1. Neurostimulation for Parkinson's Disease with Early Motor Complications
- Author
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Schuepbach, W.M., Rau, J., Knudsen, K., Volkmann, J., Krack, P., Timmermann, L., Halbig, T.D., Hesekamp, H., Navarro, S.M., Meier, N., Falk, D., Mehdorn, M., Paschen, S., Maarouf, M., Barbe, M.T., Fink, G.R., Kupsch, A., Gruber, D., Schneider, G.H., Seigneuret, E., Kistner, A., Chaynes, P., Ory-Magne, F., Brefel Courbon, C., Vesper, J., Schnitzler, A., Wojtecki, L., Houeto, J.L., Bataille, B., Maltete, D., Damier, P., Raoul, S., Sixel-Doering, F., Hellwig, D., Gharabaghi, A., Kruger, R., Pinsker, M.O., Amtage, F., Regis, J.M., Witjas, T., Thobois, S., Mertens, P., Kloss, M., Hartmann, A., Oertel, W.H., Post, B., Speelman, H., Agid, Y., Schade-Brittinger, C., Deuschl, G., Neurology, Krack, Paul, and Diener, Hans Christoph (Beitragende*r)
- Subjects
Adult ,Male ,medicine.medical_specialty ,Parkinson's disease ,DCN MP - Plasticity and memory ,medicine.medical_treatment ,Medizin ,Electric Stimulation Therapy ,610 Medicine & health ,Implantable Neurostimulators/adverse effects ,law.invention ,Antiparkinson Agents ,Randomized controlled trial ,Quality of life ,Subthalamic Nucleus ,law ,Surveys and Questionnaires ,Internal medicine ,Activities of Daily Living ,Dopamine Agonists/adverse effects/therapeutic use ,Clinical endpoint ,Humans ,Medicine ,Adverse effect ,Neurostimulation ,Electric Stimulation Therapy/adverse effects ,Dyskinesias ,Quality of Life ,Intention-to-treat analysis ,business.industry ,Parkinson Disease ,General Medicine ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,Intention to Treat Analysis ,Implantable Neurostimulators ,Parkinson Disease/drug therapy/physiopathology/*therapy ,Treatment Outcome ,Dyskinesia ,Dopamine Agonists ,Antiparkinson Agents/adverse effects/therapeutic use ,Physical therapy ,Female ,medicine.symptom ,business ,Dyskinesias/etiology - Abstract
Item does not contain fulltext BACKGROUND: Subthalamic stimulation reduces motor disability and improves quality of life in patients with advanced Parkinson's disease who have severe levodopa-induced motor complications. We hypothesized that neurostimulation would be beneficial at an earlier stage of Parkinson's disease. METHODS: In this 2-year trial, we randomly assigned 251 patients with Parkinson's disease and early motor complications (mean age, 52 years; mean duration of disease, 7.5 years) to undergo neurostimulation plus medical therapy or medical therapy alone. The primary end point was quality of life, as assessed with the use of the Parkinson's Disease Questionnaire (PDQ-39) summary index (with scores ranging from 0 to 100 and higher scores indicating worse function). Major secondary outcomes included parkinsonian motor disability, activities of daily living, levodopa-induced motor complications (as assessed with the use of the Unified Parkinson's Disease Rating Scale, parts III, II, and IV, respectively), and time with good mobility and no dyskinesia. RESULTS: For the primary outcome of quality of life, the mean score for the neurostimulation group improved by 7.8 points, and that for the medical-therapy group worsened by 0.2 points (between-group difference in mean change from baseline to 2 years, 8.0 points; P=0.002). Neurostimulation was superior to medical therapy with respect to motor disability (P
- Published
- 2013