Abstract
ObjectiveThe short-term benefits of bilateral stimulation of the subthalamic nucleus (STN) in patients with advanced Parkinson’s disease (PD) are well documented, but long-term benefits are still uncertain. The aim of this study is to evaluate the outcome of 8 years of bilateral STN stimulation to PD patients.MethodsIn this study, 31 consecutive PD patients were treated with bilateral STN stimulation. Their functional status was measured using the Activities of Daily Living section of the Unified Parkinson’s Disease Rating Scale (UPDRS-ADL) at drug on (with medication) and drug off (without medication) states preoperatively and at 1, 5, and 8 years postoperatively. In addition, Levodopa equivalent doses and stimulation parameters were also assessed.ResultsAfter 8 years of STN stimulation, the UPDRS-ADL scores were improved by 4% at drug off status (P > 0.05) and 22% at drug on status (P < 0.05) compared with baseline; the levodopa daily doses were reduced by 28% (P < 0.05) compared with baseline; the stimulation voltage and pulse width were not changed, but the stimulation frequency was decreased remarkably compared with the 5 years of follow-up. Adverse events were observed in 6 patients, including misplacement of the electrode and skin erosion requiring further surgery. All events were resolved without permanent sequelae. 2 patients died of aspiration pneumonia 6 and 7 years after surgery.ConclusionsThe marked improvement in UPDRS-ADL scores were still observed after 8 years of bilateral STN stimulation with medication.
Highlights
Chronic high-frequency deep brain stimulation (DBS) has been a standard surgical treatment to the Parkinson’s disease (PD) patients
Clinical evaluation The quality of life was assessed with Unified Parkinson Disease Rating Scale (UPDRS)-An activity of daily living (ADL) scores preoperatively and at 1, 5 and 8 years postoperatively at drug off state after overnight withdrawl of antiparkinsonian medication and drug on state after the administration of a single suprathreshold dose of levodopa (150% of the usual effective dose taken in the morning), respectively
Effects of continuous bilateral subthalamic nucleus (STN) stimulation on the quality of life of PD patients Compared with the drug off baseline, the ADL scores were improved by 58%, 33%, and 4% at 1, 5 and 8 years postoperatively under stimulation on and drug off status
Summary
31 consecutive PD patients were treated with bilateral STN stimulation. Their functional status was measured using the Activities of Daily Living section of the Unified Parkinson’s Disease Rating Scale (UPDRS-ADL) at drug on (with medication) and drug off (without medication) states preoperatively and at 1, 5, and 8 years postoperatively. Levodopa equivalent doses and stimulation parameters were assessed
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