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Titolo:
REGIONAL METABOLIC CORRELATES OF SURGICAL OUTCOME FOLLOWING UNILATERAL PALLIDOTOMY FOR PARKINSONS-DISEASE
Autore:
EIDELBERG D; MOELLER JR; ISHIKAWA T; DHAWAN V; SPETSIERIS P; SILBERSWEIG D; STERN E; WOODS RP; FAZZINI E; DOGALI M; BERIC A;
Indirizzi:
CORNELL UNIV,COLL MED,N SHORE UNIV HOSP,DEPT NEUROL,300 COMMUNITY DR MANHASSET NY 11030 COLUMBIA UNIV,COLL PHYS & SURG,NEW YORK STATE PSYCHIAT INST,DEPT PSYCHIAT NEW YORK NY 00000 CORNELL UNIV,COLL MED,DEPT PSYCHIAT NEW YORK NY 00000 UNIV CALIF LOS ANGELES,DEPT NEUROL LOS ANGELES CA 90024 NYU,SCH MED,HOSP JOINT DIS,DEPT NEUROL NEW YORK NY 00000 UNIV CALIF IRVINE,DEPT NEUROSURG IRVINE CA 00000
Titolo Testata:
Annals of neurology
fascicolo: 4, volume: 39, anno: 1996,
pagine: 450 - 459
SICI:
0364-5134(1996)39:4<450:RMCOSO>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
PET; MONKEYS; FLUORODEOXYGLUCOSE; ANATOMY; CORTEX; MPTP;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
40
Recensione:
Indirizzi per estratti:
Citazione:
D. Eidelberg et al., "REGIONAL METABOLIC CORRELATES OF SURGICAL OUTCOME FOLLOWING UNILATERAL PALLIDOTOMY FOR PARKINSONS-DISEASE", Annals of neurology, 39(4), 1996, pp. 450-459

Abstract

Stereotaxic ventral pallidotomy has been employed in the symptomatic treatment of patients with advanced Parkinson's disease (PD). To understand the pathophysiology of clinical outcome following this procedure, we studied 10 PD patients (5 men and 5 women; mean age, 60.0 +/- 6.1years; mean Hoehn and Yahr stage, 3.8 +/- 1.0) with quantitative F-18-fluorodeoxyglucose (FDG) and positron emission tomography (PET). All patients were scanned preoperatively; 8 of 10 patients were rescanned 6 to 8 months following surgery. Clinical performance was assessed offmedications before and after surgery using standardized timed motor tasks. We found that preoperative lentiform metabolism correlated significantly with improvement in contralateral motor scores at 1 week, 3 months, and 6 months following unilateral pallidotomy (p < 0.03). Postoperatively, significant metabolic increases were noted in the primary motor cortex, lateral premotor cortex, and dorsolateral prefrontal cortex (p < 0.01) of the hemisphere that underwent surgery. Improvement in contralateral limb motor performance correlated significantly with surgical declines in thalamic metabolism (p ( 0.01) and increases in lateral frontal metabolism (p < 0.05). Principal components analysis disclosed a significant covariance pattern characterized by postoperativedeclines in ipsilateral lentiform and thalamic metabolism associated with bilateral increases in supplementary motor control metabolism. Subject scores for this pattern correlated significantly with improvements in both contralateral and ipsilateral limb performance (p < 0.0005). These results suggest that pallidotomy reduced the preoperative overaction of the inhibitory pallidothalamic projection. Clinical improvement may be associated with modulations in regional brain metabolism occurring remote from the lesion site.

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Documento generato il 24/01/20 alle ore 16:22:36