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Multicentre European study of thalamic stimulation for parkinsonian tremor: a 6 year follow-up

Hariz, M I; Krack, P; Alesch, F; Augustinsson, L-E; Bosch, A; Ekberg, R; Johansson, F; Johnels, B; Meyerson, B A and N'Guyen, J-P, et al. (2008) In Journal of Neurology, Neurosurgery and Psychiatry 79(6). p.694-699
Abstract
Aim: To evaluate the results of ventral intermediate (Vim) thalamic deep brain stimulation (DBS) in patients with tremor predominant Parkinson's disease (PD) at 6 years post surgery. Methods: This was a prolonged follow-up study of 38 patients from eight centres who participated in a multicentre study, the 1 year results of which have been published previously. Total scores as well as scores for individual items of the motor part and the disability part of the Unified Parkinson's Disease Rating Scale were used for evaluation. Results: Tremor was still effectively controlled by DBS and appendicular rigidity and akinesia remained stable compared with baseline. Axial scores (speech, gait and postural instability), however, worsened, and in... (More)
Aim: To evaluate the results of ventral intermediate (Vim) thalamic deep brain stimulation (DBS) in patients with tremor predominant Parkinson's disease (PD) at 6 years post surgery. Methods: This was a prolonged follow-up study of 38 patients from eight centres who participated in a multicentre study, the 1 year results of which have been published previously. Total scores as well as scores for individual items of the motor part and the disability part of the Unified Parkinson's Disease Rating Scale were used for evaluation. Results: Tremor was still effectively controlled by DBS and appendicular rigidity and akinesia remained stable compared with baseline. Axial scores (speech, gait and postural instability), however, worsened, and in parallel the initial improvement in activities of daily living scores at the 1 year follow-up had disappeared at 6 years, despite sustained improvement of tremor. Remarkably, neither daily doses of dopaminergic medication nor fluctuations and dyskinesias had changed at 6 years compared with baseline in this particular patient group. Conclusion: This study confirms that patients with tremor dominant PD who do not present with fluctuations and dyskinesias may have a relatively benign progression of the disease. Vim DBS, although having no effect on akinesia and rigidity, is a relatively lenient surgical procedure and may still have a place for long term symptomatic control of PD tremor in selected patients. (Less)
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published
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Journal of Neurology, Neurosurgery and Psychiatry
volume
79
issue
6
pages
694 - 699
publisher
BMJ Publishing Group
external identifiers
  • wos:000255954800019
  • scopus:44449139009
ISSN
1468-330X
DOI
10.1136/jnnp.2007.118653
language
English
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yes
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1a247f3d-360f-4a56-a39b-0fb323ecfd99 (old id 1203347)
date added to LUP
2008-09-15 16:54:11
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2017-11-05 03:55:13
@article{1a247f3d-360f-4a56-a39b-0fb323ecfd99,
  abstract     = {Aim: To evaluate the results of ventral intermediate (Vim) thalamic deep brain stimulation (DBS) in patients with tremor predominant Parkinson's disease (PD) at 6 years post surgery. Methods: This was a prolonged follow-up study of 38 patients from eight centres who participated in a multicentre study, the 1 year results of which have been published previously. Total scores as well as scores for individual items of the motor part and the disability part of the Unified Parkinson's Disease Rating Scale were used for evaluation. Results: Tremor was still effectively controlled by DBS and appendicular rigidity and akinesia remained stable compared with baseline. Axial scores (speech, gait and postural instability), however, worsened, and in parallel the initial improvement in activities of daily living scores at the 1 year follow-up had disappeared at 6 years, despite sustained improvement of tremor. Remarkably, neither daily doses of dopaminergic medication nor fluctuations and dyskinesias had changed at 6 years compared with baseline in this particular patient group. Conclusion: This study confirms that patients with tremor dominant PD who do not present with fluctuations and dyskinesias may have a relatively benign progression of the disease. Vim DBS, although having no effect on akinesia and rigidity, is a relatively lenient surgical procedure and may still have a place for long term symptomatic control of PD tremor in selected patients.},
  author       = {Hariz, M I and Krack, P and Alesch, F and Augustinsson, L-E and Bosch, A and Ekberg, R and Johansson, F and Johnels, B and Meyerson, B A and N'Guyen, J-P and Pinter, M and Pollak, P and von Raison, F and Rehncrona, Stig and Speelman, J D and Sydow, O and Benabid, A-L},
  issn         = {1468-330X},
  language     = {eng},
  number       = {6},
  pages        = {694--699},
  publisher    = {BMJ Publishing Group},
  series       = {Journal of Neurology, Neurosurgery and Psychiatry},
  title        = {Multicentre European study of thalamic stimulation for parkinsonian tremor: a 6 year follow-up},
  url          = {http://dx.doi.org/10.1136/jnnp.2007.118653},
  volume       = {79},
  year         = {2008},
}