Prospective randomized 1-year follow-up comparison of bilateral subthalamotomy versus bilateral subthalamic stimulation and the combination of both in Parkinson's disease patients: a pilot study

2008 ◽  
Vol 22 (3) ◽  
pp. 415-422 ◽  
Author(s):  
M. Merello ◽  
E. Tenca ◽  
S. Pérez Lloret ◽  
M. E. Martín ◽  
V. Bruno ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pilot Study ◽  
Subthalamic Stimulation

scholarly journals Lockdown effects on Parkinson’s disease during COVID-19 pandemic: a pilot study

2021 ◽  
Author(s):  
Marika Falla ◽  
Alessandra Dodich ◽  
Costanza Papagno ◽  
Alessandro Gober ◽  
Pamela Narduzzi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pilot Study ◽  
Movement Disorder ◽  
Psychological Stress ◽  
Clinical Features ◽  
Nonmotor Symptoms ◽  
Web Based ◽  
Updrs Part

AbstractThe coronavirus-disease 2019 (COVID-19) outbreak precipitated prolonged lock-down measures. The subsequent social distancing, isolation, and reduction in mobility increased psychological stress, which may worsen Parkinson’s disease (PD). Therefore, telemedicine has been proposed to provide care to PD patients. To evaluate the effects of lock-down on motor and nonmotor symptoms in PD patients during the COVID-19 pandemic and the feasibility of telemedicine. Motor and nonmotor aspects were longitudinally assessed using structured questionnaires at baseline (in-person, February 2020) and at follow-up (remote web-based video, lock-down) evaluation. Of the seventeen PD patients evaluated at baseline, fourteen agreed to participate in, and completed follow-up evaluations. There was an impairment of nonmotor aspects measured with the MDS-UPDRS part I (p < 0.001) during lock-down. Nine patients participated independently in the telemedicine evaluation while five needed help from relatives. Our preliminary findings suggest an impairment of nonmotor symptoms in PD patients and support the feasibility and need for telemedicine in monitoring PD patients during the COVID-19 pandemic, to guarantee optimal assistance with reducing the burden of infection. Our findings also suggest that movement disorder clinics should be carefully considering socio-demographics and clinical features when developing telemedicine programs.

scholarly journals The feasibility and acceptability of using a novel wrist worn cueing device to self-manage drooling problems in people with Parkinson’s disease: A pilot study

2019 ◽  
Vol 6 ◽  
pp. 205566831985252 ◽  
Author(s):  
Roisin McNaney ◽  
Nick Miller ◽  
John Vines ◽  
Patrick Olivier ◽  
Karim Ladha ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Pilot Study ◽  
Treatment Protocol ◽  
Daily Diary ◽  
Exit Interview ◽  
Self Report ◽  
Perceived Benefit ◽  
Normal Production

Introduction Daytime drooling is experienced by around 50% of Parkinson’s patients, who fail to swallow saliva in sufficient volume or regularity, despite normal production. This research explored the feasibility and acceptability of using a cueing device, to improve drooling. Methods During a four-week intervention, 28 participants were asked to use a cueing device for 1 h per day. During this time, the device vibrated once-per-minute, reminding the participant to swallow their saliva. A daily diary was used to collect self-report around swallowing severity, frequency, and duration. This was filled out by participants for one week before, four weeks during and for one week immediately after intervention. Diaries were also collected for one week during a follow up, carried out four weeks after intervention finished. Results Participants self-reported benefits in drooling severity ( p = 0.031), frequency ( p ≤ 0.001), and duration ( p = 0.001) after using the device. Improvements were maintained at follow up. Twenty-two participants explicitly reported a positive benefit to their drooling during exit interview. All felt the intervention and device were acceptable and usable. Conclusions Using a cueing device for one month had perceived benefit to drooling severity, frequency and duration in patients with Parkinson’s. Participants accepted the device and treatment protocol.

scholarly journals “Rescue” of bilateral subthalamic stimulation by bilateral pallidal stimulation: case report

2016 ◽  
Vol 124 (2) ◽  
pp. 417-421 ◽  
Author(s):  
Caio M. Matias ◽  
Danilo Silva ◽  
Andre G. Machado ◽  
Scott E. Cooper
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Effects ◽  
Pharmacological Management ◽  
Advanced Parkinson’S Disease ◽  
Video Recordings ◽  
Subthalamic Stimulation ◽  
Pallidal Stimulation ◽  
Pars Interna

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) orglobus pallidus pars interna (GPi) is well established as a treatment for advanced Parkinson’s disease. In general, one of the 2 targets is chosen based on the clinical features of each patient. Stimulation of both targets could be viewed as redundant, given that the 2 targets are directly connected. However, it is possible that each target has different mechanisms, with clinical effects mediated by orthodromic or antidromic stimulation. The authors report the case of a patient with severe Parkinson’s disease who had previously undergone bilateral subthalamic stimulation with excellent benefits. However, he presented with significant worsening associated with disease progression and pharmacological treatment, and then underwent bilateral GPi DBS. Follow-up assessment was conducted clinically as well as through blinded ratings of video recordings. Pallidal DBS may be a safe and useful strategy to manage dystonic features and behavioral complications of subthalamic stimulation and pharmacological management. While combined stimulation was quite successful in the reported patient, further studies with larger samples and longer follow-up periods will be necessary before recommending the addition of pallidal DBS as a routine strategy for patients previously implanted with STN DBS.

Subthalamic stimulation and neuropsychiatric symptoms in Parkinson’s disease: results from a long-term follow-up cohort study

2018 ◽  
Vol 89 (8) ◽  
pp. 836-843 ◽  
Author(s):  
Marie Abbes ◽  
Eugénie Lhommée ◽  
Stéphane Thobois ◽  
Hélène Klinger ◽  
Emmanuelle Schmitt ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Impulse Control ◽  
Neuropsychiatric Symptoms ◽  
Impulse Control Disorders ◽  
Subthalamic Stimulation ◽  
Deep Brain

BackgroundReports on behavioural outcomes after subthalamic nucleus deep brain stimulation in Parkinson’s disease are controversial and limited to short-term data. Long-term observation in a large cohort allows a better counselling and management.MethodsTo determine whether a long-term treatment with subthalamic stimulation induces or reduces impulse control behaviours, neuropsychiatric fluctuations and apathy, 69 patients treated with subthalamic stimulation are prospectively and retrospectively assessed using Ardouin Scale of Behavior in Parkinson’s Disease before and after 3–10 years of stimulation.ResultsAt a mean follow-up of 6 years, all impulse control disorders and dopaminergic addiction were significantly decreased, apart from eating behaviour and hypersexuality. Neuropsychiatric fluctuations also significantly improved (ON euphoria: 38% of the patients before surgery and 1% after surgery, P<0.01; OFF dysphoria: 39% of the patients before surgery and 10% after surgery, P<0.01). However, apathy increased (25% of the patients after surgery and 3% before, P<0.01). With the retrospective analysis, several transient episodes of depression, apathy, anxiety and impulse control disorders occurred.ConclusionsBilateral subthalamic nucleus stimulation was overall very effective in improving impulse control disorders and neuropsychiatric fluctuations in parkinsonian patients in the long term despite a counteracting frequent apathy. Transient episodes of impulse control disorders still occurred within the follow-up. These findings recommend a close follow-up in parkinsonian patients presenting with neuropsychiatric symptoms before deep brain stimulation surgery.Clinical trial registrationNCT01705418;Post-results.

Bilateral subthalamic stimulation monotherapy in advanced Parkinson's disease: Long-term follow-up of patients

2001 ◽  
Vol 17 (1) ◽  
pp. 125-132 ◽  
Author(s):  
Francesc Valldeoriola ◽  
Manuela Pilleri ◽  
Eduardo Tolosa ◽  
José L. Molinuevo ◽  
Jordi Rumià ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Advanced Parkinson’S Disease ◽  
Subthalamic Stimulation ◽  
Long Term Follow Up
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