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Pallidal Stimulation in Advanced Parkinson's Patients with Contraindications for Subthalamic Stimulation

Rouaud, Tiphaine
Dondaine, Thibaut
Drapier, Sophie
Haegelen, Claire
Lallement, François
Raoul, Sylvie
Sauleau, Paul
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Published in Movement disorders. 2010, vol. 25, no. 12, p. 1839-1846
Abstract The aim of this study was to evaluate the efficacy and safety of bilateral pallidal (GPi) deep brain stimulation (DBS) 6 months after surgery in advanced parkinsonian patients whose dopa-resistant axial motor signs or cognitive decline constituted contraindications for subthalamic nucleus (STN) DBS. Seventeen patients with a mean age of 59.3 6 7.1 years (range, 45–70), mean disease duration of 12.5 6 4.3 years (range, 7–20), and contraindications for STN DBS, underwent bilateral GPi DBS. They were evaluated before surgery and 6 months afterward, in accordance with Core Assessment Program for Intracerebral Transplantation recommendations. There were mean improvements of 41.1% in the UPDRS III motor score in the off-dopa condition and 20.3% in the activities of daily living score. Motor fluctuations were reduced by 22.9% and dyskinesias by 68.6%. Axial motor signs improved in the off-dopa condition by 34.2%. Neuropsychological performances remained unchanged at the 6- month assessment. Bilateral GPi DBS is both safe and effective in advanced parkinsonian patients with untreatable motor fluctuations, for whom STN DBS is contraindicated due to dopa-resistant axial motor signs or cognitive decline. As such, it should be regarded as a viable option for these patients.
Keywords Deep brain stimulationPallidal stimulationParkinson's diseaseNeuropsychological outcomeAxial motor symptoms
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ROUAUD, Tiphaine et al. Pallidal Stimulation in Advanced Parkinson's Patients with Contraindications for Subthalamic Stimulation. In: Movement Disorders, 2010, vol. 25, n° 12, p. 1839-1846. doi: 10.1002/mds.23171

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Deposited on : 2018-04-23

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