Two-year follow-up of subthalamic deep brain stimulation in Parkinson's disease.
We studied 48 patients after bilateral subthalamic nucleus deep brain stimulation (STN-DBS) who were evaluated 6 months after the surgical procedure using the Unified Parkinson's Disease Rating Scale (UPDRS) in a standardized levodopa test. Additional follow-up was available in 32 patients after 12 months and in 20 patients after 24 months. At 6 months follow-up, STN-DBS reduced the UPDRS motor score by 50.9% compared to baseline. This improvement remained constant at 12 months with 57.5% and at 24 months with 57.3%. Relevant side effects after STN-DBS included intraoperative subdural hematoma without neurological sequelae (n = 1), minor intracerebral bleeding with slight transient hemiparesis (n = 1), dislocation of impulse generator (n = 2), transient perioperative confusional symptoms (n = 7), psychotic symptoms (n = 2), depression (n = 5), hypomanic behaviour (n = 2), and transient manic psychosis (n = 1). One patient died because of heart failure during the first postoperative year. The current series demonstrates efficacy and safety of STN-DBS beyond the first year after surgical procedure. Complications of STN-DBS comprise a wide range of psychiatric adverse events which, however, were temporary.
Herzog
Jan
J
Department of Neurology, Christian-Albrechts Universität Kiel, Kiel, Germany.
Volkmann
Jens
J
Krack
Paul
P
Kopper
Florian
F
Pötter
Monika
M
Lorenz
Delia
D
Steinbach
Meike
M
Klebe
Stefan
S
Hamel
Wolfgang
W
Schrader
Bettina
B
Weinert
Dieter
D
Müller
Dieter
D
Mehdorn
Hubertus M
HM
Deuschl
Günther
G
D004558:Electric Stimulation / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis / Q000628:therapy*; D012720:Severity of Illness Index; D020531:Subthalamic Nucleus / Q000502:physiology*