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Randomized trial of pallidotomy versus medical therapy for Parkinson's disease.
Ann Neurol. 2003 May; 53(5):558-69.AN

Abstract

Thirty-six patients with Parkinson's disease (PD) were randomized to either medical therapy (N = 18) or unilateral GPi pallidotomy (N = 18). The primary outcome variable was the change in total Unified Parkinson's Disease Rating Scale (UPDRS) score at 6 months. Secondary outcome variables included subscores and individual parkinsonian symptoms as determined from the UPDRS. At the six month follow-up, patients receiving pallidotomy had a statistically significant reduction (32% decrease) in the total UPDRS score compared to those randomized to medical therapy (5% increase). Following surgery, patients' showed improvement in all the cardinal motor signs of PD including tremor, rigidity, bradykinesia, gait and balance. Drug-induced dyskinesias were also markedly improved. Although the greatest improvement occurred on the side contralateral to the lesion, significant ipsilateral improvement was also observed for bradykinesia, rigidity and drug-induced dyskinesias. A total of twenty patients have been followed for 2 years to assess the effect of time on clinical outcome. These patients have shown sustained improvement in the total UPDRS (p < 0.0001), "off" motor (p < 0.0001) and complications of therapy subscores (p < 0.0001). Sustained improvement was also seen for tremor, rigidity, bradykinesia, percent on time and drug-induced dyskinesias.

Authors+Show Affiliations

Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA. jvitek@emory.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

12730989

Citation

Vitek, Jerrold L., et al. "Randomized Trial of Pallidotomy Versus Medical Therapy for Parkinson's Disease." Annals of Neurology, vol. 53, no. 5, 2003, pp. 558-69.
Vitek JL, Bakay RA, Freeman A, et al. Randomized trial of pallidotomy versus medical therapy for Parkinson's disease. Ann Neurol. 2003;53(5):558-69.
Vitek, J. L., Bakay, R. A., Freeman, A., Evatt, M., Green, J., McDonald, W., Haber, M., Barnhart, H., Wahlay, N., Triche, S., Mewes, K., Chockkan, V., Zhang, J. Y., & DeLong, M. R. (2003). Randomized trial of pallidotomy versus medical therapy for Parkinson's disease. Annals of Neurology, 53(5), 558-69.
Vitek JL, et al. Randomized Trial of Pallidotomy Versus Medical Therapy for Parkinson's Disease. Ann Neurol. 2003;53(5):558-69. PubMed PMID: 12730989.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized trial of pallidotomy versus medical therapy for Parkinson's disease. AU - Vitek,Jerrold L, AU - Bakay,Roy A E, AU - Freeman,Alan, AU - Evatt,Marian, AU - Green,Joanne, AU - McDonald,William, AU - Haber,Michael, AU - Barnhart,Huiman, AU - Wahlay,Natalie, AU - Triche,Shirley, AU - Mewes,Klaus, AU - Chockkan,Vijay, AU - Zhang,Jian-Yu, AU - DeLong,Mahlon R, PY - 2003/5/6/pubmed PY - 2003/6/5/medline PY - 2003/5/6/entrez SP - 558 EP - 69 JF - Annals of neurology JO - Ann Neurol VL - 53 IS - 5 N2 - Thirty-six patients with Parkinson's disease (PD) were randomized to either medical therapy (N = 18) or unilateral GPi pallidotomy (N = 18). The primary outcome variable was the change in total Unified Parkinson's Disease Rating Scale (UPDRS) score at 6 months. Secondary outcome variables included subscores and individual parkinsonian symptoms as determined from the UPDRS. At the six month follow-up, patients receiving pallidotomy had a statistically significant reduction (32% decrease) in the total UPDRS score compared to those randomized to medical therapy (5% increase). Following surgery, patients' showed improvement in all the cardinal motor signs of PD including tremor, rigidity, bradykinesia, gait and balance. Drug-induced dyskinesias were also markedly improved. Although the greatest improvement occurred on the side contralateral to the lesion, significant ipsilateral improvement was also observed for bradykinesia, rigidity and drug-induced dyskinesias. A total of twenty patients have been followed for 2 years to assess the effect of time on clinical outcome. These patients have shown sustained improvement in the total UPDRS (p < 0.0001), "off" motor (p < 0.0001) and complications of therapy subscores (p < 0.0001). Sustained improvement was also seen for tremor, rigidity, bradykinesia, percent on time and drug-induced dyskinesias. SN - 0364-5134 UR - https://www.unboundmedicine.com/medline/citation/12730989/Randomized_trial_of_pallidotomy_versus_medical_therapy_for_Parkinson's_disease_ L2 - https://doi.org/10.1002/ana.10517 DB - PRIME DP - Unbound Medicine ER -