Anti-cholinergics for axial symptoms in Parkinson's disease after subthalamic stimulation
Abstract Objective We studied the effect of anti-cholinergic therapy on axial symptoms that show a tendency to worsen over time after deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson's disease (PD). Patients and methods We conducted a prospective study of 2...
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| Veröffentlicht in: | Clinical neurology and neurosurgery 2012-12, Vol.114 (10), p.1308-1311 |
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| creator | Baba, Yasuhiko Higuchi, Masa-aki Abe, Hiroshi Fukuyama, Kouzou Onozawa, Rieko Uehara, Yoshinari Inoue, Tooru Yamada, Tatsuo |
| description | Abstract Objective We studied the effect of anti-cholinergic therapy on axial symptoms that show a tendency to worsen over time after deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson's disease (PD). Patients and methods We conducted a prospective study of 20 consecutive patients treated with the anti-cholinergic agent trihexyphenidyl after bilateral STN-DBS and assessed the effect of anti-cholinergic therapy on parkinsonism 1 month after its initiation using the Unified Parkinson's Disease Rating Scale (UPDRS). Results After a mean post-operative follow-up period of 22.3 months, the scores of axial symptoms on UPDRS part II (ADL score) and part III (motor score) deteriorated by 87% and 54% (baseline), respectively, compared with the pre-operative scores ( P < 0.001 for both comparisons). After adding trihexyphenidyl to dopaminergic medication with stimulation, the scores of axial symptoms on UPDRS part II and part III improved from baseline by 33% and 39%, respectively ( P < 0.001 for both comparisons). Conclusions Our findings demonstrated that the anti-cholinergic agent trihexyphenidyl shows positive effect for a patient population developing deterioration of axial symptoms after STN-DBS. The results in the present study may provide insights into the mechanism of emergence or progression of axial symptoms in patients with PD after STN-DBS. |
| doi_str_mv | 10.1016/j.clineuro.2012.03.046 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1272717169</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0303846712002119</els_id><sourcerecordid>1151706005</sourcerecordid><originalsourceid>FETCH-LOGICAL-c613t-c59398765cd2720a67535b740529539f64ef91b18e179b1c78b85159daa3b3303</originalsourceid><addsrcrecordid>eNqFkk9v1DAQxSMEokvhK1SREIJLwkwc28kFUVX8kyqBBBw4WY7jUG8Te_EkiP32OOyWSr30NJffe57nN1l2hlAioHi9Lc3ovF1iKCvAqgRWQi0eZBtsZFWIVjQPsw0wYEVTC3mSPSHaAgBjonmcnVQVR1Ej32Q_zv3sCnMVVrf40xnKhxBz_cfpMaf9tJvDRLnz-Rcdr52n4F9S3juymmyuh9nGnJZuvtKjnpzJaXbTMurZBf80ezTokeyz4zzNvr9_9-3iY3H5-cOni_PLwghkc2F4y9pGCm76SlagheSMd7IGXrWctYOo7dBih41F2XZoZNM1HHnba806lgKeZq8OvrsYfi2WZjU5MnYctbdhIYXJVqJE0d6PIkcJAoAn9PkddBuW6FOQfxRIxoVMlDhQJgaiaAe1i27Sca8Q1NqT2qqbntTakwKmUk9JeHa0X7rJ9v9lN8Uk4MUR0GT0OETtjaNbTggOTK7p3x44m774t7NRkXHWG9u7aM2s-uDu3-XNHYsVc-nVa7u3dJtbUdKor-tVrUeFFUCF2LK_GlTHbQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1151073567</pqid></control><display><type>article</type><title>Anti-cholinergics for axial symptoms in Parkinson's disease after subthalamic stimulation</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Baba, Yasuhiko ; Higuchi, Masa-aki ; Abe, Hiroshi ; Fukuyama, Kouzou ; Onozawa, Rieko ; Uehara, Yoshinari ; Inoue, Tooru ; Yamada, Tatsuo</creator><creatorcontrib>Baba, Yasuhiko ; Higuchi, Masa-aki ; Abe, Hiroshi ; Fukuyama, Kouzou ; Onozawa, Rieko ; Uehara, Yoshinari ; Inoue, Tooru ; Yamada, Tatsuo</creatorcontrib><description>Abstract Objective We studied the effect of anti-cholinergic therapy on axial symptoms that show a tendency to worsen over time after deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson's disease (PD). Patients and methods We conducted a prospective study of 20 consecutive patients treated with the anti-cholinergic agent trihexyphenidyl after bilateral STN-DBS and assessed the effect of anti-cholinergic therapy on parkinsonism 1 month after its initiation using the Unified Parkinson's Disease Rating Scale (UPDRS). Results After a mean post-operative follow-up period of 22.3 months, the scores of axial symptoms on UPDRS part II (ADL score) and part III (motor score) deteriorated by 87% and 54% (baseline), respectively, compared with the pre-operative scores ( P < 0.001 for both comparisons). After adding trihexyphenidyl to dopaminergic medication with stimulation, the scores of axial symptoms on UPDRS part II and part III improved from baseline by 33% and 39%, respectively ( P < 0.001 for both comparisons). Conclusions Our findings demonstrated that the anti-cholinergic agent trihexyphenidyl shows positive effect for a patient population developing deterioration of axial symptoms after STN-DBS. The results in the present study may provide insights into the mechanism of emergence or progression of axial symptoms in patients with PD after STN-DBS.</description><identifier>ISSN: 0303-8467</identifier><identifier>EISSN: 1872-6968</identifier><identifier>DOI: 10.1016/j.clineuro.2012.03.046</identifier><identifier>PMID: 22516415</identifier><identifier>CODEN: CNNSBV</identifier><language>eng</language><publisher>Amsterdam: Elsevier B.V</publisher><subject>Activities of Daily Living ; Aged ; Axial symptoms ; Basal ganglia ; Biological and medical sciences ; Central nervous system diseases ; Cholinergic Antagonists - therapeutic use ; Deep brain stimulation ; Deep Brain Stimulation - methods ; Dopamine ; Electrical stimuli ; Female ; Hospitals ; Humans ; Hypotheses ; Male ; Medical sciences ; Middle Aged ; Movement disorders ; Neurodegenerative diseases ; Neurology ; Neurosurgery ; Parkinson Disease - drug therapy ; Parkinson Disease - therapy ; Parkinson's disease ; Posture ; Prospective Studies ; Subthalamic Nucleus ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Treatment Outcome ; Trihexyphenidyl ; Trihexyphenidyl - therapeutic use</subject><ispartof>Clinical neurology and neurosurgery, 2012-12, Vol.114 (10), p.1308-1311</ispartof><rights>Elsevier B.V.</rights><rights>2012 Elsevier B.V.</rights><rights>2014 INIST-CNRS</rights><rights>Copyright © 2012 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c613t-c59398765cd2720a67535b740529539f64ef91b18e179b1c78b85159daa3b3303</citedby><cites>FETCH-LOGICAL-c613t-c59398765cd2720a67535b740529539f64ef91b18e179b1c78b85159daa3b3303</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0303846712002119$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26650370$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22516415$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baba, Yasuhiko</creatorcontrib><creatorcontrib>Higuchi, Masa-aki</creatorcontrib><creatorcontrib>Abe, Hiroshi</creatorcontrib><creatorcontrib>Fukuyama, Kouzou</creatorcontrib><creatorcontrib>Onozawa, Rieko</creatorcontrib><creatorcontrib>Uehara, Yoshinari</creatorcontrib><creatorcontrib>Inoue, Tooru</creatorcontrib><creatorcontrib>Yamada, Tatsuo</creatorcontrib><title>Anti-cholinergics for axial symptoms in Parkinson's disease after subthalamic stimulation</title><title>Clinical neurology and neurosurgery</title><addtitle>Clin Neurol Neurosurg</addtitle><description>Abstract Objective We studied the effect of anti-cholinergic therapy on axial symptoms that show a tendency to worsen over time after deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson's disease (PD). Patients and methods We conducted a prospective study of 20 consecutive patients treated with the anti-cholinergic agent trihexyphenidyl after bilateral STN-DBS and assessed the effect of anti-cholinergic therapy on parkinsonism 1 month after its initiation using the Unified Parkinson's Disease Rating Scale (UPDRS). Results After a mean post-operative follow-up period of 22.3 months, the scores of axial symptoms on UPDRS part II (ADL score) and part III (motor score) deteriorated by 87% and 54% (baseline), respectively, compared with the pre-operative scores ( P < 0.001 for both comparisons). After adding trihexyphenidyl to dopaminergic medication with stimulation, the scores of axial symptoms on UPDRS part II and part III improved from baseline by 33% and 39%, respectively ( P < 0.001 for both comparisons). Conclusions Our findings demonstrated that the anti-cholinergic agent trihexyphenidyl shows positive effect for a patient population developing deterioration of axial symptoms after STN-DBS. The results in the present study may provide insights into the mechanism of emergence or progression of axial symptoms in patients with PD after STN-DBS.</description><subject>Activities of Daily Living</subject><subject>Aged</subject><subject>Axial symptoms</subject><subject>Basal ganglia</subject><subject>Biological and medical sciences</subject><subject>Central nervous system diseases</subject><subject>Cholinergic Antagonists - therapeutic use</subject><subject>Deep brain stimulation</subject><subject>Deep Brain Stimulation - methods</subject><subject>Dopamine</subject><subject>Electrical stimuli</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypotheses</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Movement disorders</subject><subject>Neurodegenerative diseases</subject><subject>Neurology</subject><subject>Neurosurgery</subject><subject>Parkinson Disease - drug therapy</subject><subject>Parkinson Disease - therapy</subject><subject>Parkinson's disease</subject><subject>Posture</subject><subject>Prospective Studies</subject><subject>Subthalamic Nucleus</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. 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Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Treatment Outcome</topic><topic>Trihexyphenidyl</topic><topic>Trihexyphenidyl - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baba, Yasuhiko</creatorcontrib><creatorcontrib>Higuchi, Masa-aki</creatorcontrib><creatorcontrib>Abe, Hiroshi</creatorcontrib><creatorcontrib>Fukuyama, Kouzou</creatorcontrib><creatorcontrib>Onozawa, Rieko</creatorcontrib><creatorcontrib>Uehara, Yoshinari</creatorcontrib><creatorcontrib>Inoue, Tooru</creatorcontrib><creatorcontrib>Yamada, Tatsuo</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical neurology and neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baba, Yasuhiko</au><au>Higuchi, Masa-aki</au><au>Abe, Hiroshi</au><au>Fukuyama, Kouzou</au><au>Onozawa, Rieko</au><au>Uehara, Yoshinari</au><au>Inoue, Tooru</au><au>Yamada, Tatsuo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anti-cholinergics for axial symptoms in Parkinson's disease after subthalamic stimulation</atitle><jtitle>Clinical neurology and neurosurgery</jtitle><addtitle>Clin Neurol Neurosurg</addtitle><date>2012-12-01</date><risdate>2012</risdate><volume>114</volume><issue>10</issue><spage>1308</spage><epage>1311</epage><pages>1308-1311</pages><issn>0303-8467</issn><eissn>1872-6968</eissn><coden>CNNSBV</coden><abstract>Abstract Objective We studied the effect of anti-cholinergic therapy on axial symptoms that show a tendency to worsen over time after deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with Parkinson's disease (PD). Patients and methods We conducted a prospective study of 20 consecutive patients treated with the anti-cholinergic agent trihexyphenidyl after bilateral STN-DBS and assessed the effect of anti-cholinergic therapy on parkinsonism 1 month after its initiation using the Unified Parkinson's Disease Rating Scale (UPDRS). Results After a mean post-operative follow-up period of 22.3 months, the scores of axial symptoms on UPDRS part II (ADL score) and part III (motor score) deteriorated by 87% and 54% (baseline), respectively, compared with the pre-operative scores ( P < 0.001 for both comparisons). After adding trihexyphenidyl to dopaminergic medication with stimulation, the scores of axial symptoms on UPDRS part II and part III improved from baseline by 33% and 39%, respectively ( P < 0.001 for both comparisons). Conclusions Our findings demonstrated that the anti-cholinergic agent trihexyphenidyl shows positive effect for a patient population developing deterioration of axial symptoms after STN-DBS. The results in the present study may provide insights into the mechanism of emergence or progression of axial symptoms in patients with PD after STN-DBS.</abstract><cop>Amsterdam</cop><pub>Elsevier B.V</pub><pmid>22516415</pmid><doi>10.1016/j.clineuro.2012.03.046</doi><tpages>4</tpages></addata></record> |
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| subjects | Activities of Daily Living Aged Axial symptoms Basal ganglia Biological and medical sciences Central nervous system diseases Cholinergic Antagonists - therapeutic use Deep brain stimulation Deep Brain Stimulation - methods Dopamine Electrical stimuli Female Hospitals Humans Hypotheses Male Medical sciences Middle Aged Movement disorders Neurodegenerative diseases Neurology Neurosurgery Parkinson Disease - drug therapy Parkinson Disease - therapy Parkinson's disease Posture Prospective Studies Subthalamic Nucleus Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Treatment Outcome Trihexyphenidyl Trihexyphenidyl - therapeutic use |
| title | Anti-cholinergics for axial symptoms in Parkinson's disease after subthalamic stimulation |
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