Staged unilateral versus bilateral subthalamic nucleus stimulator implantation in Parkinson disease.
In 17 consecutive patients with Parkinson disease (PD), bilateral subthalamic nucleus (STN) stimulators were implanted during staged surgeries. The Unified Parkinson Disease Rating Scale (UPDRS) and the Dyskinesia Disability Scale were completed both off and on medication prior to any surgery and also OFF and ON stimulation after each surgery. On-medication UPDRS activities of daily living (ADL) and motor examination scores changed little with unilateral or bilateral stimulation. Off-medication UPDRS motor examination scores improved to similar degrees after each staged STN electrode implantation. Most of the improvements in off-medication ADL scores, dyskinesia scores, complications of therapy, and medication dose reduction occurred after unilateral STN stimulation with smaller improvements after the second operation.
Samii
Ali
A
Department of Neurology, University of Washington, Seattle, Washington, USA.|Parkinson Disease Research Education and Clinical Center, Neurology Section, VA Puget Sound Health Care System, Seattle, Washington, USA.
Kelly
Valerie E
VE
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA.
Slimp
Jefferson C
JC
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA.
Shumway-Cook
Anne
A
Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA.
Goodkin
Robert
R
Department of Neurological Surgery, University of Washington, Seattle, Washington, USA.
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D004558:Electric Stimulation / Q000379:methods; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000473:pathology* / Q000601:surgery*; D012720:Severity of Illness Index; D020531:Subthalamic Nucleus / Q000503:physiopathology*