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Recent evidence suggests that Parkinson’s disease (PD) patients with rapid eye movement sleep behavior disorder (RBD) may exhibit more severe phenotypes, including greater movement disorders and axial symptoms, autonomic nerve disorders, and cognitive Obstacles, visual hallucinations, and impulse control disorders
.
Deep subthalamic nucleus stimulation (STN-DBS) is a well-documented treatment for motor fluctuations and dyskinesias in severe PD
.
However, some patients may exhibit worsening of other symptoms after STNDBS, such as apathy, impulsive behavior, and axial symptoms including freezing gait, postural instability, and dysarthria
Neuroimaging indicators have been proposed to guide the surgical decision-making of DBS, such as connectivity maps, the lower limit of T2-relaxometry measurement in STN, reportedly predictable exercise results, or the volume of the nucleus accumbens as a post-STN-DBS A sign of the risk of cognitive decline
.
However, these tools are difficult to use in daily practice.
Identifying PD patients who are at risk of negative outcomes after STN-DBS remains a challenge because there are currently no clinical indicators to determine the patients most likely to benefit from this treatment
.
Until recently, only two single-center studies (conducted in 41 and 50 patients, respectively) evaluated the results of PD patients receiving STN-DBS with RBD and reported conflicting results
Until recently, only two single-center studies (conducted in 41 and 50 patients, respectively) evaluated the results of PD patients receiving RBD with STN-DBS and reported conflicting results
Compared with preoperative RBD-, preoperative RBD+ patients were older (61±7.
2 years vs.
59.
5±7.
7 years; P=0.
02) and less dyskinesias (MDS-UPDRS III Off: 38.
7±16.
2 vs.
43.
Both preoperative RBD+ and preoperative RBD- had a significant decrease in MDS-UPDRS IV scores after surgery (-37% and -33%, respectively), and MDS-UPDRS III "MedOff/StimOn" scores decreased (-52% and- 54%), and a decline in dopaminergic therapy (-52% and -49%), there was no difference between the groups
.
There were no differences between groups in the results of cognitive ability and overall quality of life
The important significance of this study is to find that in PD patients who meet STN-DBS, there is no relationship between the possible RBD before surgery and the difference in clinical results 1 year after neurosurgery
.
.
Original source:
Elsa Besse-Pinot et al.
Preoperative REM Sleep Behavior Disorder and Subthalamic Deep Brain Stimulation Outcome in Parkinson Disease 1 Year After Surgery.
Published online 2021:35.
Preoperative REM Sleep Behavior Disorder and Subthalamic Deep Brain Stimulation Outcome in Parkinson Disease 1 Year After Surgery.
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