Neurostimulation et mouvements anormaux

Marie Vidhailet
Durée : 2069000
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Présentation : neurostimulation et mouvements anormaux
P Pollak Grenoble, France Q;iq Since the seminal observations Observation séminale "des résultats spectaculaires"
Cervical trunk dystonia syndrome dystonie primaire
Cervical trunk Meige syndrome dystonia dystonie généralisée
is an effective in and severe focal dystonia with good ratio improvement of and • of of cognitive fonctions ratio Mean 0f improvement 51% improvement in 1 and of 10 La DBS est un traitement efficace
placebo Sham versus effective of severity I 3 no score: 39% change • score: 38% of life: 30% 6 months • score: 47% Un petit effet placebo
may persist the stimulation has been switched off After 6 hours patients flot reach the stage 3 3 L'effet bénéfique peut durer après l'arret de la stimulation
Long 48 hours Patient the stage 48 heures après la stimulation
Long 3 and 5 dystonia 48% at 6 70% at 3 and 67% at 5 ail with Segmental showed a stable change of 54% at 6 60% at 3 and 49% at 5 dystonia: 51% improvement in 1 year 58% in 3 years k Effets bénéfiques à long terme (3-5 ans)
improvement a or 10 Up to 10 in DYTI patients pair cf pairs f Effets bénéfiques à long terme (10 ans)
among patients response in 30 (83%) 36 patients at 6 months, 29 (94%) of 31 at 3 and 26 (81%) of 32 at 5 2 of the patients, had been as at 6 had a motor score improvement of 50% and 94%, at 5 after sessions of 4 who responded to had than 25% at 5 No or diseaserelated the outcome in the four and the four non-responders in this variabilité inexpliquée de réponse entre patients
Good prognosis factors Patients dystonia are to have the best outcome from DBS those who are younger 21 k an d sh orter d isease du ration and normal of life dystonia correlates with response to pallidal deep brain stimulation See for Moro E, 2013 Facteurs positifs de prédiction
Good factors Patients dystonia are to have the best from DBS those who are 21 a nd shorter d isease du ration and normal of life dystonia with response to deep brain stimulation See for E, RE, 2013 Facteurs négatifs de prédiction
Similar benefit in focal dystonia 50 % improvement. tonic movements 4 studies cf cervical et al 2007 Preto TE et al J 2008 et J Korean Soc. 1M et al 2012 R et al Brain 2013 5 patients DBS Capelle HH et al 2012 Long disease of stimulation in cervical K et al 2013 & dystonia Benefices sur dystonie focale
and Meige syndrome in most on scores at 6 Pr P Poila k Facial Challenge: speech but was an in at 3 (60%) in patients almost before the procedure. 2010. Soc. 2010 Bénéfices sur Blepharospasme et syndroime de meige
and Meige syndrome in most patients, on scores at 6 Pr P Poila k Facial Challenge: speech but was an in at 3 (60%) in patients before the procedure. et et Bénéfices sur les tremblements
STN stimulation in cervical dystonia rater TWSTRS total scores good total score 62.9% Most of the improvement in reached the response variable transient worsening depression • gain (3/9 movements absence of adverse r0 Problème : Des évolutions de plus en plus longues
STN stimulation in cervical dystonia rater TWSTRS total scores good total score 62.9% Most of the improvement in reached the response variable transient worsening depression • gain (3/9 in movements absence of adverse D'autres cibles ?.
STN stimulation may be of some in dystonia moderate of STN stimulation the patient to drink and stand up of Conclusion et questions du public
  • Présentation : neurostimulation et mouvements anormaux (0)
  • Observation séminale "des résultats spectaculaires" (85000)
  • dystonie primaire (146000)
  • dystonie généralisée (166000)
  • La DBS est un traitement efficace (368000)
  • Un petit effet placebo (474000)
  • L'effet bénéfique peut durer après l'arret de la stimulation (518000)
  • 48 heures après la stimulation (561000)
  • Effets bénéfiques à long terme (3-5 ans) (681000)
  • Effets bénéfiques à long terme (10 ans) (700000)
  • variabilité inexpliquée de réponse entre patients (818000)
  • Facteurs positifs de prédiction (898000)
  • Facteurs négatifs de prédiction (977000)
  • Benefices sur dystonie focale (1176000)
  • Bénéfices sur Blepharospasme et syndroime de meige (1200000)
  • Bénéfices sur les tremblements (1240000)
  • Problème : Des évolutions de plus en plus longues (1266000)
  • D'autres cibles ?. (1331000)
  • Conclusion et questions du public (1490000)
Marie Vidhailet

Hôpital Pitié-Salpétrière, Paris

74000
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