The "brittle response" to Parkinson's disease medications: characterization and response to deep brain stimulation.

<h4>Objective</h4>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.<h4>Methods</h4>An UF...

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Autores principales:	Daniel Martinez-Ramirez, Juan Giugni, Vinata Vedam-Mai, Aparna Wagle Shukla, Irene A Malaty, Nikolaus R McFarland, Ramon L Rodriguez, Kelly D Foote, Michael S Okun
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/34ebfaef1fce4beb9f7668df8e050de1
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spelling	oai:doaj.org-article:34ebfaef1fce4beb9f7668df8e050de12021-11-18T08:23:25ZThe "brittle response" to Parkinson's disease medications: characterization and response to deep brain stimulation.1932-620310.1371/journal.pone.0094856https://doaj.org/article/34ebfaef1fce4beb9f7668df8e050de12014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24733172/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.Daniel Martinez-RamirezJuan GiugniVinata Vedam-MaiAparna Wagle ShuklaIrene A MalatyNikolaus R McFarlandRamon L RodriguezKelly D FooteMichael S OkunPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 4, p e94856 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Daniel Martinez-Ramirez Juan Giugni Vinata Vedam-Mai Aparna Wagle Shukla Irene A Malaty Nikolaus R McFarland Ramon L Rodriguez Kelly D Foote Michael S Okun The "brittle response" to Parkinson's disease medications: characterization and response to deep brain stimulation.
description	<h4>Objective</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>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.
format	article
author	Daniel Martinez-Ramirez Juan Giugni Vinata Vedam-Mai Aparna Wagle Shukla Irene A Malaty Nikolaus R McFarland Ramon L Rodriguez Kelly D Foote Michael S Okun
author_facet	Daniel Martinez-Ramirez Juan Giugni Vinata Vedam-Mai Aparna Wagle Shukla Irene A Malaty Nikolaus R McFarland Ramon L Rodriguez Kelly D Foote Michael S Okun
author_sort	Daniel Martinez-Ramirez
title	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_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_sort	"brittle response" to parkinson's disease medications: characterization and response to deep brain stimulation.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/34ebfaef1fce4beb9f7668df8e050de1
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The "brittle response" to Parkinson's disease medications: characterization and response to deep brain stimulation.

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