Article
Predictors of effective bilateral subthalamic nucleus stimulation for PD.
Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France.
Neurology (impact factor:
8.31).
10/2002;
59(6):932-4.
pp.932-4
Source: PubMed
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Citations (0)
- Cited In (7)
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Article: Levodopa and subthalamic deep brain stimulation responses are not congruent.
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ABSTRACT: There is a consensus that in Parkinson's disease, the extent of preoperative levodopa responsiveness predicts the efficacy of subthalamic nucleus deep brain stimulation (STN DBS). However, this may be the result of statistical methods and primary assumptions. We were able to reproduce previously published correlation results on our data (N = 49 patients). Yet, these same results were demonstrated even after random shuffling of our data. Notably, we did not observe a correlation between STN DBS efficacy and preoperative levodopa responsiveness when using their respective baselines and fractional scores of motor improvement. Furthermore, postoperative responses were not limited by preoperative scores, with tremor demonstrating the greatest discrepancy. We conclude that preoperative levodopa responsiveness does not predict or limit the outcome of STN DBS. These results imply different therapeutic mechanisms for levodopa and STN DBS and therefore question the validity of using substantial preoperative levodopa responsiveness as a selection criterion for STN DBS.Movement Disorders 10/2010; 25(14):2379-86. · 4.51 Impact Factor -
Article: Available and emerging treatments for Parkinson's disease: a review.
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ABSTRACT: Parkinson's disease is a commonly encountered neurodegenerative disorder primarily found in aged populations. A number of medications are available to control symptoms, although these are less effective in advanced disease. Deep brain stimulation provides a practicable alternative at this stage, although a minority of patients meet the strict criteria for surgery. Novel medications that provide enhanced symptomatic control remain in developmental demand. Both gene and cell-based therapies have shown promise in early clinical studies. A major unmet need is a treatment that slows or stops disease progression.Drug Design, Development and Therapy 01/2011; 5:241-54. · 2.88 Impact Factor -
Article: Motor improvement with bilateral subthalamic nucleus deep brain stimulation in a patient with levodopa-responsive secondary parkinsonism.
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ABSTRACT: At many centers, subthalamic nucleus (STN) deep brain stimulation (DBS) is not considered for patients with secondary forms of parkinsonism, due to higher expected rates of treatment failure. We present the case of a woman with secondary parkinsonism that developed following a Measles, Mumps, and Rubella (MMR) vaccination, who experienced sustained improvement in motor function following STN DBS. Despite the diagnosis of a secondary parkinsonism, this patient responded well to dopaminergic therapy, a good predictor of DBS outcome in patients with idiopathic Parkinson's disease. This case suggests that DBS may be considered in the setting of secondary parkinsonism if such patients have levodopa-responsive symptoms.Parkinsonism & Related Disorders 09/2011; 18(1):79-81. · 3.80 Impact Factor
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Keywords
bilateral STN stimulation
effective bilateral subthalamic nucleus
factors predictive
individual PD symptoms
levodopa responsiveness
postoperative Unified PD Rating Scale
pre-
suprathreshold dose levodopa challenge
Younger age