title: STN DBS of Advanced Parkinson's Disease Experienced in a Specialized Monitoring Unit with a Prospective Protocol.
abstract: OBJECTIVE
  In the evaluation of patients with Parkinson's disease (PD), most neurologists only see their patients during a limited period of their fluctuating 24-hour-a-day lives. This study aimed to assess the short-term outcome of STN stimulation for patients with advanced PD evaluated in a 24-hour monitoring unit for movement disorder (MUMD) using a prospective protocol.
  
  
  METHODS
  Forty-two patients with advanced PD consecutively treated with bilateral STN stimulation using multi-channel microelectrode recording were included in this study. All patients were evaluated using a 24-hour MUMD with a video recording/editing system and were evaluated with a prospective protocol of the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr Staging, Schwab and England Activities of Daily Living, levodopa equivalent daily dose (LEDD), Short Form-36 Health Survey, and neuropsychological tests. Magnetic resonance (MR) images of the brain were performed prior to and six months after surgery.
  
  
  RESULTS
  All patients were evaluated at three and six months after surgery. There was a rapid and significant improvement of the motor symptoms, especially in tremor and rigidity, after STN stimulation with low morbidity. Dyskinesia was markedly decreased with much lowered LEDD values by 50% after STN stimulation. 1.5T MR images were safely taken according to the manufacturer's guidelines at six months after surgery without any adverse effects in 41 patients treated with STN stimulations.
  
  
  CONCLUSIONS
  Evaluations in a 24-hour monitoring unit could reduce the dose of medication efficiently to an optimal level with patients'comfort and improve the clinical symptoms in harmony with STN stimulation.
authors.affiliation: Department of Neurosurgery, Cancer Research Institute, Seoul National University College of Medicine, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea.
authors.forename: Ji Yeoun
authors.initials: JY
authors.lastname: Lee
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Han
authors.forename: Han Joon
authors.initials: HJ
authors.lastname: Kim
authors.forename: Beom Seok
authors.initials: BS
authors.lastname: Jeon
authors.forename: Dong Gyu
authors.initials: DG
authors.lastname: Kim
authors.forename: Sun Ha
authors.initials: SH
authors.lastname: Paek