Levodopa Withdrawal After Bilateral Subthalamic Nucleus Stimulation in Advanced Parkinson Disease

Molinuevo, José Luís; Valldeoriola, Francesc; Tolosa, Eduardo; Rumià, Jordi; Valls‐Solé, Josep; Roldan, Hector A.; Ferrer, Elisa

doi:10.1001/archneur.57.7.983

Cited by 187 publications

(142 citation statements)

References 36 publications

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“…Several studies have demonstrated that dopaminergic medications influence hallucinations in PD and that they are associated with increased age and longer disease duration [23] [24] [25]. In this present study, hallucinations were associated with increased age and longer disease duration, which is consistent with the current literature.…”

Section: Discussionsupporting

confidence: 92%

Medication Side Effect Profiles in PD Patients in a Safety-Net Hospital

Sisniega¹,

Madhusudhan²,

Rahmani³

et al. 2017

APD

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Background: Compulsive behavior, dyskinesias, motor fluctuations, and hallucinations are common Parkinson's disease (PD) medication side effects.These are yet to be examined in relation to race and level of education. The goal of this analysis was to identify socioeconomic or clinical variables that are associated with compulsive behavior, dyskinesias, motor fluctuations, and hallucinations in patients in a safety-net hospital. Methods: A movement disorder patient database containing 452 patients with idiopathic PD was analyzed for differences in PD medication side effects using univariate and multivariate logistic regression analysis. Race, sex, and level of education were evaluated as possible confounders. Results: A greater proportion of the patients in this study were Caucasian males. The only variable associated with compulsive behavior was age, with higher age having a protective effect (p = 0.0336). Disease duration (defined as time since the onset of symptoms), diagnosis duration (time since formal diagnosis), and level of education were significantly associated with dyskinesia inunivariate analysis (p =< 0.0001, <0.0001, 0.1236 respectively). However, diagnosis duration was the only variable significantly associated with dyskinesia in multivariate analysis (p = 0.0038), in addition to a borderline significant association when comparing individuals with graduate degree to those who had completed high school education or less (p = 0.0599), with a protective effect of higher education. Disease duration, diagnosis duration, and use of monoamineoxidase inhibitors were also significantly associated with motor fluctuations in the univariate analysis, while only diagnosis duration was significantly associated with motor fluctuations in multivariate analysis (p = 0.0035) with longer diagnosis duration associated with higher risk of motor fluctuations. Age, disease duration, and diagnosis duration were associated with an increased risk of hallucinations

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Section: Discussionsupporting

confidence: 92%

Medication Side Effect Profiles in PD Patients in a Safety-Net Hospital

Sisniega¹,

Madhusudhan²,

Rahmani³

et al. 2017

APD

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“…(off-medication, worstoff motor condition: Off-Med) 6-12 Unified Parkinson Disease Rating Scale (UPDRS) [3][4][5][6][7][8][9] (UPDRS part II) 44-72% (UPDRS part III) 38-66%…”

Section: パーキンソン病に対する視床下核 Dbs (Stn-dbs) Stn-dbs の短期成績mentioning

confidence: 99%

Deep Brain Stimulation for Parkinson Disease

Oshima¹,

吉野²,

片山³

2014

Nichidai Igaku Zasshi

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“…However, the assessment of the effectiveness of DBS for the treatment of symptoms is generally limited by the number of individuals analysed; significant losses to follow-up in some studies; and follow-up of the participants to a maximum of only 48 months. The reduction in antiparkinsonian medication after DBS may also significantly reduce some of the side effects of high-dose levodopa treatment over a long time (Charles et al, 2004;Mínguez-Castellanos et al, 2005;Molinuevo et al, 2000). Most of the studies on cost-effectiveness in STN-DBS have been designed in the absence of a control group of similar characteristics receiving conventional oral medication supposed to be the BMT possible.…”

Section: Cost-effectiveness Of Bilateral Subthalamic Stimulation In Amentioning

confidence: 99%