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Long-term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson's disease.
Mov Disord. 2010 Apr 15; 25(5):578-86.MD

Abstract

We report the 5 to 6 year follow-up of a multicenter study of bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) in advanced Parkinson's disease (PD) patients. Thirty-five STN patients and 16 GPi patients were assessed at 5 to 6 years after DBS surgery. Primary outcome measure was the stimulation effect on the motor Unified Parkinson's Disease Rating Scale (UPDRS) assessed with a prospective cross-over double-blind assessment without medications (stimulation was randomly switched on or off). Secondary outcomes were motor UPDRS changes with unblinded assessments in off- and on-medication states with and without stimulation, activities of daily living (ADL), anti-PD medications, and dyskinesias. In double-blind assessment, both STN and GPi DBS were significantly effective in improving the motor UPDRS scores (STN, P < 0.0001, 45.4%; GPi, P = 0.008, 20.0%) compared with off-stimulation, regardless of the sequence of stimulation. In open assessment, both STN- and GPi-DBS significantly improved the off-medication motor UPDRS when compared with before surgery (STN, P < 0.001, 50.5%; GPi, P = 0.002, 35.6%). Dyskinesias and ADL were significantly improved in both groups. Anti-PD medications were significantly reduced only in the STN group. Adverse events were more frequent in the STN group. These results confirm the long-term efficacy of STN and GPi DBS in advanced PD. Although the surgical targets were not randomized, there was a trend to a better outcome of motor signs in the STN-DBS patients and fewer adverse events in the GPi-DBS group.

Authors+Show Affiliations

Toronto Western Hospital, Movement Disorders Center, University of Toronto and University Health Network, Toronto, Ontario, Canada. elena.moro@uhn.on.caNo 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 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 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
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

20213817

Citation

Moro, Elena, et al. "Long-term Results of a Multicenter Study On Subthalamic and Pallidal Stimulation in Parkinson's Disease." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 25, no. 5, 2010, pp. 578-86.
Moro E, Lozano AM, Pollak P, et al. Long-term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson's disease. Mov Disord. 2010;25(5):578-86.
Moro, E., Lozano, A. M., Pollak, P., Agid, Y., Rehncrona, S., Volkmann, J., Kulisevsky, J., Obeso, J. A., Albanese, A., Hariz, M. I., Quinn, N. P., Speelman, J. D., Benabid, A. L., Fraix, V., Mendes, A., Welter, M. L., Houeto, J. L., Cornu, P., Dormont, D., ... Lang, A. E. (2010). Long-term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson's disease. Movement Disorders : Official Journal of the Movement Disorder Society, 25(5), 578-86. https://doi.org/10.1002/mds.22735
Moro E, et al. Long-term Results of a Multicenter Study On Subthalamic and Pallidal Stimulation in Parkinson's Disease. Mov Disord. 2010 Apr 15;25(5):578-86. PubMed PMID: 20213817.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson's disease. AU - Moro,Elena, AU - Lozano,Andres M, AU - Pollak,Pierre, AU - Agid,Yves, AU - Rehncrona,Stig, AU - Volkmann,Jens, AU - Kulisevsky,Jaime, AU - Obeso,Jose A, AU - Albanese,Alberto, AU - Hariz,Marwan I, AU - Quinn,Niall P, AU - Speelman,Jans D, AU - Benabid,Alim L, AU - Fraix,Valerie, AU - Mendes,Alexandre, AU - Welter,Marie-Laure, AU - Houeto,Jean-Luc, AU - Cornu,Philippe, AU - Dormont,Didier, AU - Tornqvist,Annalena L, AU - Ekberg,Ron, AU - Schnitzler,Alfons, AU - Timmermann,Lars, AU - Wojtecki,Lars, AU - Gironell,Andres, AU - Rodriguez-Oroz,Maria C, AU - Guridi,Jorge, AU - Bentivoglio,Anna R, AU - Contarino,Maria F, AU - Romito,Luigi, AU - Scerrati,Massimo, AU - Janssens,Marc, AU - Lang,Anthony E, PY - 2010/3/10/entrez PY - 2010/3/10/pubmed PY - 2010/7/24/medline SP - 578 EP - 86 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 25 IS - 5 N2 - We report the 5 to 6 year follow-up of a multicenter study of bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) in advanced Parkinson's disease (PD) patients. Thirty-five STN patients and 16 GPi patients were assessed at 5 to 6 years after DBS surgery. Primary outcome measure was the stimulation effect on the motor Unified Parkinson's Disease Rating Scale (UPDRS) assessed with a prospective cross-over double-blind assessment without medications (stimulation was randomly switched on or off). Secondary outcomes were motor UPDRS changes with unblinded assessments in off- and on-medication states with and without stimulation, activities of daily living (ADL), anti-PD medications, and dyskinesias. In double-blind assessment, both STN and GPi DBS were significantly effective in improving the motor UPDRS scores (STN, P < 0.0001, 45.4%; GPi, P = 0.008, 20.0%) compared with off-stimulation, regardless of the sequence of stimulation. In open assessment, both STN- and GPi-DBS significantly improved the off-medication motor UPDRS when compared with before surgery (STN, P < 0.001, 50.5%; GPi, P = 0.002, 35.6%). Dyskinesias and ADL were significantly improved in both groups. Anti-PD medications were significantly reduced only in the STN group. Adverse events were more frequent in the STN group. These results confirm the long-term efficacy of STN and GPi DBS in advanced PD. Although the surgical targets were not randomized, there was a trend to a better outcome of motor signs in the STN-DBS patients and fewer adverse events in the GPi-DBS group. SN - 1531-8257 UR - https://www.unboundmedicine.com/medline/citation/20213817/Long_term_results_of_a_multicenter_study_on_subthalamic_and_pallidal_stimulation_in_Parkinson's_disease_ L2 - https://doi.org/10.1002/mds.22735 DB - PRIME DP - Unbound Medicine ER -