from erika
Thanks for the PMID Janet.
If I read it correctly the apomorhine test can be used to predict the
outcome of DBS in persons with IDP. In this particular test the person with
MSA was accurately predicted to NOT benefit from the DBS. Yes?
My question is do any listfolk know of anyone with MSA who has had DBS and
what the outcome was?
Comments from Dr. Van der Linden?
I know I should perhaps go to the Shy-Drager list for this, but have not
changed over (yet).
I kind'a like this list but don't think I could manage keeping up with two
lists.
BTW this list with kerfuffles, heated discussions etc. seems to me to be
like the sea
it ebbs and flows and
storms stir up the sand and weeds
and all the while the fishes feed......
(well, at least most of our 1800, cause we're still here) :-)
Love, Erika.
-----Original Message-----
From: janet paterson <[log in to unmask]>
To: [log in to unmask] <[log in to unmask]>
Date: Tuesday, November 16, 1999 2:52 AM
Subject: PMID: 10552237: Can apomorphine test predict STN outcome?
>Apomorphine test: a predictor for motor responsiveness
>to deep brain stimulation of the subthalamic nucleus.
>
>The value of the apomorphine test as a predictor of the clinical outcome of
deep brain stimulation of the subthalamic nucleus (STN) was evaluated in
patients with advanced idiopathic Parkinson's disease (IPD) or multiple
system atrophy (MSA).
>
>13 IPD patients with severe diurnal fluctuations and 1 MSA patient not
responding to dopaminergic drugs were assessed with the Unified Parkinson's
Disease Rating Scale (UPDRS) and the timed finger tapping test (FTT),
measured preoperatively on and off apomorphine and postoperatively on and
off STN stimulation.
>
>UPDRS motor items 20-25 were assessed intraoperatively on and off STN
stimulation when the clinically effective target was approached.
>
>The motor response to immediate intraoperative and long-term STN
stimulation was correlated with results of the apomorphine test.
>
>The response to immediate intraoperative STN stimulation was accurately
predicted by apomorphine challenge in all 13 IPD patients.
>
>Clinical outcome following long-term STN stimulation was correlated
significantly with preoperative changes due to apomorphine measured with the
UPDRS motor scores (r = 0.7125, P < 0.01) and FTT (r = 0.9276, P < 0.001).
>
>Moreover, comparison of long-term STN stimulation to preoperative drug
treatment displayed a significant reduction in the duration of off-phases
and a significant increase in the duration of on-phases.
>
>However, in the single patient with MSA no beneficial response was obtained
either to apomorphine or to STN stimulation intraoperatively and during the
postoperative externalized test period.
>
>Our results indicate that the apomorphine test can predict the outcome of
immediate and long-term STN stimulation and may help in the selection of
candidates for surgery.
>
>
>J Neurol 1999 Oct 25;246(10):907-913
>Pinter MM, Alesch F, Murg M, Helscher RJ, Binder H
>Neurological Hospital Maria Theresien Schlossel, Vienna, Austria
>PMID: 10552237
>
><http://www.ncbi.nlm.nih.gov/PubMed/>
