Karlo J Lizarraga, Bhairavei Gnanamanogaran, Tameem M Al-Ozzi, Melanie Cohn, George Tomlinson, Alexandre Boutet, Gavin J B Elias, Jürgen Germann, Derrick Soh, Suneil K Kalia, Mojgan Hodaie, Renato P Munhoz, Connie Marras, William D Hutchison, Andres M Lozano, Anthony E Lang, Alfonso Fasano
{"title":"侧位丘脑下刺激治疗帕金森病的轴向功能障碍:探索性结果和开放标签扩展。","authors":"Karlo J Lizarraga, Bhairavei Gnanamanogaran, Tameem M Al-Ozzi, Melanie Cohn, George Tomlinson, Alexandre Boutet, Gavin J B Elias, Jürgen Germann, Derrick Soh, Suneil K Kalia, Mojgan Hodaie, Renato P Munhoz, Connie Marras, William D Hutchison, Andres M Lozano, Anthony E Lang, Alfonso Fasano","doi":"10.1002/mdc3.14188","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>A randomized trial suggested that reducing left-sided subthalamic stimulation amplitude could improve axial dysfunction.</p><p><strong>Objectives: </strong>To explore open-label tolerability and associations between trial outcomes and asymmetry data.</p><p><strong>Methods: </strong>We collected adverse events in trial participants treated with open-label lateralized settings for ≥3 months. We explored associations between trial outcomes, location of stimulation and motor asymmetry.</p><p><strong>Results: </strong>14/17 participants tolerated unilateral amplitude reduction (left-sided = 10, right-sided = 4). Two hundred eighty-four left-sided and 1113 right-sided stimulated voxels were associated with faster gait velocity, 81 left-sided and 22 right-sided stimulated voxels were associated with slower gait velocity. Amplitude reduction contralateral to shorter step length was associated with 2.4-point reduction in axial MDS-UPDRS. Reduction contralateral to longer step length was associated with 10-point increase in MDS-UPDRS.</p><p><strong>Conclusions: </strong>Left-sided amplitude reduction is potentially more tolerable than right-sided amplitude reduction. Right-sided more than left-sided stimulation could be associated with faster gait velocity. Shortened step length might reflect contralateral overstimulation.</p>","PeriodicalId":19029,"journal":{"name":"Movement Disorders Clinical Practice","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Lateralized Subthalamic Stimulation for Axial Dysfunction in Parkinson's Disease: Exploratory Outcomes and Open-Label Extension.\",\"authors\":\"Karlo J Lizarraga, Bhairavei Gnanamanogaran, Tameem M Al-Ozzi, Melanie Cohn, George Tomlinson, Alexandre Boutet, Gavin J B Elias, Jürgen Germann, Derrick Soh, Suneil K Kalia, Mojgan Hodaie, Renato P Munhoz, Connie Marras, William D Hutchison, Andres M Lozano, Anthony E Lang, Alfonso Fasano\",\"doi\":\"10.1002/mdc3.14188\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>A randomized trial suggested that reducing left-sided subthalamic stimulation amplitude could improve axial dysfunction.</p><p><strong>Objectives: </strong>To explore open-label tolerability and associations between trial outcomes and asymmetry data.</p><p><strong>Methods: </strong>We collected adverse events in trial participants treated with open-label lateralized settings for ≥3 months. We explored associations between trial outcomes, location of stimulation and motor asymmetry.</p><p><strong>Results: </strong>14/17 participants tolerated unilateral amplitude reduction (left-sided = 10, right-sided = 4). Two hundred eighty-four left-sided and 1113 right-sided stimulated voxels were associated with faster gait velocity, 81 left-sided and 22 right-sided stimulated voxels were associated with slower gait velocity. Amplitude reduction contralateral to shorter step length was associated with 2.4-point reduction in axial MDS-UPDRS. Reduction contralateral to longer step length was associated with 10-point increase in MDS-UPDRS.</p><p><strong>Conclusions: </strong>Left-sided amplitude reduction is potentially more tolerable than right-sided amplitude reduction. Right-sided more than left-sided stimulation could be associated with faster gait velocity. Shortened step length might reflect contralateral overstimulation.</p>\",\"PeriodicalId\":19029,\"journal\":{\"name\":\"Movement Disorders Clinical Practice\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2024-08-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Movement Disorders Clinical Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/mdc3.14188\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Movement Disorders Clinical Practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/mdc3.14188","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Lateralized Subthalamic Stimulation for Axial Dysfunction in Parkinson's Disease: Exploratory Outcomes and Open-Label Extension.
Background: A randomized trial suggested that reducing left-sided subthalamic stimulation amplitude could improve axial dysfunction.
Objectives: To explore open-label tolerability and associations between trial outcomes and asymmetry data.
Methods: We collected adverse events in trial participants treated with open-label lateralized settings for ≥3 months. We explored associations between trial outcomes, location of stimulation and motor asymmetry.
Results: 14/17 participants tolerated unilateral amplitude reduction (left-sided = 10, right-sided = 4). Two hundred eighty-four left-sided and 1113 right-sided stimulated voxels were associated with faster gait velocity, 81 left-sided and 22 right-sided stimulated voxels were associated with slower gait velocity. Amplitude reduction contralateral to shorter step length was associated with 2.4-point reduction in axial MDS-UPDRS. Reduction contralateral to longer step length was associated with 10-point increase in MDS-UPDRS.
Conclusions: Left-sided amplitude reduction is potentially more tolerable than right-sided amplitude reduction. Right-sided more than left-sided stimulation could be associated with faster gait velocity. Shortened step length might reflect contralateral overstimulation.
期刊介绍:
Movement Disorders Clinical Practice- is an online-only journal committed to publishing high quality peer reviewed articles related to clinical aspects of movement disorders which broadly include phenomenology (interesting case/case series/rarities), investigative (for e.g- genetics, imaging), translational (phenotype-genotype or other) and treatment aspects (clinical guidelines, diagnostic and treatment algorithms)