Staged bilateral deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson’s disease
| Autor: | Yoshiki Kaneoke, Takafumi Tanei, Daisuke Nakatsubo, Yasukazu Kajita, Toshihiko Wakabayashi, Shigenori Takebayashi |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Deep brain stimulation Neurology Parkinson's disease Deep Brain Stimulation medicine.medical_treatment Risk Assessment Functional Laterality Antiparkinson Agents Postoperative Complications Subthalamic Nucleus Neural Pathways Outcome Assessment Health Care medicine Humans Age of Onset Aged Retrospective Studies Neuroradiology Dose-Response Relationship Drug medicine.diagnostic_test business.industry Brain Parkinson Disease Interventional radiology Recovery of Function Middle Aged medicine.disease nervous system diseases Surgery Subthalamic nucleus Treatment Outcome surgical procedures operative nervous system Anesthesia Female Neurology (clinical) Neurosurgery business therapeutics |
| Zdroj: | Acta Neurochirurgica. 151:589-594 |
| ISSN: | 0942-0940 0001-6268 |
| DOI: | 10.1007/s00701-009-0293-6 |
| Popis: | Several investigators have described the efficacy and safety of unilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) for the treatment of Parkinson's disease (PD). Some patients who underwent unilateral STN DBS required additional surgery on the contralateral side because the unilateral treatment was insufficient. The goal of this study was to assess the efficacy and safety of staged bilateral STN DBS compared to the simultaneous bilateral procedure.Ten patients with medically intractable PD underwent staged bilateral STN DBS, and 12 patients underwent a simultaneous bilateral procedure. Clinical assessments were performed preoperatively and 6 months after the last surgery using the Unified Parkinson's Disease Rating Scale (UPDRS), motor and activity of daily living (ADL) subscores, and Hoehn and Yahr stages.Both the staged and simultaneous groups experienced significant improvement in the UPDRS motor and ADL scores, and the Hoehn and Yahr stages. There were no statistical differences between the two groups in the percent improvement in UPDRS scores. The rate of adverse events in the staged group (20%) was less than that of the simultaneous group (42%), although the difference was not statistically significant.Both the staged bilateral STN DBS and the simultaneous bilateral procedure are effective and safe treatment options, but the staged bilateral procedure may be regarded as the preferred choice for the treatment of some patients. |
| Databáze: | OpenAIRE |
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