Deep brain stimulation of the subthalamic nucleus in Parkinson's disease.
OBJECTIVE
To evaluate the clinical effects of subthalamic nucleus deep brain stimulation in patients with Parkinson's disease within the first 12 months after surgery.


METHODS
We performed a prospective study in 8 patients with Parkinson's disease, in whom electrodes were implanted in the subthalamic nucleus bilaterally. We compared levodopa-equivalents and the scores of the Unified Parkinson's Disease Rating Scale pre- and post-operatively. The post-operative evaluation was done between 3 and 12 months after surgery.


RESULTS
Antiparkinsonian medications were reduced post-operatively by a mean of 61.5% (P < 0.01) from a levodopa-equivalent dosage of 1144.9 +/- 572.5 mg/day to 440.9 +/- 172.1 mg/day. Motor scores improved 44.4% (P < 0.01) and activities of daily living scores 38.2% (P < 0.01). Adverse events included a subcutaneous hematoma in 1 patient after internal pulse generator implantation necessitating evacuation.


CONCLUSIONS
Bilateral stimulation of the subthalamic nucleus is associated with significant improvement in motor function and reduction of antiparkinsonian medications in patients with Parkinson's disease in the first 12 months after surgery. On-state dyskinesias were greatly reduced, probably due to the reduction of total antiparkinsonian medications. The procedure is well tolerated.
Kawakami
Noriaki
N
Department of Neurological Surgery, University of Wisconsin-Madison, USA.
Jessen
Heather
H
Bordini
Brett
B
Gallagher
Catherine
C
Klootwyk
Jennifer
J
Garell
Charles P
CP
D000368:Aged; D000978:Antiparkinson Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D046690:Deep Brain Stimulation; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000628:therapy*; D018709:Statistics, Nonparametric; D013238:Stereotaxic Techniques; D020531:Subthalamic Nucleus; D016896:Treatment Outcome
D000978:Antiparkinson Agents