Unilateral pallidotomy for Parkinson’s disease: results after more than 1 year
OBJECTIVE To examine follow up results of unilateral ventral medial pallidotomy in 22 patients with advanced Parkinson’s disease more than 1 year after the operation in comparison with their results (previously reported) at 3 months. METHODS Twenty patients who had undergone unilateral pallidotomy w...
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| Veröffentlicht in: | Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 1999-10, Vol.67 (4), p.511-517 |
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| container_title | Journal of neurology, neurosurgery and psychiatry |
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| creator | Schrag, A Samuel, M Caputo, E Scaravilli, T Troyer, M Marsden, C D Thomas, D G T Lees, A J Brooks, D J Quinn, N P |
| description | OBJECTIVE To examine follow up results of unilateral ventral medial pallidotomy in 22 patients with advanced Parkinson’s disease more than 1 year after the operation in comparison with their results (previously reported) at 3 months. METHODS Twenty patients who had undergone unilateral pallidotomy were assessed with the core assessment programme for intracerebral transplantation (CAPIT) protocol preoperatively, at 3 months postoperatively, and again after a median postoperative follow up of 14 months. Two further patients had only one evaluation 3 months postoperatively. RESULTS The reduction of contralateral dyskinesias (median 67%) at 3 months was slightly attenuated after 1 year to 55% (both p |
| doi_str_mv | 10.1136/jnnp.67.4.511 |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_1736584</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4025646821</sourcerecordid><originalsourceid>FETCH-LOGICAL-b511t-405764a1d531ac3395de6ae61abf056b685dc22f00ea63874d75db82930a6ce13</originalsourceid><addsrcrecordid>eNqFkc9uEzEQxi0EomnhyBVZAlVcNtjrfxsOSCiCghSgErRUXKzZXS918NrB3kXNjdfg9fokdUjUFi7MZQ7z8zff-EPoESVTSpl8vvR-NZVqyqeC0jtoQrmsCsbI2V00IaQsC0YE2UP7KS3JpqrZfbRHCa8kJ2SCjk-8dTCYCA6vwDnbhiH0a9yFiI8hfrc-BX_563fCrU0GknmBo0mjGxKGLj_DfYgGD-fgMcVrA_EButeBS-bhrh-gkzevP8_fFouPR-_mrxZFnX0OBSdCSQ60FYxCw9hMtEaCkRTqjghZy0q0TVl2hBiQrFK8VaKtq3LGCMjGUHaAXm51V2Pdm7Yxfsg36FW0PcS1DmD13xNvz_W38FNTxaSoeBY43AnE8GM0adC9TY1xDrwJY9KKEC6Ukhl88g-4DGP0-bisVVFBhfhDFVuqiSGlaLprK5ToTVJ6k5SWSnOdfyDzj2_7v0Vvo8nA0x0AqQHXRfCNTTfcjDHK-M1emwZzcT3O0eVdTAn94XSuP50Jdvpl8VW_z_yzLV_3y_9YvALjtbnn</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1781515576</pqid></control><display><type>article</type><title>Unilateral pallidotomy for Parkinson’s disease: results after more than 1 year</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Schrag, A ; Samuel, M ; Caputo, E ; Scaravilli, T ; Troyer, M ; Marsden, C D ; Thomas, D G T ; Lees, A J ; Brooks, D J ; Quinn, N P</creator><creatorcontrib>Schrag, A ; Samuel, M ; Caputo, E ; Scaravilli, T ; Troyer, M ; Marsden, C D ; Thomas, D G T ; Lees, A J ; Brooks, D J ; Quinn, N P</creatorcontrib><description><![CDATA[OBJECTIVE To examine follow up results of unilateral ventral medial pallidotomy in 22 patients with advanced Parkinson’s disease more than 1 year after the operation in comparison with their results (previously reported) at 3 months. METHODS Twenty patients who had undergone unilateral pallidotomy were assessed with the core assessment programme for intracerebral transplantation (CAPIT) protocol preoperatively, at 3 months postoperatively, and again after a median postoperative follow up of 14 months. Two further patients had only one evaluation 3 months postoperatively. RESULTS The reduction of contralateral dyskinesias (median 67%) at 3 months was slightly attenuated after 1 year to 55% (both p<0.001 compared with baseline). A less pronounced effect on ipsilateral and axial dyskinesias decreased from 39% to 33% (p<0.005 and p<0.01), and from 50% to 12.5% (p<0.001 and p<0.01), respectively. However, there was no significant change between the 3 month and the follow up assessment. The modest improvement of the contralateral unified Parkinson’s disease rating scale (UPDRS) motor score in the “off” state remained improved compared with preoperative levels, but less significantly (26%, p<0.001, and 18%, p<0.01). The activities of daily living (ADL) subscore of the UPDRS in the off state remained improved with median changes of 23% and 22% at follow up (both p<0.005). There was no significant improvement of “on” state or ipsilateral off state motor scores. Median modified Hoehn and Yahr scores in off and on state were unchanged, as was the time spent off. Speech in off had significantly deteriorated by 1 year after the operation. CONCLUSIONS The beneficial effects of unilateral pallidotomy persist for at least 12 months and, dyskinesias are most responsive to this procedure.]]></description><identifier>ISSN: 0022-3050</identifier><identifier>EISSN: 1468-330X</identifier><identifier>DOI: 10.1136/jnnp.67.4.511</identifier><identifier>PMID: 10486400</identifier><identifier>CODEN: JNNPAU</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd</publisher><subject>Adult ; adverse events ; Aged ; Biological and medical sciences ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Disability Evaluation ; Follow-Up Studies ; Functional Laterality ; Globus Pallidus - surgery ; Hospitals ; Humans ; Medical sciences ; Middle Aged ; Mortality ; Neurology ; Neurosurgery ; pallidotomy ; Parkinson Disease - physiopathology ; Parkinson Disease - surgery ; Parkinson's disease ; Prognosis ; Surgery ; Time Factors ; treatment</subject><ispartof>Journal of neurology, neurosurgery and psychiatry, 1999-10, Vol.67 (4), p.511-517</ispartof><rights>Journal of Neurology, Neurosurgery, and Psychiatry</rights><rights>1999 INIST-CNRS</rights><rights>Copyright: 1999 Journal of Neurology, Neurosurgery, and Psychiatry</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b511t-405764a1d531ac3395de6ae61abf056b685dc22f00ea63874d75db82930a6ce13</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1736584/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1736584/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1933134$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10486400$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schrag, A</creatorcontrib><creatorcontrib>Samuel, M</creatorcontrib><creatorcontrib>Caputo, E</creatorcontrib><creatorcontrib>Scaravilli, T</creatorcontrib><creatorcontrib>Troyer, M</creatorcontrib><creatorcontrib>Marsden, C D</creatorcontrib><creatorcontrib>Thomas, D G T</creatorcontrib><creatorcontrib>Lees, A J</creatorcontrib><creatorcontrib>Brooks, D J</creatorcontrib><creatorcontrib>Quinn, N P</creatorcontrib><title>Unilateral pallidotomy for Parkinson’s disease: results after more than 1 year</title><title>Journal of neurology, neurosurgery and psychiatry</title><addtitle>J Neurol Neurosurg Psychiatry</addtitle><description><![CDATA[OBJECTIVE To examine follow up results of unilateral ventral medial pallidotomy in 22 patients with advanced Parkinson’s disease more than 1 year after the operation in comparison with their results (previously reported) at 3 months. METHODS Twenty patients who had undergone unilateral pallidotomy were assessed with the core assessment programme for intracerebral transplantation (CAPIT) protocol preoperatively, at 3 months postoperatively, and again after a median postoperative follow up of 14 months. Two further patients had only one evaluation 3 months postoperatively. RESULTS The reduction of contralateral dyskinesias (median 67%) at 3 months was slightly attenuated after 1 year to 55% (both p<0.001 compared with baseline). A less pronounced effect on ipsilateral and axial dyskinesias decreased from 39% to 33% (p<0.005 and p<0.01), and from 50% to 12.5% (p<0.001 and p<0.01), respectively. However, there was no significant change between the 3 month and the follow up assessment. The modest improvement of the contralateral unified Parkinson’s disease rating scale (UPDRS) motor score in the “off” state remained improved compared with preoperative levels, but less significantly (26%, p<0.001, and 18%, p<0.01). The activities of daily living (ADL) subscore of the UPDRS in the off state remained improved with median changes of 23% and 22% at follow up (both p<0.005). There was no significant improvement of “on” state or ipsilateral off state motor scores. Median modified Hoehn and Yahr scores in off and on state were unchanged, as was the time spent off. Speech in off had significantly deteriorated by 1 year after the operation. CONCLUSIONS The beneficial effects of unilateral pallidotomy persist for at least 12 months and, dyskinesias are most responsive to this procedure.]]></description><subject>Adult</subject><subject>adverse events</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Disability Evaluation</subject><subject>Follow-Up Studies</subject><subject>Functional Laterality</subject><subject>Globus Pallidus - surgery</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neurology</subject><subject>Neurosurgery</subject><subject>pallidotomy</subject><subject>Parkinson Disease - physiopathology</subject><subject>Parkinson Disease - surgery</subject><subject>Parkinson's disease</subject><subject>Prognosis</subject><subject>Surgery</subject><subject>Time Factors</subject><subject>treatment</subject><issn>0022-3050</issn><issn>1468-330X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkc9uEzEQxi0EomnhyBVZAlVcNtjrfxsOSCiCghSgErRUXKzZXS918NrB3kXNjdfg9fokdUjUFi7MZQ7z8zff-EPoESVTSpl8vvR-NZVqyqeC0jtoQrmsCsbI2V00IaQsC0YE2UP7KS3JpqrZfbRHCa8kJ2SCjk-8dTCYCA6vwDnbhiH0a9yFiI8hfrc-BX_563fCrU0GknmBo0mjGxKGLj_DfYgGD-fgMcVrA_EButeBS-bhrh-gkzevP8_fFouPR-_mrxZFnX0OBSdCSQ60FYxCw9hMtEaCkRTqjghZy0q0TVl2hBiQrFK8VaKtq3LGCMjGUHaAXm51V2Pdm7Yxfsg36FW0PcS1DmD13xNvz_W38FNTxaSoeBY43AnE8GM0adC9TY1xDrwJY9KKEC6Ukhl88g-4DGP0-bisVVFBhfhDFVuqiSGlaLprK5ToTVJ6k5SWSnOdfyDzj2_7v0Vvo8nA0x0AqQHXRfCNTTfcjDHK-M1emwZzcT3O0eVdTAn94XSuP50Jdvpl8VW_z_yzLV_3y_9YvALjtbnn</recordid><startdate>19991001</startdate><enddate>19991001</enddate><creator>Schrag, A</creator><creator>Samuel, M</creator><creator>Caputo, E</creator><creator>Scaravilli, T</creator><creator>Troyer, M</creator><creator>Marsden, C D</creator><creator>Thomas, D G T</creator><creator>Lees, A J</creator><creator>Brooks, D J</creator><creator>Quinn, N P</creator><general>BMJ Publishing Group Ltd</general><general>BMJ</general><general>BMJ Publishing Group LTD</general><general>BMJ Group</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19991001</creationdate><title>Unilateral pallidotomy for Parkinson’s disease: results after more than 1 year</title><author>Schrag, A ; Samuel, M ; Caputo, E ; Scaravilli, T ; Troyer, M ; Marsden, C D ; Thomas, D G T ; Lees, A J ; Brooks, D J ; Quinn, N P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b511t-405764a1d531ac3395de6ae61abf056b685dc22f00ea63874d75db82930a6ce13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adult</topic><topic>adverse events</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>Disability Evaluation</topic><topic>Follow-Up Studies</topic><topic>Functional Laterality</topic><topic>Globus Pallidus - surgery</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neurology</topic><topic>Neurosurgery</topic><topic>pallidotomy</topic><topic>Parkinson Disease - physiopathology</topic><topic>Parkinson Disease - surgery</topic><topic>Parkinson's disease</topic><topic>Prognosis</topic><topic>Surgery</topic><topic>Time Factors</topic><topic>treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schrag, A</creatorcontrib><creatorcontrib>Samuel, M</creatorcontrib><creatorcontrib>Caputo, E</creatorcontrib><creatorcontrib>Scaravilli, T</creatorcontrib><creatorcontrib>Troyer, M</creatorcontrib><creatorcontrib>Marsden, C D</creatorcontrib><creatorcontrib>Thomas, D G T</creatorcontrib><creatorcontrib>Lees, A J</creatorcontrib><creatorcontrib>Brooks, D J</creatorcontrib><creatorcontrib>Quinn, N P</creatorcontrib><collection>Istex</collection><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>Nursing & Allied Health Database</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>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>BMJ Journals</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>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Science Database</collection><collection>Nursing & Allied Health Premium</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><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of neurology, neurosurgery and psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schrag, A</au><au>Samuel, M</au><au>Caputo, E</au><au>Scaravilli, T</au><au>Troyer, M</au><au>Marsden, C D</au><au>Thomas, D G T</au><au>Lees, A J</au><au>Brooks, D J</au><au>Quinn, N P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Unilateral pallidotomy for Parkinson’s disease: results after more than 1 year</atitle><jtitle>Journal of neurology, neurosurgery and psychiatry</jtitle><addtitle>J Neurol Neurosurg Psychiatry</addtitle><date>1999-10-01</date><risdate>1999</risdate><volume>67</volume><issue>4</issue><spage>511</spage><epage>517</epage><pages>511-517</pages><issn>0022-3050</issn><eissn>1468-330X</eissn><coden>JNNPAU</coden><abstract><![CDATA[OBJECTIVE To examine follow up results of unilateral ventral medial pallidotomy in 22 patients with advanced Parkinson’s disease more than 1 year after the operation in comparison with their results (previously reported) at 3 months. METHODS Twenty patients who had undergone unilateral pallidotomy were assessed with the core assessment programme for intracerebral transplantation (CAPIT) protocol preoperatively, at 3 months postoperatively, and again after a median postoperative follow up of 14 months. Two further patients had only one evaluation 3 months postoperatively. RESULTS The reduction of contralateral dyskinesias (median 67%) at 3 months was slightly attenuated after 1 year to 55% (both p<0.001 compared with baseline). A less pronounced effect on ipsilateral and axial dyskinesias decreased from 39% to 33% (p<0.005 and p<0.01), and from 50% to 12.5% (p<0.001 and p<0.01), respectively. However, there was no significant change between the 3 month and the follow up assessment. The modest improvement of the contralateral unified Parkinson’s disease rating scale (UPDRS) motor score in the “off” state remained improved compared with preoperative levels, but less significantly (26%, p<0.001, and 18%, p<0.01). The activities of daily living (ADL) subscore of the UPDRS in the off state remained improved with median changes of 23% and 22% at follow up (both p<0.005). There was no significant improvement of “on” state or ipsilateral off state motor scores. Median modified Hoehn and Yahr scores in off and on state were unchanged, as was the time spent off. Speech in off had significantly deteriorated by 1 year after the operation. CONCLUSIONS The beneficial effects of unilateral pallidotomy persist for at least 12 months and, dyskinesias are most responsive to this procedure.]]></abstract><cop>London</cop><pub>BMJ Publishing Group Ltd</pub><pmid>10486400</pmid><doi>10.1136/jnnp.67.4.511</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult adverse events Aged Biological and medical sciences Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Disability Evaluation Follow-Up Studies Functional Laterality Globus Pallidus - surgery Hospitals Humans Medical sciences Middle Aged Mortality Neurology Neurosurgery pallidotomy Parkinson Disease - physiopathology Parkinson Disease - surgery Parkinson's disease Prognosis Surgery Time Factors treatment |
| title | Unilateral pallidotomy for Parkinson’s disease: results after more than 1 year |
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