Long-Term Results of a Multicenter Study on Subthalamic and Pallidal Stimulation in Parkinson's Disease

Elena Moro; Andres M. Lozano; Pierre Pollak; Yves Agid; Stig Rehncrona; Jens Volkmann; Jaime Kulisevsky; Jose A. Obeso; Alberto Albanese; Marwan I. Hariz; Niall P. Quinn; Jans D. Speelman; Alim L. Benabid; Valerie Fraix; Alexandre Mendes; Marie-Laure Welter; Jean-Luc Houeto; Philippe Cornu; Didier Dormont; Anna Lena Törnqvist; Ron Ekberg; Alfons Schnitzler; Lars Timmermann; Lars Wojtecki; Andres Gironell; Maria C. Rodriguez-Oroz; Jorge Guridi; Anna R. Bentivoglio; Maria F. Contarino; Luigi Romito; Massimo Scerrati; Marc Janssens; Anthony E. Lang

doi:10.1002/mds.22735

Long-Term Results of a Multicenter Study on Subthalamic and Pallidal Stimulation in Parkinson's Disease

Elena Moro, Andres M. Lozano, Pierre Pollak, Yves Agid, Stig Rehncrona, Jens Volkmann, Jaime Kulisevsky, Jose A. Obeso, Alberto Albanese, Marwan I. Hariz, Niall P. Quinn, Jans D. Speelman, Alim L. Benabid, Valerie Fraix, Alexandre Mendes, Marie-Laure Welter, Jean-Luc Houeto, Philippe Cornu, Didier Dormont, Anna Lena TörnqvistRon Ekberg, Alfons Schnitzler, Lars Timmermann, Lars Wojtecki, Andres Gironell, Maria C. Rodriguez-Oroz, Jorge Guridi, Anna R. Bentivoglio, Maria F. Contarino, Luigi Romito, Massimo Scerrati, Marc Janssens, Anthony E. Lang

Neurosurgery

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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-live STN patients and 16 GPi patienis 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 of 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 advanced PD. Although the surgical targets were not randomized, there was a trend to 1 better outcome of motor signs in the STN-DBS patients and fewer adverse events in the GPi-DBS group. (C) 2010 Movement Disorder Society

Original language	English
Pages (from-to)	578-586
Journal	Movement Disorders
Volume	25
Issue number	5
DOIs	https://doi.org/10.1002/mds.22735
Publication status	Published - 2010

Subject classification (UKÄ)

Neurology

Free keywords

subthalamic nucleus
globus pallidus internus
Parkinson's disease
deep brain stimulation

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10.1002/mds.22735

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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, 25(5), 578-586. https://doi.org/10.1002/mds.22735

@article{d79dc53a7e1c4c8fa929351867001264,

title = "Long-Term Results of a Multicenter Study on Subthalamic and Pallidal Stimulation in Parkinson's Disease",

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-live STN patients and 16 GPi patienis 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 of 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 advanced PD. Although the surgical targets were not randomized, there was a trend to 1 better outcome of motor signs in the STN-DBS patients and fewer adverse events in the GPi-DBS group. (C) 2010 Movement Disorder Society",

keywords = "subthalamic nucleus, globus pallidus internus, Parkinson's disease, deep brain stimulation",

author = "Elena Moro and Lozano, {Andres M.} and Pierre Pollak and Yves Agid and Stig Rehncrona and Jens Volkmann and Jaime Kulisevsky and Obeso, {Jose A.} and Alberto Albanese and Hariz, {Marwan I.} and Quinn, {Niall P.} and Speelman, {Jans D.} and Benabid, {Alim L.} and Valerie Fraix and Alexandre Mendes and Marie-Laure Welter and Jean-Luc Houeto and Philippe Cornu and Didier Dormont and T{\"o}rnqvist, {Anna Lena} and Ron Ekberg and Alfons Schnitzler and Lars Timmermann and Lars Wojtecki and Andres Gironell and Rodriguez-Oroz, {Maria C.} and Jorge Guridi and Bentivoglio, {Anna R.} and Contarino, {Maria F.} and Luigi Romito and Massimo Scerrati and Marc Janssens and Lang, {Anthony E.}",

year = "2010",

doi = "10.1002/mds.22735",

language = "English",

volume = "25",

pages = "578--586",

journal = "Movement Disorders",

issn = "0885-3185",

publisher = "John Wiley & Sons Inc.",

number = "5",

}

Moro, E, Lozano, AM, Pollak, P, Agid, Y, Rehncrona, S, Volkmann, J, Kulisevsky, J, Obeso, JA, Albanese, A, Hariz, MI, Quinn, NP, Speelman, JD, Benabid, AL, Fraix, V, Mendes, A, Welter, M-L, Houeto, J-L, Cornu, P, Dormont, D, Törnqvist, AL, Ekberg, R, Schnitzler, A, Timmermann, L, Wojtecki, L, Gironell, A, Rodriguez-Oroz, MC, Guridi, J, Bentivoglio, AR, Contarino, MF, Romito, L, Scerrati, M, Janssens, M & Lang, AE 2010, 'Long-Term Results of a Multicenter Study on Subthalamic and Pallidal Stimulation in Parkinson's Disease', Movement Disorders, vol. 25, no. 5, pp. 578-586. https://doi.org/10.1002/mds.22735

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 - Törnqvist, Anna Lena

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

Y1 - 2010

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-live STN patients and 16 GPi patienis 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 of 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 advanced PD. Although the surgical targets were not randomized, there was a trend to 1 better outcome of motor signs in the STN-DBS patients and fewer adverse events in the GPi-DBS group. (C) 2010 Movement Disorder Society

AB - 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-live STN patients and 16 GPi patienis 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 of 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 advanced PD. Although the surgical targets were not randomized, there was a trend to 1 better outcome of motor signs in the STN-DBS patients and fewer adverse events in the GPi-DBS group. (C) 2010 Movement Disorder Society

KW - subthalamic nucleus

KW - globus pallidus internus

KW - Parkinson's disease

KW - deep brain stimulation

U2 - 10.1002/mds.22735

DO - 10.1002/mds.22735

M3 - Article

C2 - 20213817

SN - 0885-3185

VL - 25

SP - 578

EP - 586

JO - Movement Disorders

JF - Movement Disorders

IS - 5

ER -

Long-Term Results of a Multicenter Study on Subthalamic and Pallidal Stimulation in Parkinson's Disease

Abstract

Subject classification (UKÄ)

Free keywords

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