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The “Brittle Response” to Parkinson’s Disease Medications: Characterization and Response to Deep Brain Stimulation

OBJECTIVE: Formulate a definition and describe the clinical characteristics of PD patients with a “brittle response” (BR) to medications versus a “non-brittle response” (NBR), and characterize the use of DBS for this population. METHODS: An UF IRB approved protocol used a retrospective chart review...

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Autores principales: Martinez-Ramirez, Daniel, Giugni, Juan, Vedam-Mai, Vinata, Shukla, Aparna Wagle, Malaty, Irene A., McFarland, Nikolaus R., Rodriguez, Ramon L., Foote, Kelly D., Okun, Michael S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3986256/
https://www.ncbi.nlm.nih.gov/pubmed/24733172
http://dx.doi.org/10.1371/journal.pone.0094856
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author Martinez-Ramirez, Daniel
Giugni, Juan
Vedam-Mai, Vinata
Shukla, Aparna Wagle
Malaty, Irene A.
McFarland, Nikolaus R.
Rodriguez, Ramon L.
Foote, Kelly D.
Okun, Michael S.
author_facet Martinez-Ramirez, Daniel
Giugni, Juan
Vedam-Mai, Vinata
Shukla, Aparna Wagle
Malaty, Irene A.
McFarland, Nikolaus R.
Rodriguez, Ramon L.
Foote, Kelly D.
Okun, Michael S.
author_sort Martinez-Ramirez, Daniel
collection PubMed
description OBJECTIVE: Formulate a definition and describe the clinical characteristics of PD patients with a “brittle response” (BR) to medications versus a “non-brittle response” (NBR), and characterize the use of DBS for this population. METHODS: An UF IRB approved protocol used a retrospective chart review of 400 consecutive PD patients presenting to the UF Center for Movement Disorders and Neurorestoration. Patient records were anonymized and de-identified prior to analysis. SPSS statistics were used to analyze data. RESULTS: Of 345 included patients, 19 (5.5%) met criteria for BR PD. The BR group was comprised of 58% females, compared to 29% in the NBR group (P = .008). The former had a mean age of 63.4 compared to 68.1 in the latter. BR patients had lower mean weight (63.5 vs. 79.6, P = <.001), longer mean disease duration (12.6 vs. 8.9 years, P = .003), and had been on LD for more years compared to NBR patients (9.8 vs. 5.9, P = .001). UPDRS motor scores were higher (40.4 vs. 30.0, P = .001) in BR patients. No differences were observed regarding the Schwab and England scale, PDQ-39, and BDI-II. Sixty-three percent of the BR group had undergone DBS surgery compared to 18% (P = .001). Dyskinesias were more common, severe, and more often painful (P = <.001) in the BR group. There was an overall positive benefit from DBS. CONCLUSION: BR PD occurred more commonly in female patients with a low body weight. Patients with longer disease duration and longer duration of LD therapy were also at risk. The BR group responded well to DBS.
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spelling pubmed-39862562014-04-15 The “Brittle Response” to Parkinson’s Disease Medications: Characterization and Response to Deep Brain Stimulation Martinez-Ramirez, Daniel Giugni, Juan Vedam-Mai, Vinata Shukla, Aparna Wagle Malaty, Irene A. McFarland, Nikolaus R. Rodriguez, Ramon L. Foote, Kelly D. Okun, Michael S. PLoS One Research Article OBJECTIVE: Formulate a definition and describe the clinical characteristics of PD patients with a “brittle response” (BR) to medications versus a “non-brittle response” (NBR), and characterize the use of DBS for this population. METHODS: An UF IRB approved protocol used a retrospective chart review of 400 consecutive PD patients presenting to the UF Center for Movement Disorders and Neurorestoration. Patient records were anonymized and de-identified prior to analysis. SPSS statistics were used to analyze data. RESULTS: Of 345 included patients, 19 (5.5%) met criteria for BR PD. The BR group was comprised of 58% females, compared to 29% in the NBR group (P = .008). The former had a mean age of 63.4 compared to 68.1 in the latter. BR patients had lower mean weight (63.5 vs. 79.6, P = <.001), longer mean disease duration (12.6 vs. 8.9 years, P = .003), and had been on LD for more years compared to NBR patients (9.8 vs. 5.9, P = .001). UPDRS motor scores were higher (40.4 vs. 30.0, P = .001) in BR patients. No differences were observed regarding the Schwab and England scale, PDQ-39, and BDI-II. Sixty-three percent of the BR group had undergone DBS surgery compared to 18% (P = .001). Dyskinesias were more common, severe, and more often painful (P = <.001) in the BR group. There was an overall positive benefit from DBS. CONCLUSION: BR PD occurred more commonly in female patients with a low body weight. Patients with longer disease duration and longer duration of LD therapy were also at risk. The BR group responded well to DBS. Public Library of Science 2014-04-14 /pmc/articles/PMC3986256/ /pubmed/24733172 http://dx.doi.org/10.1371/journal.pone.0094856 Text en © 2014 Martinez-Ramirez et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Martinez-Ramirez, Daniel
Giugni, Juan
Vedam-Mai, Vinata
Shukla, Aparna Wagle
Malaty, Irene A.
McFarland, Nikolaus R.
Rodriguez, Ramon L.
Foote, Kelly D.
Okun, Michael S.
The “Brittle Response” to Parkinson’s Disease Medications: Characterization and Response to Deep Brain Stimulation
title The “Brittle Response” to Parkinson’s Disease Medications: Characterization and Response to Deep Brain Stimulation
title_full The “Brittle Response” to Parkinson’s Disease Medications: Characterization and Response to Deep Brain Stimulation
title_fullStr The “Brittle Response” to Parkinson’s Disease Medications: Characterization and Response to Deep Brain Stimulation
title_full_unstemmed The “Brittle Response” to Parkinson’s Disease Medications: Characterization and Response to Deep Brain Stimulation
title_short The “Brittle Response” to Parkinson’s Disease Medications: Characterization and Response to Deep Brain Stimulation
title_sort “brittle response” to parkinson’s disease medications: characterization and response to deep brain stimulation
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3986256/
https://www.ncbi.nlm.nih.gov/pubmed/24733172
http://dx.doi.org/10.1371/journal.pone.0094856
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