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Effects of chronic subthalamic stimulation on nonmotor fluctuations in Parkinson's disease.
Witjas, Tatiana; Kaphan, Elsa; Régis, Jean; Jouve, Elisabeth; Chérif, André Ali; Péragut, Jean-Claude; Azulay, Jean Philippe.
Afiliação
  • Witjas T; Department of Clinical Neurosciences, University Hospital Timone, Marseille, France. tatiana.witjas@ap-hm.fr
Mov Disord ; 22(12): 1729-34, 2007 Sep 15.
Article em En | MEDLINE | ID: mdl-17557355
ABSTRACT
The aim of this study was to assess the outcome of nonmotor fluctuations (NMF) after chronic Subthalamic nucleus (STN) Deep Brain Stimulation (DBS) in Parkinson's disease(PD). Chronic stimulation of the STN has proved to be an effective treatment for advanced PD with motor complications. The outcome of NMF, which are also disabling, remains unknown. Forty-patients underwent bilateral STN stimulation. Each patient was interviewed before and after 1 yr of STN DBS with a structured questionnaire about their NMF. After 1 yr of chronic stimulation, the improvement in the motor score (UPDRS III) and dyskinesia amounted respectively to 67.4 and 76.3%. The decrease in motor fluctuations (MF) was 59% and 13 patients reported that their MF had disappeared. Comparatively, a reduction of the total number of NMF was also observed (mean number preoperatively 15.6 per patient, postoperatively 6.6). Most of the nonmotor fluctuating symptoms occurred in the "off" state preoperatively and no longer depended on the patient's motor state after surgery. The improvement in NMF was not identical for the different categories pain/sensory fluctuations showed the best response to STN DBS (84.2%). Dysautonomic and cognitive fluctuations were also markedly improved (>60%) while psychic fluctuations remained the most frequent postoperative NMF observed. Some incapacitating manifestations such as drenching sweats and akathisia showed a remarkably good response to STN stimulation. In conclusion STN DBS alleviates NMF. It has strikingly successful effects on sensory, dysautonomic and cognitive fluctuations. However, psychic fluctuations respond less consistently to this treatment.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença de Parkinson / Doenças do Sistema Nervoso Autônomo / Núcleo Subtalâmico / Estimulação Encefálica Profunda / Manejo da Dor / Transtornos Mentais Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Qualitative_research / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2007 Tipo de documento: Article
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença de Parkinson / Doenças do Sistema Nervoso Autônomo / Núcleo Subtalâmico / Estimulação Encefálica Profunda / Manejo da Dor / Transtornos Mentais Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Qualitative_research / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2007 Tipo de documento: Article