Motor, Cognitive, and Behavioral Performance Following Unilateral Ventroposterior Pallidotomy for Parkinson Disease

Masterman, Donna; DeSalles, Antonio; Baloh, Robert W.; Frysinger, Robert C.; Foti, Dean; Behnke, Eric; Cabatan-Awang, Cynthia; Hoetzel, Alexander; Intemann, Peter M.; Fairbanks, Lynn A.; Bronstein, Jeff M.

doi:10.1001/archneur.55.9.1201

Cited by 89 publications

(61 citation statements)

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“…Other serious reported complications including worsening of cognitive function, most commonly decreased verbal¯uency and working memory (TreÂ panier et al, 1998;JunqueÂ et al, 1999). Generally the functional consequences of cognitive problems after unilateral PVP are considered to be minimal, provided there had been no cognitive deterioration prior to the surgery (Baron et al, 1996;Hariz and DeSalles, 1997;Soukup et al, 1997;Masterman et al, 1998;Perrine et al, 1998). Delayed infarctions are rare, but belong to the serious complications of PVP (Lim et al, 1997;Samuel et al, 1998).…”

Section: Side-eects Of Unilateral Pallidotomymentioning

confidence: 99%

Mirthful laughter induced by subthalamic nucleus stimulation

et al. 2001

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Copper salts, which are abundant, relatively inexpensive and possess low toxicity, have long been used as versatile catalysts for various reactions in organic synthesis. Recently, the development of Cu‐catalyzed or ‐mediated CH functionalization reactions has gained significant attention. Since the pioneering work of Daugulis on the introduction of 8‐aminoquinoline and picolinic acid auxiliaries as removable directing groups in transition metal‐catalyzed CH bond activations, the combination of copper salts with these bidentate directing groups has emerged as an innovative strategy for the construction of carbon‐carbon or carbon‐heteroatom bonds through CH bond cleavage. In addition to the 8‐aminoquinoline and picolinamide systems, several other bidentate directing groups including the 2‐aminophenyloxazoline group by Yu and Dai and the PIP system by Shi, have been developed as well. This review intends to cover most of the recent advances on copper‐catalyzed or ‐mediated direct sp2 and sp3 CH bond functionalizations assisted by these bidentate directing groups. The major achievements in this area are discussed and catalogued by the type of bonds formed (CC, CO, CN, CS, CP etc.). Special attention is paid to the reaction mechanisms. Selected examples of substrates are listed as well. In addition, a personal outlook is given at the end.

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Section: Side-eects Of Unilateral Pallidotomymentioning

confidence: 99%

Mirthful laughter induced by subthalamic nucleus stimulation

et al. 2001

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“…Em sua maioria, os protocolos que analisam a melhora dos pacientes parkinsonianos submetidos a tratamento cirúrgico utilizam a escala UPDRS, levando muito em consideração o desempenho motor (item -III) mostrando melhora da função motora [2][3][4][5][6] Entretanto, poucos são os estudos que dão ênfase às atividades da vida diária, aspecto de grande importância para os parkinsoniamos, uma vez que, estão relacionadas à independência destes indivídu-os. Uma forma de avaliar este aspecto, é com a escala UPDRS (item -II) para atividades da vida diária, a escala de Schwab & England e a escala de Hoehn & Yahr.…”

Section: Discussionunclassified

“…Na análise realizada por Masterman et al, que avaliaram pacientes parkinsonianos submetidos a palidotomia unilateral no 3º e 6º mês pós-operatório, 44% dos pacientes mantiveram a mesma dose de levodopa, 41% tiveram a dose diminuída e 15% necessitaram de aumento na dose de levodopa 5 . Estudo realizado por Dogali et al 3 e outro por Laitinen 14 mostraram diminuição na dose da levodopa no período pós-operatório.…”

Section: Discussionunclassified

“…Estudo realizado por Baron et al, também mostra melhora quanto à independência dos pacientes submetidos a palidotomia no 3º, 6º e 12º mês pós-operatório 26 . O benefício cirúrgico também foi constatado por outros autores 5,13,28,29 .…”

Section: Discussionunclassified

“…Masterman publicou estudo com pacientes submetidos a PPV unilateral que foram avaliados no 3º e 6º mês pós-operatório, também relatando melhora estatisticamente significante, pela escala de Hoehn & Yahr tanto em "on" quanto em "off" 5 . A análise da escala de Hoehn & Yahr de 126 pacientes, realizada por Iacono durante o primeiro ano pós-operatório, mostra diminuição do escore na fase "on", evidenciando melhora destes pacientes 2 .…”

Section: Discussionunclassified

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Avaliação das atividades da vida diária dos pacientes com doença de Parkinson submetidos a cirurgia estereotáxica

Pinto

Borges

Aguiar

et al. 2002

Arq. Neuro-Psiquiatr.

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RESUMO -Objetivo: Avaliar o impacto da cirurgia estereotáxica sobre a realização das atividades da vida diária dos paciente com doença de Parkinson (DP). Método: Foram avaliados 30 pacientes com DP forma idiopática submetidos a cirurgia estereotáxica nos períodos pré-operatório, 1º, 3º, 6º e 12º mês pós-operatório, segundo as escala UPDRS -Item II (escala unificada para DP), Schwab & England e Hoehn & Yahr. Destes, nove pacientes foram também avaliados no 24º mês pós-operatório. Resultados: Foram realizadas nove palidotomias póstero-ventrais (PPV), sendo duas à esquerda e sete à direita; duas PPV bilaterais no mesmo tempo cirúrgico; 17 talamotomias ventro-laterais (TVL), sendo 12 à esquerda e cinco à direita; duas TVL à esquerda com PPV à direita no mesmo tempo cirúrgico. Os escores médios, na fase off, das escalas utilizadas foram: 65,6 no pré-operatório,74 no 1º mês, 76,6 no 3º mês, 75,6 no 6º mês e 72,3 no 12º mês pós-operatório (Schwab & England); 21 no pré-operatório, 12,3 no 1º mês, 14,7 no 3º mês, 15,27 no 6º mês e 17,1 no 12º mês pós-operatório (UPDRS); 3,1 no pré-operatório, 2,8 no 1º mês, 2,7 no 3º mês, 2,8 no 6º mês e 2,85 no 12º mês pós-operatório (Hoehn & Yarh). Conclusão: A TVL e a PPV são procedimentos capazes de melhorar a independência dos pacientes para realização das atividades cotidianas, sendo constatado benefício maior nos seis primeiros meses de pós-operatório. PALAVRAS-CHAVE: doença de Parkinson, cirurgia estereotáxica, atividades da vida diária.Daily living activities in P Daily living activities in P Daily living activities in P Daily living activities in P Daily living activities in Parkinson's disease patients underwent to stereotactic surgery arkinson's disease patients underwent to stereotactic surgery arkinson's disease patients underwent to stereotactic surgery arkinson's disease patients underwent to stereotactic surgery arkinson's disease patients underwent to stereotactic surgery ABSTRACT -Objective: To evaluate the impact of stereotactic surgery on daily activities of Parkinson's disease (PD) patients. Method: Thirty patients with idiopathic PD were evaluated before surgery and one, three, six and twelve months after surgery. Patients were evaluated with the UPDRS -part II (Unified Parkinson's Disease Rating Scale) and the Schwab & England scales. Nine of the patients had also been evaluated after twenty four months. Results: We performed nine posteroventral pallidotomies (PVP), two on the left hemisphere and seven on the right; 17 ventrolateral thalamotomies (VLT), 12 on the left and five on the right; two VLT on the left associated with PVP on the right at the same surgical procedure. The mean "off" phase scores of Schwab & England scale were: 60.6 before surgery, 74 after the first, 76.6 after the third, 75.6 after the sixth, 72.3 after the twelfth and 71.1 after the twenty fourth months after surgery. The mean "off" phase scores of UPDRS -part II scale were: 21 before surgery, 12.3 after the first, 14.7 after the third, 15.27 after the sixth, 17.1 after the twelfth and 17....

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Stereotactic Pallidotomy in the Treatment of Parkinson Disease

Bronstein

DeSalles²,

DeLong³

1999

Arch Neurol

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The objective of this workshop was to provide recommendations on several issues involving pallidotomy for patients with medically intractable Parkinson disease to physicians, patients, and other health care providers. An international consortium of experts in neurology, neurosurgery, and neurophysiology who had extensive experience with pallidotomy were invited to the workshop. Participants were sent background materials from the scientific literature for review-based participant recommendations. A proposed agenda was circulated to all participants before the workshop, and the final agenda was based on their recommendations. Topics were introduced at the workshop by members of the organizing committee, followed by extensive group discussion. A draft of a consensus statement, based on the previous day's discussion, was circulated and further modifications were made. The final statement was agreed on by all members. The conclusions of the participants were: (1) Pallidotomy should be performed only at centers that have a team of physicians with substantial expertise and experience in the field. (2) Patients with disabling idiopathic Parkinson disease, without dementia, and who have exhausted medical therapy should be considered for pallidotomy. (3) All patients should be examined by means of standardized rating scales both preoperatively and postoperatively to ensure quality of care at each center. (4) Symptoms that respond best to pallidotomy include medication-induced dyskinesias, rigidity, and tremor, while balance, gait disorders, and hypophonia are generally less responsive to surgery. Benefits of pallidotomy appear to be long lasting. (5) Each institution's complication rate should be discussed before surgery.

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Motor, Cognitive, and Behavioral Performance Following Unilateral Ventroposterior Pallidotomy for Parkinson Disease

Abstract: 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.

Cited by 89 publications

References 26 publications

Mirthful laughter induced by subthalamic nucleus stimulation

Mirthful laughter induced by subthalamic nucleus stimulation

Avaliação das atividades da vida diária dos pacientes com doença de Parkinson submetidos a cirurgia estereotáxica

Stereotactic Pallidotomy in the Treatment of Parkinson Disease

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