Deep Brain Stimulation in Parkinson Disease: A Switch for On/Off Dystonia.

Autor: Lo Faso V; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy. Electronic address: valeria.lofaso@unimi.it., Schisano L; Unit of Neurosurgery, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy., Remore LG; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy., Tariciotti L; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy., Fiore G; Unit of Neurosurgery, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy., Valcamonica G; Unit of Neurology, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Unit of Neurology, ASST Ovest Milanese, Legnano, Italy., Borellini L; Unit of Neurology, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy., Cogiamanian F; Unit of Neurology, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy., D'Ammando A; Unit of Neurosurgery, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy., Pirola E; Unit of Neurosurgery, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy., Ampollini A; Unit of Neurosurgery, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy., Marfia G; Unit of Neurosurgery, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy; Unit of Pathology, Aerospace Medical Institute 'A. Mosso', Italian Air Force Medical Corps, Milan, Italy., Locatelli M; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy; Unit of Neurosurgery, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2024 Dec 06, pp. 123438. Date of Electronic Publication: 2024 Dec 06.
DOI: 10.1016/j.wneu.2024.11.021
Abstrakt: Background: Dystonia is common in Parkinson disease patients, affecting about 30% of them. Bilateral subthalamic nucleus deep brain stimulation (DBS) can sometimes lead to dystonia, but this relationship is not well understood. Our aim was to provide a better understanding of dystonia's causes and its connection to DBS.
Methods: We conducted a retrospective analysis of clinical data from 80 Parkinson disease patients who underwent bilateral subthalamic nucleus stimulation, focusing on dystonia before and after surgery and its relation to medication state (on-dystonia/off-dystonia).
Results: After DBS, off-dystonia had a higher recovery rate than on-dystonia (43.5% vs. 9.1%). Among patients suffering for on-dystonia, 74.4% had it for the first time after surgery; these patients assumed higher doses of levodopa before DBS.
Conclusions: Patients with off-dystonia before surgery tend to improve after DBS. Otherwise, DBS could have the role of "additive boost" in the process of sensitization of striato-pallidal pathways and lead to on-dystonia in particular patients.
(Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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