Differential effects of levodopa and subthalamic nucleus deep brain stimulation on bradykinesia in Parkinson's disease
Identifieur interne : 000E20 ( Main/Exploration ); précédent : 000E19; suivant : 000E21Differential effects of levodopa and subthalamic nucleus deep brain stimulation on bradykinesia in Parkinson's disease
Auteurs : Lars Timmermann [Allemagne] ; Martin Braun [Allemagne] ; Stefan Groiss [Allemagne] ; Lars Wojtecki [Allemagne] ; Stefan Ostrowski [Allemagne] ; Holger Krause [Allemagne] ; Bettina Pollok [Allemagne] ; Martin Südmeyer [Allemagne] ; Markus Ploner [Allemagne] ; Joachim Gross [Allemagne] ; Mohammad Maarouf [Allemagne] ; Jürgen Voges [Allemagne] ; Volker Sturm [Allemagne] ; Alfons Schnitzler [Allemagne]Source :
- Movement Disorders [ 0885-3185 ] ; 2008-01-30.
English descriptors
Abstract
Cardinal symptoms of Parkinson's disease (PD) respond well to treatment with levodopa and deep brain stimulation (DBS) of the subthalamic nucleus (STN). However, it has remained unclear whether levodopa and STN‐DBS have differential effects on bradykinesia. We investigated 8 PD‐patients with STN‐electrodes in four conditions: STN‐DBS and levodopa (ONMED/ONSTIM), STN‐DBS only (OFFMED/ONSTIM), levodopa only (ONMED/OFFSTIM), without STN‐DBS/levodopa (OFFMED/OFFSTIM). Fourteen volunteers served as controls. Subjects performed fastest possible (1) pronation/supination of the forearm (diadochokinesia) and (2) flexion and extension of the index finger (finger movements). Movements were recorded using a 3D‐ultrasound‐system. Maximum frequency, amplitude, and smoothness of movements were determined. During OFFMED/OFFSTIM, all parameters were worser than in all other conditions. In proximal diadochokinesia, OFFMED/ONSTIM significantly improved the amplitude and frequency, whereas ONMED/OFFSTIM had no significant effect. In contrast, we found a stronger effect of levodopa (ONMED/OFFSTIM) on amplitudes of distal finger movement than on amplitudes of diadochokinesia. Combination of treatments during ONMED/ONSTIM further improved both movements. However, maximum frequency remained lower in PD‐patients during ONMED/ONSTIM compared with controls. This study demonstrates a better effect of levodopa on distal finger movements and STN‐DBS on proximal diadochokinesia. Furthermore, a complementary effect of both therapies on brain areas involved in bradykinesia can be assumed. © 2007 Movement Disorder Society
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DOI: 10.1002/mds.21808
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xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, Technical University Munich, Munich</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Haute-Bavière</region><settlement type="city">Munich</settlement></placeName></affiliation></author><author><name sortKey="Gross, Joachim" sort="Gross, Joachim" uniqKey="Gross J" first="Joachim" last="Gross">Joachim Gross</name><affiliation wicri:level="1"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, Heinrich‐Heine University, Duesseldorf</wicri:regionArea><wicri:noRegion>Duesseldorf</wicri:noRegion><wicri:noRegion>Duesseldorf</wicri:noRegion></affiliation></author><author><name sortKey="Maarouf, Mohammad" sort="Maarouf, Mohammad" uniqKey="Maarouf M" first="Mohammad" last="Maarouf">Mohammad Maarouf</name><affiliation wicri:level="3"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, 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Cologne</wicri:regionArea><wicri:noRegion>Cologne</wicri:noRegion><wicri:noRegion>Cologne</wicri:noRegion></affiliation></author><author><name sortKey="Schnitzler, Alfons" sort="Schnitzler, Alfons" uniqKey="Schnitzler A" first="Alfons" last="Schnitzler">Alfons Schnitzler</name><affiliation wicri:level="1"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Neurology, Heinrich‐Heine University, Duesseldorf</wicri:regionArea><wicri:noRegion>Duesseldorf</wicri:noRegion><wicri:noRegion>Duesseldorf</wicri:noRegion></affiliation><affiliation wicri:level="1"><country xml:lang="fr">Allemagne</country><wicri:regionArea>Lars Timmermann, Department of Neurology, University Hospital Cologne, Josef‐Stelzmann‐Str. 9, 50924 Cologne, GermanyAlfons Schnitzler, Department of Neurology, University Hospital of the Heinrich‐Heine‐University, Moorenstr. 5, 40225 Duesseldorf</wicri:regionArea><wicri:noRegion>40225 Duesseldorf</wicri:noRegion><wicri:noRegion>40225 Duesseldorf</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</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>Hoboken</pubPlace><date type="published" when="2008-01-30">2008-01-30</date><biblScope unit="volume">23</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="218">218</biblScope><biblScope unit="page" to="227">227</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">CB335A18C57A71D20E2315DC495D0841A274A403</idno><idno type="DOI">10.1002/mds.21808</idno><idno type="ArticleID">MDS21808</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>L‐dopa</term><term>Parkinson's disease</term><term>bradykinesia</term><term>deep brain stimulation</term><term>motion detection</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Cardinal symptoms of Parkinson's disease (PD) respond well to treatment with levodopa and deep brain stimulation (DBS) of the subthalamic nucleus (STN). However, it has remained unclear whether levodopa and STN‐DBS have differential effects on bradykinesia. We investigated 8 PD‐patients with STN‐electrodes in four conditions: STN‐DBS and levodopa (ONMED/ONSTIM), STN‐DBS only (OFFMED/ONSTIM), levodopa only (ONMED/OFFSTIM), without STN‐DBS/levodopa (OFFMED/OFFSTIM). Fourteen volunteers served as controls. Subjects performed fastest possible (1) pronation/supination of the forearm (diadochokinesia) and (2) flexion and extension of the index finger (finger movements). Movements were recorded using a 3D‐ultrasound‐system. Maximum frequency, amplitude, and smoothness of movements were determined. During OFFMED/OFFSTIM, all parameters were worser than in all other conditions. In proximal diadochokinesia, OFFMED/ONSTIM significantly improved the amplitude and frequency, whereas ONMED/OFFSTIM had no significant effect. In contrast, we found a stronger effect of levodopa (ONMED/OFFSTIM) on amplitudes of distal finger movement than on amplitudes of diadochokinesia. Combination of treatments during ONMED/ONSTIM further improved both movements. However, maximum frequency remained lower in PD‐patients during ONMED/ONSTIM compared with controls. This study demonstrates a better effect of levodopa on distal finger movements and STN‐DBS on proximal diadochokinesia. Furthermore, a complementary effect of both therapies on brain areas involved in bradykinesia can be assumed. © 2007 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Allemagne</li></country><region><li>Bavière</li><li>District de Haute-Bavière</li></region><settlement><li>Munich</li></settlement></list><tree><country name="Allemagne"><noRegion><name sortKey="Timmermann, Lars" sort="Timmermann, Lars" uniqKey="Timmermann L" first="Lars" last="Timmermann">Lars Timmermann</name></noRegion><name sortKey="Braun, Martin" sort="Braun, Martin" uniqKey="Braun M" first="Martin" last="Braun">Martin Braun</name><name sortKey="Groiss, Stefan" sort="Groiss, Stefan" uniqKey="Groiss S" first="Stefan" last="Groiss">Stefan Groiss</name><name sortKey="Gross, Joachim" sort="Gross, Joachim" uniqKey="Gross J" first="Joachim" last="Gross">Joachim Gross</name><name sortKey="Krause, Holger" sort="Krause, Holger" uniqKey="Krause H" first="Holger" last="Krause">Holger Krause</name><name sortKey="Maarouf, Mohammad" sort="Maarouf, Mohammad" uniqKey="Maarouf M" first="Mohammad" last="Maarouf">Mohammad Maarouf</name><name sortKey="Ostrowski, Stefan" sort="Ostrowski, Stefan" uniqKey="Ostrowski S" first="Stefan" last="Ostrowski">Stefan Ostrowski</name><name sortKey="Ploner, Markus" sort="Ploner, Markus" uniqKey="Ploner M" first="Markus" last="Ploner">Markus Ploner</name><name sortKey="Pollok, Bettina" sort="Pollok, Bettina" uniqKey="Pollok B" first="Bettina" last="Pollok">Bettina Pollok</name><name sortKey="Schnitzler, Alfons" sort="Schnitzler, Alfons" uniqKey="Schnitzler A" first="Alfons" last="Schnitzler">Alfons Schnitzler</name><name sortKey="Schnitzler, Alfons" sort="Schnitzler, Alfons" uniqKey="Schnitzler A" first="Alfons" last="Schnitzler">Alfons Schnitzler</name><name sortKey="Sturm, Volker" sort="Sturm, Volker" uniqKey="Sturm V" first="Volker" last="Sturm">Volker Sturm</name><name sortKey="Sudmeyer, Martin" sort="Sudmeyer, Martin" uniqKey="Sudmeyer M" first="Martin" last="Südmeyer">Martin Südmeyer</name><name sortKey="Timmermann, Lars" sort="Timmermann, Lars" uniqKey="Timmermann L" first="Lars" last="Timmermann">Lars Timmermann</name><name sortKey="Voges, Jurgen" sort="Voges, Jurgen" uniqKey="Voges J" first="Jürgen" last="Voges">Jürgen Voges</name><name sortKey="Wojtecki, Lars" sort="Wojtecki, Lars" uniqKey="Wojtecki L" first="Lars" last="Wojtecki">Lars Wojtecki</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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