Download e-book for iPad: Annual Review of Medicine Volume 55 2004 by C. Thomas Caskey

By C. Thomas Caskey

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Muradov KG, Artemyev NO. 2000. Loss of the effector function in a transducin-α mutant associated with Nougaret night blindness. J. Biol. Chem. 275:6969–74 11. Lyons J, Landis CA, Harsh G, et al. 1990. Two G protein oncogenes in human endocrine tumors. Science 249:655–59 12. Williamson EA, Johnson SJ, Foster S, et al. 1995. G protein gene mutations in patients 13. 14. 15. 16. 17. 18. 19. 20. with multiple endocrinopathies. J. Clin. Endocrinol. 80:1702–5 Hayward BE, Barlier A, Korbonits M, et al.

Org by Universitaet Heidelberg on 10/04/05. For personal use only. sgm LaTeX2e(2002/01/18) P1: GBC OLANOW with bilateral stimulation of the GPi. Stimulation of either target also significantly reduced the percentage of daily “off” time and the severity of parkinsonism during “off” periods. Direct comparisons of stimulation of the STN versus GPi have not been performed, but open-label comparisons suggest that DBS of the STN may be superior. Adverse effects associated with DBS include those related to the surgical intervention (hemorrhage, stroke, infection), the stimulator system (lead breaks, mechanical malfunction, infection), and stimulation of the target (muscle twitch, paresthesia, dysarthria, eye-movement disorder).

Clinically significant adverse events occur in ∼2%–4% of patients. In the multicenter study, bilateral DBS procedures performed in 143 patients were associated with seven brain hemorrhages, four of which resulted in persistent disability. DBS thus offers promise for patients with advanced PD who suffer severe motor complications that cannot be controlled satisfactorally with currently available medical therapies. It is very important to appreciate that antiparkinsonian benefits obtained with DBS and other surgical procedures are no greater than what can be achieved with levodopa and primarily consist of reduced motor complications.

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Annual Review of Medicine Volume 55 2004 by C. Thomas Caskey

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