. Rodriguez</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville</wicri:cityArea></affiliation></author><author><name sortKey="Foote, Kelly D" sort="Foote, Kelly D" uniqKey="Foote K" first="Kelly D." last="Foote">Kelly D. Foote</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><placeName><region type="state">Floride</region></placeName><wicri:cityArea>Movement Disorders Center, University of Florida, McKnight Brain Institute, College of Medicine, Gainesville</wicri:cityArea></affiliation></author></analytic><monogr></monogr><series><title level="j">Annals of Neurology</title><title level="j" type="sub">Official Journal of the American Neurological Association and the Child Neurology Society</title><title level="j" type="abbrev">Ann Neurol.</title><idno type="ISSN">0364-5134</idno><idno type="eISSN">1531-8249</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2009-05">2009-05</date><biblScope unit="volume">65</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="586">586</biblScope><biblScope unit="page" to="595">595</biblScope></imprint><idno type="ISSN">0364-5134</idno></series><idno type="istex">2141B2BB9FCAC7CE59D2B44FB021AAA0FFC116FB</idno><idno type="DOI">10.1002/ana.21596</idno><idno type="ArticleID">ANA21596</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0364-5134</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: Our aim was to compare in a prospective blinded study the cognitive and mood effects of subthalamic nucleus (STN) vs. globus pallidus interna (GPi) deep brain stimulation (DBS) in Parkinson disease. Methods: Fifty‐two subjects were randomized to unilateral STN or GPi DBS. The co‐primary outcome measures were the Visual Analog Mood Scale, and verbal fluency (semantic and letter) at 7 months post‐DBS in the optimal setting compared to pre‐DBS. At 7 months post‐DBS, subjects were tested in four randomized/counterbalanced conditions (optimal, ventral, dorsal, and off DBS). Results: Forty‐five subjects (23 GPi, 22 STN) completed the protocol. The study revealed no difference between STN and GPi DBS in the change of co‐primary mood and cognitive outcomes pre‐ to post‐DBS in the optimal setting (Hotelling's T2 test: p = 0.16 and 0.08 respectively). Subjects in both targets were less “happy”, less “energetic” and more “confused” when stimulated ventrally. Comparison of the other 3 DBS conditions to pre‐DBS showed a larger deterioration of letter verbal fluency in STN, especially when off DBS. There was no difference in UPDRS motor improvement between targets. Interpretation: There were no significant differences in the co‐primary outcome measures (mood and cognition) between STN and GPi in the optimal DBS state. Adverse mood effects occurred ventrally in both targets. A worsening of letter verbal fluency was seen in STN. The persistence of deterioration in verbal fluency in the off STN DBS state was suggestive of a surgical rather than a stimulation‐induced effect. Similar motor improvement were observed with both STN and GPi DBS. Ann Neurol 2009</div></front></TEI><affiliations><list><country><li>États-Unis</li></country><region><li>Floride</li></region></list><tree><country name="États-Unis"><region name="Floride"><name sortKey="Okun, Michael S" sort="Okun, Michael S" uniqKey="Okun M" first="Michael S." last="Okun">Michael S. Okun</name></region><name sortKey="Bova, Frank" sort="Bova, Frank" uniqKey="Bova F" first="Frank" last="Bova">Frank Bova</name><name sortKey="Bowers, Dawn" sort="Bowers, Dawn" uniqKey="Bowers D" first="Dawn" last="Bowers">Dawn Bowers</name><name sortKey="Fernandez, Hubert H" sort="Fernandez, Hubert H" uniqKey="Fernandez H" first="Hubert H." last="Fernandez">Hubert H. Fernandez</name><name sortKey="Foote, Kelly D" sort="Foote, Kelly D" uniqKey="Foote K" first="Kelly D." last="Foote">Kelly D. Foote</name><name sortKey="Gordon Jr, Clifford W" sort="Gordon Jr, Clifford W" uniqKey="Gordon Jr C" first="Clifford W." last="Gordon Jr.">Clifford W. Gordon Jr.</name><name sortKey="Jacobson Iv, Charles E" sort="Jacobson Iv, Charles E" uniqKey="Jacobson Iv C" first="Charles E." last="Jacobson Iv">Charles E. Jacobson Iv</name><name sortKey="Kirsch Arrow, Lindsey" sort="Kirsch Arrow, Lindsey" uniqKey="Kirsch Arrow L" first="Lindsey" last="Kirsch-Darrow">Lindsey Kirsch-Darrow</name><name sortKey="Martin, Pam" sort="Martin, Pam" uniqKey="Martin P" first="Pam" last="Martin">Pam Martin</name><name sortKey="Rodriguez, Ramon L" sort="Rodriguez, Ramon L" uniqKey="Rodriguez R" first="Ramon L." last="Rodriguez">Ramon L. Rodriguez</name><name sortKey="Romrell, Janet" sort="Romrell, Janet" uniqKey="Romrell J" first="Janet" last="Romrell">Janet Romrell</name><name sortKey="Suelter, Michele" sort="Suelter, Michele" uniqKey="Suelter M" first="Michele" last="Suelter">Michele Suelter</name><name sortKey="Wang, Xinping" sort="Wang, Xinping" uniqKey="Wang X" first="Xinping" last="Wang">Xinping Wang</name><name sortKey="Ward, Herbert" sort="Ward, Herbert" uniqKey="Ward H" first="Herbert" last="Ward">Herbert Ward</name><name sortKey="Wu, Samuel S" sort="Wu, Samuel S" uniqKey="Wu S" first="Samuel S." last="Wu">Samuel S. Wu</name><name sortKey="Zeilman, Pam" sort="Zeilman, Pam" uniqKey="Zeilman P" first="Pam" last="Zeilman">Pam Zeilman</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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