Unilateral pallidotomy versus bilateral subthalamic nucleus stimulation in PD

Smeding, Harriët; Esselink, Rianne A.J.; Schmand, Ben; Koning-Haanstra, M.; Nijhuis, Ilse J. M.; Wijnalda, Elze M.; Speelman, Johannes D.

doi:10.1007/s00415-005-0628-z

Cited by 41 publications

(32 citation statements)

References 38 publications

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“…Both STN-and GPi-DBS can have non-motor side effects, especially affecting verbal fluency, cognition and mood (Kumar et al, 1999a, b;Dujardin et al, 2001;Schupbach et al, 2005;Smeding et al, 2005Smeding et al, , 2006Smeding et al, , 2011Castelli et al, 2006;De Gaspari et al, 2006, Merello et al, 2008. Verbal fluency and cognition problems are more often seen in old patients (Hariz et al, 2000;Saint-Cyr et al, 2000;Funkiewiez et al, 2004;Smeding et al, 2011), or in those with poor cognition or depression at baseline (De Gaspari et al, 2006).…”

Section: Non-motor Side Effects Of Stn and Gpi-dbsmentioning

confidence: 99%

“…There is evidence that DBS may also worsen depression and mania, increase apathy, affect emotional lability, and increase the risk of suicide (Berney et al, 2002;Doshi et al, 2002;Okun et al, 2003Okun et al, , 2009Funkiewiez et al, 2004;Smeding et al, 2005Smeding et al, , 2006Drapier et al, 2008;Voon et al, 2008). Mood problems are more common in patients treated with STN-DBS than those treated with GPi-DBS Follett et al, 2010;Moro et al, 2010;Bronstein et al, 2011).…”

Section: Non-motor Side Effects Of Stn and Gpi-dbsmentioning

confidence: 99%

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Parkinson's Disease Therapeutics: New Developments and Challenges Since the Introduction of Levodopa

Smith

Wichmann

Factor

et al. 2011

Neuropsychopharmacol

196

137

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The demonstration that dopamine loss is the key pathological feature of Parkinson's disease (PD), and the subsequent introduction of levodopa have revolutionalized the field of PD therapeutics. This review will discuss the significant progress that has been made in the development of new pharmacological and surgical tools to treat PD motor symptoms since this major breakthrough in the 1960s. However, we will also highlight some of the challenges the field of PD therapeutics has been struggling with during the past decades. The lack of neuroprotective therapies and the limited treatment strategies for the nonmotor symptoms of the disease (ie, cognitive impairments, autonomic dysfunctions, psychiatric disorders, etc.) are among the most pressing issues to be addressed in the years to come. It appears that the combination of early PD nonmotor symptoms with imaging of the nigrostriatal dopaminergic system offers a promising path toward the identification of PD biomarkers, which, once characterized, will set the stage for efficient use of neuroprotective agents that could slow down and alter the course of the disease.

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Section: Non-motor Side Effects Of Stn and Gpi-dbsmentioning

confidence: 99%

Section: Non-motor Side Effects Of Stn and Gpi-dbsmentioning

confidence: 99%

Parkinson's Disease Therapeutics: New Developments and Challenges Since the Introduction of Levodopa

Smith

Wichmann

Factor

et al. 2011

Neuropsychopharmacol

196

137

View full text Add to dashboard Cite

show abstract

“…[1,11,39,42] Research regarding the short-term neurocognitive changes in individuals with Parkinson's disease following pallidotomy has been variable. While some studies reported few cognitive changes following pallidotomy, [3,30,[36][37] other investigations have more consistently shown cognitive changes postoperatively. [1,13,[32][33]35,39,40,41] Our research found a transient decline in verbal memory 3 months post-pallidotomy that returned to baseline at the 1 year follow-up.…”

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confidence: 99%

Five-year follow-up of unilateral posteroventral pallidotomy in Parkinson's disease

et al. 2009

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“…Twenty patients in the STN group have been previously described. 19 The other patients were recruited between June 2001 and June 2005 from three participating Dutch hospitals experienced in STN stimulation for PD. Eligible patients had idiopathic PD with an unequivocal reduction in off phase symptoms on levodopa, and despite optimal pharmacologic treatment at least one of the following symptoms: severe response fluctuations, dyskinesias, dystonia, tremor, or bradykinesia.…”

Section: Methodsmentioning

confidence: 99%

Solitary pyogenic abscess of the medulla oblongata: Survival after aspiration and antibiotics

Kniss¹,

Sivakumar²

2006

Neurology

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Abstract-Objective:To evaluate the cognitive and behavioral effects of bilateral subthalamic nucleus (STN) stimulation in patients with Parkinson disease (PD). Methods: The authors included 103 patients; 99 patients were evaluated 6 months after surgery. A control group of 39 patients with PD was formed and 36 patients were evaluated 6 months later. At baseline and at follow-up we administered neuropsychological tests of language, memory, visuospatial function, mental speed, and executive functions. A depression rating scale, a quality of life scale, self and proxy ratings of memory and dysexecutive symptoms, and a neuropsychiatric interview were also administered. Results: Six months after surgery, the STN group showed a larger decline than the control group on measures of verbal fluency, color naming, selective attention, and verbal memory. Moreover, the STN group showed a decrease in positive affect, and an increase in emotional lability and cognitive complaints. On the other hand, the STN group showed an increase in quality of life and a slight decrease in depressive symptoms. Nine percent of the STN patients had psychiatric complications (vs 3% of controls). Conclusions: Bilateral subthalamic nucleus stimulation has an adverse effect on executive functions with implications for daily life of the patients and their relatives.

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Unilateral pallidotomy versus bilateral subthalamic nucleus stimulation in PD

Abstract: Although we need larger groups to draw firm conclusions, our results suggest that bilateral STN stimulation has slightly more negative effects on executive functioning than unilateral pallidotomy.

Cited by 41 publications

References 38 publications

Parkinson's Disease Therapeutics: New Developments and Challenges Since the Introduction of Levodopa

Parkinson's Disease Therapeutics: New Developments and Challenges Since the Introduction of Levodopa

Five-year follow-up of unilateral posteroventral pallidotomy in Parkinson's disease

Solitary pyogenic abscess of the medulla oblongata: Survival after aspiration and antibiotics

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