Usefulness of pallidotomy in advanced Parkinson's disease
OBJECTIVE: The combined effect of posteroventral pallidotomy and optimal medical treatment was assessed in 22 patients with levodopa sensitive Parkinson's disease. METHODS: Timed motor tests, video recordings, and computer assisted optoelectronic movement analysis were used for serial hourly as...
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| Veröffentlicht in: | Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 1997-02, Vol.62 (2), p.125-132 |
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| creator | Johansson, F Malm, J Nordh, E Hariz, M |
| description | OBJECTIVE: The combined effect of posteroventral pallidotomy and optimal medical treatment was assessed in 22 patients with levodopa sensitive Parkinson's disease. METHODS: Timed motor tests, video recordings, and computer assisted optoelectronic movement analysis were used for serial hourly assessments performed preoperatively and four and 12 months after operation. Tests were made while patients were on optimal medical therapy. RESULTS: There were no serious adverse events of surgery. Two of the 22 patients could not complete all the tests after operation. The proportion of dyskinesia periods decreased in the 20 patients and there was a proportional increase in normal or fairly normal occasions. "Off" periods were not significantly affected. In 12 of 13 patients with limb dyskinesia this symptom was completely abolished in the contralateral limbs. There was also some degree of improvement axially and ipsilaterally. Tremor was moderately improved contralaterally. Bradykinesia remained unchanged. Results at 12 months follow up were similar to those at four months. CONCLUSION: Pallidotomy produced a pronounced positive effect on dyskinesia and a moderate effect on tremor. Bradykinesia was not affected. Posteroventral pallidotomy may be useful in patients with Parkinson's disease who have severe motor fluctuations and may allow an increase in levodopa dose to alleviate bradykinesia in "off" states. |
| doi_str_mv | 10.1136/jnnp.62.2.125 |
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METHODS: Timed motor tests, video recordings, and computer assisted optoelectronic movement analysis were used for serial hourly assessments performed preoperatively and four and 12 months after operation. Tests were made while patients were on optimal medical therapy. RESULTS: There were no serious adverse events of surgery. Two of the 22 patients could not complete all the tests after operation. The proportion of dyskinesia periods decreased in the 20 patients and there was a proportional increase in normal or fairly normal occasions. "Off" periods were not significantly affected. In 12 of 13 patients with limb dyskinesia this symptom was completely abolished in the contralateral limbs. There was also some degree of improvement axially and ipsilaterally. Tremor was moderately improved contralaterally. Bradykinesia remained unchanged. Results at 12 months follow up were similar to those at four months. CONCLUSION: Pallidotomy produced a pronounced positive effect on dyskinesia and a moderate effect on tremor. Bradykinesia was not affected. Posteroventral pallidotomy may be useful in patients with Parkinson's disease who have severe motor fluctuations and may allow an increase in levodopa dose to alleviate bradykinesia in "off" states.</description><identifier>ISSN: 0022-3050</identifier><identifier>EISSN: 1468-330X</identifier><identifier>DOI: 10.1136/jnnp.62.2.125</identifier><identifier>PMID: 9048711</identifier><identifier>CODEN: JNNPAU</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd</publisher><subject>Adult ; Aged ; Analysis of Variance ; Biological and medical sciences ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Female ; Follow-Up Studies ; Globus Pallidus - surgery ; Humans ; Intraoperative Complications ; Levodopa - administration & dosage ; Lifting ; Male ; Medical sciences ; Middle Aged ; Movement - physiology ; Movement Disorders - prevention & control ; Neurology ; Parkinson Disease - diagnostic imaging ; Parkinson Disease - surgery ; Pilot Projects ; Prospective Studies ; Reoperation ; Statistics, Nonparametric ; Tomography, X-Ray Computed ; Treatment Outcome ; Tremor - prevention & control</subject><ispartof>Journal of neurology, neurosurgery and psychiatry, 1997-02, Vol.62 (2), p.125-132</ispartof><rights>1997 INIST-CNRS</rights><rights>Copyright BMJ Publishing Group LTD Feb 1997</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b509t-bfd1a34ca83ac031cc58c63d24c4233048b69ff953f1f0333d442f25ea23b4353</citedby><cites>FETCH-LOGICAL-b509t-bfd1a34ca83ac031cc58c63d24c4233048b69ff953f1f0333d442f25ea23b4353</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC486722/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC486722/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2580980$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9048711$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Johansson, F</creatorcontrib><creatorcontrib>Malm, J</creatorcontrib><creatorcontrib>Nordh, E</creatorcontrib><creatorcontrib>Hariz, M</creatorcontrib><title>Usefulness of pallidotomy in advanced Parkinson's disease</title><title>Journal of neurology, neurosurgery and psychiatry</title><addtitle>J Neurol Neurosurg Psychiatry</addtitle><description>OBJECTIVE: The combined effect of posteroventral pallidotomy and optimal medical treatment was assessed in 22 patients with levodopa sensitive Parkinson's disease. METHODS: Timed motor tests, video recordings, and computer assisted optoelectronic movement analysis were used for serial hourly assessments performed preoperatively and four and 12 months after operation. Tests were made while patients were on optimal medical therapy. RESULTS: There were no serious adverse events of surgery. Two of the 22 patients could not complete all the tests after operation. The proportion of dyskinesia periods decreased in the 20 patients and there was a proportional increase in normal or fairly normal occasions. "Off" periods were not significantly affected. In 12 of 13 patients with limb dyskinesia this symptom was completely abolished in the contralateral limbs. There was also some degree of improvement axially and ipsilaterally. Tremor was moderately improved contralaterally. Bradykinesia remained unchanged. Results at 12 months follow up were similar to those at four months. CONCLUSION: Pallidotomy produced a pronounced positive effect on dyskinesia and a moderate effect on tremor. Bradykinesia was not affected. Posteroventral pallidotomy may be useful in patients with Parkinson's disease who have severe motor fluctuations and may allow an increase in levodopa dose to alleviate bradykinesia in "off" states.</description><subject>Adult</subject><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Globus Pallidus - surgery</subject><subject>Humans</subject><subject>Intraoperative Complications</subject><subject>Levodopa - administration & dosage</subject><subject>Lifting</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Movement - physiology</subject><subject>Movement Disorders - prevention & control</subject><subject>Neurology</subject><subject>Parkinson Disease - diagnostic imaging</subject><subject>Parkinson Disease - surgery</subject><subject>Pilot Projects</subject><subject>Prospective Studies</subject><subject>Reoperation</subject><subject>Statistics, Nonparametric</subject><subject>Tomography, X-Ray Computed</subject><subject>Treatment Outcome</subject><subject>Tremor - prevention & control</subject><issn>0022-3050</issn><issn>1468-330X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1997</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>eNqFkc1v1DAQxS0EKkvhyBEpEgh6yeLPxDlwqFbQolYFVW3hZjmODV4Se-tJqva_x6tdbSmX-jKH95vxm3kIvSZ4TgirPi5DWM0rOqdzQsUTNCO8kiVj-OdTNMOY0pJhgZ-jFwBLvH6y2UN7DeayJmSGmkuwbuqDBSiiK1a6730XxzjcFT4UurvRwdiu-K7THx8ghg9QdB6sBvsSPXO6B_tqW_fR5ZfPF4vj8vTb0dfF4WnZCtyMZes6ohk3WjJtMCPGCGkq1lFuOM02uWyrxrlGMEccZox1nFNHhdWUtZwJto8-beaupnawnbFhTLpXq-QHne5U1F49VIL_rX7FG8VlVVOa-99v-1O8niyMavBgbN_rYOMEqpZSYMFIBt_-By7jlELeTZG6zlfkWMpMlRvKpAiQrNs5IVitA1HrQFRFFVU5kMy_-df-jt4mkPV3W12D0b1L-eAedhgVEjcS33_rYbS3OznHoqqa1UKdXS0UET_o-dHJlVrbPNjw7bB8xOFfxR2vpw</recordid><startdate>19970201</startdate><enddate>19970201</enddate><creator>Johansson, F</creator><creator>Malm, J</creator><creator>Nordh, E</creator><creator>Hariz, M</creator><general>BMJ Publishing Group Ltd</general><general>BMJ</general><general>BMJ Publishing Group LTD</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>19970201</creationdate><title>Usefulness of pallidotomy in advanced Parkinson's disease</title><author>Johansson, F ; Malm, J ; Nordh, E ; Hariz, M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b509t-bfd1a34ca83ac031cc58c63d24c4233048b69ff953f1f0333d442f25ea23b4353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1997</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Analysis of Variance</topic><topic>Biological and medical sciences</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Globus Pallidus - surgery</topic><topic>Humans</topic><topic>Intraoperative Complications</topic><topic>Levodopa - administration & dosage</topic><topic>Lifting</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Movement - physiology</topic><topic>Movement Disorders - prevention & control</topic><topic>Neurology</topic><topic>Parkinson Disease - diagnostic imaging</topic><topic>Parkinson Disease - surgery</topic><topic>Pilot Projects</topic><topic>Prospective Studies</topic><topic>Reoperation</topic><topic>Statistics, Nonparametric</topic><topic>Tomography, X-Ray Computed</topic><topic>Treatment Outcome</topic><topic>Tremor - prevention & control</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Johansson, F</creatorcontrib><creatorcontrib>Malm, J</creatorcontrib><creatorcontrib>Nordh, E</creatorcontrib><creatorcontrib>Hariz, M</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>Psychology Database</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>Johansson, F</au><au>Malm, J</au><au>Nordh, E</au><au>Hariz, M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Usefulness of pallidotomy in advanced Parkinson's disease</atitle><jtitle>Journal of neurology, neurosurgery and psychiatry</jtitle><addtitle>J Neurol Neurosurg Psychiatry</addtitle><date>1997-02-01</date><risdate>1997</risdate><volume>62</volume><issue>2</issue><spage>125</spage><epage>132</epage><pages>125-132</pages><issn>0022-3050</issn><eissn>1468-330X</eissn><coden>JNNPAU</coden><abstract>OBJECTIVE: The combined effect of posteroventral pallidotomy and optimal medical treatment was assessed in 22 patients with levodopa sensitive Parkinson's disease. METHODS: Timed motor tests, video recordings, and computer assisted optoelectronic movement analysis were used for serial hourly assessments performed preoperatively and four and 12 months after operation. Tests were made while patients were on optimal medical therapy. RESULTS: There were no serious adverse events of surgery. Two of the 22 patients could not complete all the tests after operation. The proportion of dyskinesia periods decreased in the 20 patients and there was a proportional increase in normal or fairly normal occasions. "Off" periods were not significantly affected. In 12 of 13 patients with limb dyskinesia this symptom was completely abolished in the contralateral limbs. There was also some degree of improvement axially and ipsilaterally. Tremor was moderately improved contralaterally. Bradykinesia remained unchanged. Results at 12 months follow up were similar to those at four months. CONCLUSION: Pallidotomy produced a pronounced positive effect on dyskinesia and a moderate effect on tremor. Bradykinesia was not affected. Posteroventral pallidotomy may be useful in patients with Parkinson's disease who have severe motor fluctuations and may allow an increase in levodopa dose to alleviate bradykinesia in "off" states.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd</pub><pmid>9048711</pmid><doi>10.1136/jnnp.62.2.125</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 0022-3050 1468-330X |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Adult Aged Analysis of Variance Biological and medical sciences Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Female Follow-Up Studies Globus Pallidus - surgery Humans Intraoperative Complications Levodopa - administration & dosage Lifting Male Medical sciences Middle Aged Movement - physiology Movement Disorders - prevention & control Neurology Parkinson Disease - diagnostic imaging Parkinson Disease - surgery Pilot Projects Prospective Studies Reoperation Statistics, Nonparametric Tomography, X-Ray Computed Treatment Outcome Tremor - prevention & control |
| title | Usefulness of pallidotomy in advanced Parkinson's disease |
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