Antiparkinsonian therapy modifications in PD patients after STN DBS: a retrospective observational analysis.
OBJECTIVE
This study reports a retrospective analysis of 67 consecutive parkinsonian patients to assess changes in antiparkinsonian medications after Deep Brain Stimulation (DBS) of the Subthalamic Nucleus (STN).


METHODS
All antiparkinsonian drugs, including levodopa, dopamine agonists, associated drugs such as COMT and MAO inhibitors, amantadine and anticholinergics, were evaluated pre- and post-operatively at 1 and 3 years follow-up.


RESULTS
The levodopa mean daily dose was reduced approximately 60% after 1 year and remained stable after 3 years. Apomorphine, bromocriptine, tolcapone, entacapone and selegiline were withdrawn after STN DBS. Three years post-operatively, 9 patients (13.4%) no longer required levodopa and 6 patients (8.9%) completely stopped all dopaminergic medications. More patients were on monotherapy of either levodopa or dopamine agonist and fewer patients required a combined treatment of dopamine agonist and levodopa, compared to the pre-surgical condition.


CONCLUSIONS
STN DBS treated PD patients experience a significant long-term reduction and simplification of the pharmacological treatment.
Zibetti
M
M
Department of Neuroscience, University of Turin, via Cherasco 15, 10126 Turin, Italy. mzibetti@molinette.piemonte.it
Pesare
M
M
Cinquepalmi
A
A
Rosso
M
M
Bergamasco
B
B
Ducati
A
A
Lanotte
M
M
Lopiano
L
L
D000368:Aged; D000978:Antiparkinson Agents / Q000145:classification / Q000627:therapeutic use*; D003131:Combined Modality Therapy / Q000379:methods; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects / Q000502:physiology; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020531:Subthalamic Nucleus / Q000502:physiology; D013997:Time Factors
D000978:Antiparkinson Agents