Effect of bilateral subthalamic deep brain stimulation on diphasic dyskinesia.
OBJECTIVE
The goal of this study was to assess the effect of bilateral subthalamic deep brain stimulation (STN DBS) on levodopa-induced diphasic dyskinesia in patients with Parkinson disease (PD).


METHODS
Six PD patients with diphasic dyskinesia were included in this study. Prior to surgery, the duration and severity of dyskinesia were determined in each patient, along with the Unified Parkinson Disease Rating Scale score and Hoehn and Yahr stage. Bilateral STN electrode implantation was performed during a single operation.


RESULTS
The median duration of the follow-up period was 21.5 months (range 14-24 months). STN DBS had a beneficial effect on diphasic dyskinesia in all patients. At the last follow-up, 3 patients had no dyskinesia and 1 had only a small amount of peak-dose dyskinesia. One patient showed a reduction in the duration of diphasic dyskinesia, despite a lack of reduction in the total duration of dyskinesia. In the last patient, although the total duration of dyskinesia increased, the pattern of dyskinesia changed from severe painful disabling dyskinesia to the less severe peak-dose type of dyskinesia. There were no intraoperative or postoperative surgical complications.


CONCLUSIONS
Bilateral STN DBS is good at reducing diphasic dyskinesia, and it can be a good therapeutic option for patients with diphasic dyskinesia.
Kim
Han-Joon
HJ
Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea.
Lee
Jee-Young
JY
Kim
Ji-Young
JY
Kim
Dong Gyu
DG
Paek
Sun Ha
SH
Jeon
Beom S
BS
D000328:Adult; D000978:Antiparkinson Agents / Q000009:adverse effects* / Q000627:therapeutic use; D046690:Deep Brain Stimulation; D004292:Dominance, Cerebral / Q000502:physiology; D004359:Drug Therapy, Combination; D004409:Dyskinesia, Drug-Induced / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007980:Levodopa / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000187:drug effects; D010300:Parkinson Disease / Q000188:drug therapy*; D020531:Subthalamic Nucleus / Q000503:physiopathology*
D000978:Antiparkinson Agents; D007980:Levodopa