Dyskinesias induced by subthalamotomy in Parkinson's disease are unresponsive to amantadine
- Autores
- Merello, Marcelo Jorge; Perez Lloret, Santiago; Antico, J.; Obeso, J. A.
- Año de publicación
- 2006
- Idioma
- inglés
- Tipo de recurso
- artículo
- Estado
- versión publicada
- Descripción
- Background: Dyskinesias are a transient but severe complication of subthalamotomy in some patients. Patients and methods: Three patients with Parkinson’s disease undergoing bilateral micro-recording guided surgery of the subthalamic nucleus (STN) are described; deep brain stimulation (DBS) was used in one case, and subthalamotomy in the other two. Prior to surgery, levodopa induced dyskinesia had improved (⩽50%) under treatment with amantadine (400 mg/day, po) in all three patients. The patient treated with DBS developed severe dyskinesia a few days after discharge and began self medication with amantadine but showed no improvement. This suggested a possible lack of response to amantadine for treatment of dyskinesias induced by surgery of the STN. Results: Both patients treated with bilateral subthalamotomy developed unilateral choreoballistic movements immediately after surgery, despite not taking levodopa (L-dopa). Patients were scored using the dyskinesia scale and started treatment with 400 mg amantadine (po) for 4 days within the first postoperative week with no effect on dyskinesia score or its phenomenology. Amantadine was therefore discontinued. One month after surgery both patients were free of involuntary movements with an improvement of about 60% in the “off” state UPDRS motor score. Six month follow up showed maintained antiparkinsonian benefit, without need for levodopa treatment and complete absence of dyskinesia. Conclusion: The present findings suggest that: (i) amantadine probably exerts its anti-dyskinetic effect by acting on the “indirect” pathway; (ii) the pathophysiological mechanisms of subthalamotomy induced dyskinesias may differ from those involved in L-dopa induced dyskinesias; (iii) dyskinesias induced by STN surgery resolve spontaneously as compensatory mechanisms develop.
Fil: Merello, Marcelo Jorge. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Perez Lloret, Santiago. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Antico, J.. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina
Fil: Obeso, J. A.. Universidad de Navarra; España - Materia
- PARKINSON
- Nivel de accesibilidad
- acceso abierto
- Condiciones de uso
- https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
- Repositorio
- Institución
- Consejo Nacional de Investigaciones Científicas y Técnicas
- OAI Identificador
- oai:ri.conicet.gov.ar:11336/242490
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Dyskinesias induced by subthalamotomy in Parkinson's disease are unresponsive to amantadineMerello, Marcelo JorgePerez Lloret, SantiagoAntico, J.Obeso, J. A.PARKINSONhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3Background: Dyskinesias are a transient but severe complication of subthalamotomy in some patients. Patients and methods: Three patients with Parkinson’s disease undergoing bilateral micro-recording guided surgery of the subthalamic nucleus (STN) are described; deep brain stimulation (DBS) was used in one case, and subthalamotomy in the other two. Prior to surgery, levodopa induced dyskinesia had improved (⩽50%) under treatment with amantadine (400 mg/day, po) in all three patients. The patient treated with DBS developed severe dyskinesia a few days after discharge and began self medication with amantadine but showed no improvement. This suggested a possible lack of response to amantadine for treatment of dyskinesias induced by surgery of the STN. Results: Both patients treated with bilateral subthalamotomy developed unilateral choreoballistic movements immediately after surgery, despite not taking levodopa (L-dopa). Patients were scored using the dyskinesia scale and started treatment with 400 mg amantadine (po) for 4 days within the first postoperative week with no effect on dyskinesia score or its phenomenology. Amantadine was therefore discontinued. One month after surgery both patients were free of involuntary movements with an improvement of about 60% in the “off” state UPDRS motor score. Six month follow up showed maintained antiparkinsonian benefit, without need for levodopa treatment and complete absence of dyskinesia. Conclusion: The present findings suggest that: (i) amantadine probably exerts its anti-dyskinetic effect by acting on the “indirect” pathway; (ii) the pathophysiological mechanisms of subthalamotomy induced dyskinesias may differ from those involved in L-dopa induced dyskinesias; (iii) dyskinesias induced by STN surgery resolve spontaneously as compensatory mechanisms develop.Fil: Merello, Marcelo Jorge. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Perez Lloret, Santiago. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Antico, J.. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; ArgentinaFil: Obeso, J. A.. Universidad de Navarra; EspañaB M J Publishing Group2006-12info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/242490Merello, Marcelo Jorge; Perez Lloret, Santiago; Antico, J. ; Obeso, J. A.; Dyskinesias induced by subthalamotomy in Parkinson's disease are unresponsive to amantadine; B M J Publishing Group; Neuropsychiatry Of Basal Ganglia; 77; 2; 12-2006; 172-1740022-3050CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077561/info:eu-repo/semantics/altIdentifier/url/https://jnnp.bmj.com/content/77/2/172.longinfo:eu-repo/semantics/altIdentifier/doi/10.1136/jnnp.2005.068940info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:09:49Zoai:ri.conicet.gov.ar:11336/242490instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:09:49.887CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse |
dc.title.none.fl_str_mv |
Dyskinesias induced by subthalamotomy in Parkinson's disease are unresponsive to amantadine |
title |
Dyskinesias induced by subthalamotomy in Parkinson's disease are unresponsive to amantadine |
spellingShingle |
Dyskinesias induced by subthalamotomy in Parkinson's disease are unresponsive to amantadine Merello, Marcelo Jorge PARKINSON |
title_short |
Dyskinesias induced by subthalamotomy in Parkinson's disease are unresponsive to amantadine |
title_full |
Dyskinesias induced by subthalamotomy in Parkinson's disease are unresponsive to amantadine |
title_fullStr |
Dyskinesias induced by subthalamotomy in Parkinson's disease are unresponsive to amantadine |
title_full_unstemmed |
Dyskinesias induced by subthalamotomy in Parkinson's disease are unresponsive to amantadine |
title_sort |
Dyskinesias induced by subthalamotomy in Parkinson's disease are unresponsive to amantadine |
dc.creator.none.fl_str_mv |
Merello, Marcelo Jorge Perez Lloret, Santiago Antico, J. Obeso, J. A. |
author |
Merello, Marcelo Jorge |
author_facet |
Merello, Marcelo Jorge Perez Lloret, Santiago Antico, J. Obeso, J. A. |
author_role |
author |
author2 |
Perez Lloret, Santiago Antico, J. Obeso, J. A. |
author2_role |
author author author |
dc.subject.none.fl_str_mv |
PARKINSON |
topic |
PARKINSON |
purl_subject.fl_str_mv |
https://purl.org/becyt/ford/3.2 https://purl.org/becyt/ford/3 |
dc.description.none.fl_txt_mv |
Background: Dyskinesias are a transient but severe complication of subthalamotomy in some patients. Patients and methods: Three patients with Parkinson’s disease undergoing bilateral micro-recording guided surgery of the subthalamic nucleus (STN) are described; deep brain stimulation (DBS) was used in one case, and subthalamotomy in the other two. Prior to surgery, levodopa induced dyskinesia had improved (⩽50%) under treatment with amantadine (400 mg/day, po) in all three patients. The patient treated with DBS developed severe dyskinesia a few days after discharge and began self medication with amantadine but showed no improvement. This suggested a possible lack of response to amantadine for treatment of dyskinesias induced by surgery of the STN. Results: Both patients treated with bilateral subthalamotomy developed unilateral choreoballistic movements immediately after surgery, despite not taking levodopa (L-dopa). Patients were scored using the dyskinesia scale and started treatment with 400 mg amantadine (po) for 4 days within the first postoperative week with no effect on dyskinesia score or its phenomenology. Amantadine was therefore discontinued. One month after surgery both patients were free of involuntary movements with an improvement of about 60% in the “off” state UPDRS motor score. Six month follow up showed maintained antiparkinsonian benefit, without need for levodopa treatment and complete absence of dyskinesia. Conclusion: The present findings suggest that: (i) amantadine probably exerts its anti-dyskinetic effect by acting on the “indirect” pathway; (ii) the pathophysiological mechanisms of subthalamotomy induced dyskinesias may differ from those involved in L-dopa induced dyskinesias; (iii) dyskinesias induced by STN surgery resolve spontaneously as compensatory mechanisms develop. Fil: Merello, Marcelo Jorge. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Perez Lloret, Santiago. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Antico, J.. Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia; Argentina Fil: Obeso, J. A.. Universidad de Navarra; España |
description |
Background: Dyskinesias are a transient but severe complication of subthalamotomy in some patients. Patients and methods: Three patients with Parkinson’s disease undergoing bilateral micro-recording guided surgery of the subthalamic nucleus (STN) are described; deep brain stimulation (DBS) was used in one case, and subthalamotomy in the other two. Prior to surgery, levodopa induced dyskinesia had improved (⩽50%) under treatment with amantadine (400 mg/day, po) in all three patients. The patient treated with DBS developed severe dyskinesia a few days after discharge and began self medication with amantadine but showed no improvement. This suggested a possible lack of response to amantadine for treatment of dyskinesias induced by surgery of the STN. Results: Both patients treated with bilateral subthalamotomy developed unilateral choreoballistic movements immediately after surgery, despite not taking levodopa (L-dopa). Patients were scored using the dyskinesia scale and started treatment with 400 mg amantadine (po) for 4 days within the first postoperative week with no effect on dyskinesia score or its phenomenology. Amantadine was therefore discontinued. One month after surgery both patients were free of involuntary movements with an improvement of about 60% in the “off” state UPDRS motor score. Six month follow up showed maintained antiparkinsonian benefit, without need for levodopa treatment and complete absence of dyskinesia. Conclusion: The present findings suggest that: (i) amantadine probably exerts its anti-dyskinetic effect by acting on the “indirect” pathway; (ii) the pathophysiological mechanisms of subthalamotomy induced dyskinesias may differ from those involved in L-dopa induced dyskinesias; (iii) dyskinesias induced by STN surgery resolve spontaneously as compensatory mechanisms develop. |
publishDate |
2006 |
dc.date.none.fl_str_mv |
2006-12 |
dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://purl.org/coar/resource_type/c_6501 info:ar-repo/semantics/articulo |
format |
article |
status_str |
publishedVersion |
dc.identifier.none.fl_str_mv |
http://hdl.handle.net/11336/242490 Merello, Marcelo Jorge; Perez Lloret, Santiago; Antico, J. ; Obeso, J. A.; Dyskinesias induced by subthalamotomy in Parkinson's disease are unresponsive to amantadine; B M J Publishing Group; Neuropsychiatry Of Basal Ganglia; 77; 2; 12-2006; 172-174 0022-3050 CONICET Digital CONICET |
url |
http://hdl.handle.net/11336/242490 |
identifier_str_mv |
Merello, Marcelo Jorge; Perez Lloret, Santiago; Antico, J. ; Obeso, J. A.; Dyskinesias induced by subthalamotomy in Parkinson's disease are unresponsive to amantadine; B M J Publishing Group; Neuropsychiatry Of Basal Ganglia; 77; 2; 12-2006; 172-174 0022-3050 CONICET Digital CONICET |
dc.language.none.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
info:eu-repo/semantics/altIdentifier/url/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077561/ info:eu-repo/semantics/altIdentifier/url/https://jnnp.bmj.com/content/77/2/172.long info:eu-repo/semantics/altIdentifier/doi/10.1136/jnnp.2005.068940 |
dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by-nc-sa/2.5/ar/ |
eu_rights_str_mv |
openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/ |
dc.format.none.fl_str_mv |
application/pdf application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
B M J Publishing Group |
publisher.none.fl_str_mv |
B M J Publishing Group |
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reponame:CONICET Digital (CONICET) instname:Consejo Nacional de Investigaciones Científicas y Técnicas |
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CONICET Digital (CONICET) |
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CONICET Digital (CONICET) |
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Consejo Nacional de Investigaciones Científicas y Técnicas |
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CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas |
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dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar |
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