Abstract
We present our experience at the University of Illinois at Chicago (UIC) in deep brain stimulation (DBS) of the subthalamic nucleus (STN), describing our surgical technique, and reporting our clinical results, and morbidities. Twenty patients with advanced Parkinson’s disease (PD) who underwent bilateral STN-DBS were studied. Patients were assessed preoperatively and followed up for one year using the Unified Parkinson’s Disease Rating Scale (UPDRS) in “on” and “off” medication and “on” and “off” stimulation conditions. At one-year follow-up, we calculated significant improvement in all the motor aspects of PD (UPDRS III) and in activities of daily living (UPDRS II) in the “off” medication state. The “off” medication UPDRS improved by 49.3%, tremors improved by 81.6%, rigidity improved by 50.0%, and bradykinesia improved by 39.3%. The “off” medication UPDRS II scores improved by 73.8%. The Levodopa equivalent daily dose was reduced by 54.1%. The UPDRS IVa score (dyskinesia) was reduced by 65.1%. The UPDRS IVb score (motor fluctuation) was reduced by 48.6%. Deep brain stimulation of the STN improves the cardinal motor manifestations of the idiopathic PD. It also improves activities of daily living, and reduces medication-induced complications.
Highlights
The deep brain stimulation (DBS) system consists of a lead that is implanted into a specific deep brain target
After obtaining an appropriate IRB approval, we retrospectively analyzed the data of 20 patients diagnosed with advanced Parkinson’s disease (PD) who underwent bilateral subthalamic nucleus (STN)-DBS at the University of Illinois at Chicago (UIC) in the period from 2013 to 2014
Patients who qualified for surgery had idiopathic PD and showed sustained response to levodopa, with a minimum of 30% improvement in Unified Parkinson’s Disease Rating Scale (UPDRS)
Summary
The deep brain stimulation (DBS) system consists of a lead that is implanted into a specific deep brain target. The lead is connected to an implantable pulse generator (IPG), which is the power source of the system. The lead and the IPG are connected by an extension wire that is tunneled under the skin between both of them. This system is used to chronically stimulate the deep brain target by delivering a high-frequency current to this target [1,2]. James Parkinson was the first to describe Parkinson’s disease (PD) in 1817; he described it as a combination of tremor, rigidity, postural abnormalities, and bradykinesia [3]. The main step that marked the onset of stereotactic surgery and the surgical treatment of different movement disorders was in 1947, when Ernest Spiegel and Henry Wycis invented the first frame-based stereotactic apparatus
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