Table of Contents
To view the fulltext, log-in or choose pay-per-view options:
Get Access

Long-Term Outcomes of Bilateral Subthalamic Nucleus Stimulation in Patients with Advanced Parkinson’s Disease

Liang G.S.a · Chou K.L.b · Baltuch G.H.c · Jaggi J.L.d · Loveland-Jones C.d · Leng L.d · Maccarone H.d · Hurtig H.I.d · Colcher A.d · Stern M.B.d · Kleiner-Fisman G.d · Simuni T.e · Siderowf A.D.d
aThe Parkinson’s Institute, Sunnyvale, Calif., bDepartment of Clinical Neurosciences, Brown University School of Medicine, Providence, R.I., cDepartment of Neurosurgery, dDepartment of Neurology, The Parkinson’s Disease and Movement Disorders Center, University of Pennsylvania School of Medicine, Philadelphia, Pa., and eDepartment of Neurology, Northwestern University School of Medicine, Chicago, Ill., USA Stereotact Funct Neurosurg 2006;84:221–227 (DOI:10.1159/000096495)

Abstract

Background: In patients with advanced Parkinson’s disease (PD), deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been shown to improve motor function and decrease medication requirements in the short term. However, the long-term benefits of DBS are not yet established. Objective: It was the aim of this study to evaluate long-term outcomes of patients with PD treated with bilateral DBS of the STN. Design and Methods: Thirty-three subjects who had bilateral STN DBS were followed prospectively after surgery. We evaluated subjects, using the Unified Parkinson’s Disease Rating Scale (UPDRS), preoperatively, 12 months after surgery and at a long-term follow-up visit. Ratings were performed on and off dopaminergic medications. We compared postoperative UPDRS scores, dyskinesia ratings and medication dosages with preoperative values. Results: Twenty-seven subjects had evaluations beyond 18 months (median 33.7 months). Total UPDRS scores in the ‘medication-off’ state were improved by 37% (p < 0.001) at 12 months and 17.7% (p = 0.0051) at the long-term evaluation. Medication-off state UPDRS part III scores were significantly improved at both 1 year and at the last evaluation (37.6 and 29.3%; p < 0.001). Dopaminergic medication requirements were decreased by 35.3% (p < 0.001) during the first postoperative year and remained below preoperative levels at the long-term evaluation. Average duration of ‘off’ time remained decreased by about 40% at both 1 year and at the time of last evaluation. Subjects had a sustained reduction in dyskinesia severity (88.6% at 1 year and 68.8% at last evaluation). Conclusions: In this cohort of subjects with advanced PD, bilateral STN stimulation improved ‘off’ medication motor function, reduced time spent in the medication-off state and reduced medication requirements for up to 4 years after surgery. We conclude that STN DBS is an effective long-term therapy for selected patients with advanced PD.

 

Individual Users: Register with Karger Login Information

Please create your User ID & Password





Contact Information











I have read the Karger Terms and Conditions and agree.


Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50