Long-term Outcomes (15 Years) After Subthalamic Nucleus Deep Brain Stimulation in Patients With Parkinson Disease
- PMID: 34078713
- DOI: 10.1212/WNL.0000000000012246
Long-term Outcomes (15 Years) After Subthalamic Nucleus Deep Brain Stimulation in Patients With Parkinson Disease
Abstract
Objective: To evaluate the effects of deep brain stimulation of the subthalamic nucleus (STN-DBS) on motor complications in patients with Parkinson disease (PD) beyond 15 years after surgery.
Methods: Data on motor complications, quality of life (QoL), activities of daily living, Unified Parkinson's Disease Rating Scale motor scores, dopaminergic treatment, stimulation measures, and side effects of STN-DBS were retrospectively retrieved and compared before surgery, at 1 year, and beyond 15 years after bilateral STN-DBS.
Results: Fifty-one patients with 17.06 ± 2.18 years STN-DBS follow-up were recruited. Compared to baseline, the time spent with dyskinesia and the time spent in the "off" state were reduced by 75% (p < 0.001) and by 58.7% (p < 0.001), respectively. Moreover, dopaminergic drugs were reduced by 50.6% (p < 0.001). Parkinson's Disease Quality of Life Questionnaire total score and the emotional function and social function domains improved 13.8% (p = 0.005), 13.6% (p = 0.01), and 29.9% (p < 0.001), respectively. Few and mostly manageable device-related adverse events were observed during the follow-up.
Conclusions: STN-DBS is effective beyond 15 years from the intervention, notably with significant improvement in motor complications and stable reduction of dopaminergic drugs. Furthermore, despite the natural continuous progression of PD with worsening of levodopa-resistant motor and nonmotor symptoms over the years, patients undergoing STN-DBS could maintain an improvement in QoL.
Classification of evidence: This study provides Class IV evidence that, for patients with PD, STN-DBS remains effective at treating motor complications 15 years after surgery.
© 2021 American Academy of Neurology.
Comment in
-
Subthalamic Nucleus Deep Brain Stimulation: Uncomplicating Motor Complications for the Long Haul.Neurology. 2021 Jul 19;97(3):107-108. doi: 10.1212/WNL.0000000000012245. Neurology. 2021. PMID: 34078714 No abstract available.
Comment on
-
Subthalamic Nucleus Deep Brain Stimulation: Uncomplicating Motor Complications for the Long Haul.Neurology. 2021 Jul 19;97(3):107-108. doi: 10.1212/WNL.0000000000012245. Neurology. 2021. PMID: 34078714 No abstract available.
Similar articles
-
Subthalamic Nucleus Deep Brain Stimulation Modulate Catecholamine Levels with Significant Relations to Clinical Outcome after Surgery in Patients with Parkinson's Disease.PLoS One. 2015 Sep 22;10(9):e0138462. doi: 10.1371/journal.pone.0138462. eCollection 2015. PLoS One. 2015. PMID: 26394059 Free PMC article.
-
Meta-analysis comparing deep brain stimulation of the globus pallidus and subthalamic nucleus to treat advanced Parkinson disease.J Neurosurg. 2014 Sep;121(3):709-18. doi: 10.3171/2014.4.JNS131711. Epub 2014 Jun 6. J Neurosurg. 2014. PMID: 24905564
-
Bilateral subthalamic deep brain stimulation initial impact on nonmotor and motor symptoms in Parkinson's disease: An open prospective single institution study.Medicine (Baltimore). 2018 Feb;97(5):e9750. doi: 10.1097/MD.0000000000009750. Medicine (Baltimore). 2018. PMID: 29384860 Free PMC article.
-
Long-term effects of bilateral subthalamic nucleus stimulation on sleep in patients with Parkinson's disease.PLoS One. 2019 Aug 27;14(8):e0221219. doi: 10.1371/journal.pone.0221219. eCollection 2019. PLoS One. 2019. PMID: 31454366 Free PMC article.
-
Subthalamic deep brain stimulation and levodopa in Parkinson's disease: a meta-analysis of combined effects.J Neurol. 2019 Feb;266(2):289-297. doi: 10.1007/s00415-018-8936-2. Epub 2018 Jun 16. J Neurol. 2019. PMID: 29909467 Review.
Cited by
-
Effects of STN-DBS on cognition and mood in young-onset Parkinson's disease: a two-year follow-up.Front Aging Neurosci. 2024 Jan 16;15:1177889. doi: 10.3389/fnagi.2023.1177889. eCollection 2023. Front Aging Neurosci. 2024. PMID: 38292047 Free PMC article.
-
Parkinson's Disease: A Tale of Many Players.Med Princ Pract. 2023;32(3):155-165. doi: 10.1159/000531422. Epub 2023 Jun 7. Med Princ Pract. 2023. PMID: 37285828 Free PMC article. Review.
-
Comparison of beta peak detection algorithms for data-driven deep brain stimulation programming strategies in Parkinson's disease.NPJ Parkinsons Dis. 2024 Aug 9;10(1):150. doi: 10.1038/s41531-024-00762-7. NPJ Parkinsons Dis. 2024. PMID: 39122725 Free PMC article.
-
Caregivers' burden and deep brain stimulation for Parkinson disease: A systematic review of qualitative studies.Eur J Neurol. 2024 Mar;31(3):e16149. doi: 10.1111/ene.16149. Epub 2023 Nov 17. Eur J Neurol. 2024. PMID: 37975788 Free PMC article. Review.
-
Comparative Effectiveness of Device-Aided Therapies on Quality of Life and Off-Time in Advanced Parkinson's Disease: A Systematic Review and Bayesian Network Meta-analysis.CNS Drugs. 2022 Dec;36(12):1269-1283. doi: 10.1007/s40263-022-00963-9. Epub 2022 Nov 21. CNS Drugs. 2022. PMID: 36414908 Free PMC article.
Publication types
LinkOut - more resources
Full Text Sources
Research Materials