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Effects of deep brain stimulation on rest tremor progression in early stage Parkinson disease.
Hacker, Mallory L; DeLong, Mahlon R; Turchan, Maxim; Heusinkveld, Lauren E; Ostrem, Jill L; Molinari, Anna L; Currie, Amanda D; Konrad, Peter E; Davis, Thomas L; Phibbs, Fenna T; Hedera, Peter; Cannard, Kevin R; Drye, Lea T; Sternberg, Alice L; Shade, David M; Tonascia, James; Charles, David.
Afiliación
  • Hacker ML; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • DeLong MR; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • Turchan M; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • Heusinkveld LE; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • Ostrem JL; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • Molinari AL; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • Currie AD; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • Konrad PE; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • Davis TL; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • Phibbs FT; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • Hedera P; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • Cannard KR; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • Drye LT; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • Sternberg AL; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • Shade DM; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • Tonascia J; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
  • Charles D; From the Departments of Neurology (M.L.H., M.T., L.E.H., A.L.M., A.D.C., T.L.D., F.T.P., P.H., D.C.) and Neurosurgery (P.E.K.), Vanderbilt University Medical Center, Nashville, TN; Department of Neurology (M.R.D.), Emory University School of Medicine, Atlanta, GA; Laboratory of Molecular Immunology
Neurology ; 91(5): e463-e471, 2018 07 31.
Article en En | MEDLINE | ID: mdl-29959266
OBJECTIVE: To evaluate whether the progression of individual motor features was influenced by early deep brain stimulation (DBS), a post hoc analysis of Unified Parkinson's Disease Rating Scale-III (UPDRS-III) score (after a 7-day washout) was conducted from the 2-year DBS in early Parkinson disease (PD) pilot trial dataset. METHODS: The prospective pilot trial enrolled patients with PD aged 50-75 years, treated with PD medications for 6 months-4 years, and no history of dyskinesia or other motor fluctuations, who were randomized to receive optimal drug therapy (ODT) or DBS plus ODT (DBS + ODT). At baseline and 6, 12, 18, and 24 months, all patients stopped all PD therapy for 1 week (medication and stimulation, if applicable). UPDRS-III "off" item scores were compared between the ODT and DBS + ODT groups (n = 28); items with significant between-group differences were analyzed further. RESULTS: UPDRS-III "off" rest tremor score change from baseline to 24 months was worse in patients receiving ODT vs DBS + ODT (p = 0.002). Rest tremor slopes from baseline to 24 months favored DBS + ODT both "off" and "on" therapy (p < 0.001, p = 0.003, respectively). More ODT patients developed new rest tremor in previously unaffected limbs than those receiving DBS + ODT (p = 0.001). CONCLUSIONS: These results suggest the possibility that DBS in early PD may slow rest tremor progression. Future investigation in a larger cohort is needed, and these findings will be tested in the Food and Drug Administration-approved, phase III, pivotal, multicenter clinical trial evaluating DBS in early PD. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that for patients with early PD, DBS may slow the progression of rest tremor.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de Parkinson / Temblor / Progresión de la Enfermedad / Estimulación Encefálica Profunda Tipo de estudio: Clinical_trials / Diagnostic_studies / Observational_studies / Screening_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Neurology Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de Parkinson / Temblor / Progresión de la Enfermedad / Estimulación Encefálica Profunda Tipo de estudio: Clinical_trials / Diagnostic_studies / Observational_studies / Screening_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Neurology Año: 2018 Tipo del documento: Article Pais de publicación: Estados Unidos