Document Detail


Motor, cognitive, and behavioral performance following unilateral ventroposterior pallidotomy for Parkinson disease.
MedLine Citation:
PMID:  9740114     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the effects of ventroposterior pallidotomy on motor disability and on behavior and cognition in patients with medically intractable idiopathic Parkinson disease. DESIGN: Detailed motor testing both while receiving and discontinuing levodopa medication, posturography, and neurocognitive and behavioral assessments were performed before and 3 to 6 months after unilateral ventroposterior pallidotomy. SETTING: University-based movement disorder program. PATIENTS: Thirty-two patients without dementia with medically refractory idiopathic Parkinson disease were studied. MAIN OUTCOME MEASURES: Motor function and disability were measured using the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr stage, and the Schwab and England Activities of Daily Living Scale. Dynamic balance was measured by sway (amplitude and velocity) using the Chattecx Balance System. Detailed cognitive and behavioral assessments were also performed both before and after surgery. RESULTS: Eighty-three percent of patients experienced improvement of their total Unified Parkinson's Disease Rating Scale score at 3 to 6 months after surgery. Significant improvements were also seen in the contralateral Unified Parkinson's Disease Rating Scale motor subscore (78%) as well as in the contralateral Unified Parkinson's Disease Rating Scale total score both during the on and off period (78% and 79%, respectively). The Hoehn and Yahr stage, Schwab and England Activities of Daily Living Scale score, and dynamic balance when standing on foam also improved following unilateral pallidotomy in many patients. Cognitive performance remained relatively unchanged following surgery with the exception of category fluency, which exhibited a modest decline (P < .04). A significant improvement in depression was found on the Beck Depression Inventory. CONCLUSIONS: Ventroposterior pallidotomy significantly improves motor performance and daily level of function in Parkinson disease. Cognition and behavior are not adversely affected in patients without dementia, and a cognitive screening battery is proposed.
Authors:
D Masterman; A DeSalles; R W Baloh; R Frysinger; D Foti; E Behnke; C Cabatan-Awang; A Hoetzel; P M Intemann; L Fairbanks; J M Bronstein
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of neurology     Volume:  55     ISSN:  0003-9942     ISO Abbreviation:  Arch. Neurol.     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1998-09-25     Completed Date:  1998-09-25     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1201-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, University of California, Los Angeles School of Medicine, USA. dmasterm@ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Case-Control Studies
Cognition*
Female
Globus Pallidus / surgery*
Humans
Male
Middle Aged
Neuropsychological Tests
Parkinson Disease / physiopathology*,  psychology*,  surgery
Posture
Psychomotor Performance*
Grant Support
ID/Acronym/Agency:
AG9063/AG/NIA NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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