Long-term stability of effects of subthalamic stimulation in Parkinson's disease: Indian Experience.
Reports of long-term effects of subthalamic (STN) stimulation for Parkinson's disease (PD) are few, mostly open-label evaluations and from Western centers. We used single-blind and open-label motor, cognitive and quality of life (QOL) evaluations to study the effects of bilateral STN stimulation in 45 patients over 5 years. Our patients showed a stable and substantial reduction in the cardinal signs of PD, motor fluctuations, and dyskinesias but less so for axial signs. The reduction in medications and the intensity of electrical stimulation needed also remained stable during follow up. Although the total QOL and its parkinsonism and social components showed sustained benefits till 5 years, the gains in emotional and systemic subsets were short lasting. Global scores for mood and cognition did not show significant worsening. Benefits of STN stimulation on the cardinal signs, motor complications, and QOL of advanced PD were substantial and sustained till 5 years. The initial benefits in axial motor signs and emotional and psychological aspects of QOL did not show similar stability. In general, the procedure had insignificant impact on cognition and mood. This is the first report of STN stimulation in Asian patients with PD.
Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India. ashakishore99@gmail.com
Asha
A
Kishore
Ravimohan
R
Rao
Syam
S
Krishnan
Dilip
D
Panikar
Gangadhara
G
Sarma
Mathuranath Pavagada
MP
Sivasanakaran
Sankara
S
Sarma
D000328:Adult; D000978:Antiparkinson Agents / Q000627:therapeutic use; D001288:Attention / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology / Q000628:therapy; D046690:Deep Brain Stimulation / Q000379:methods*; D020820:Dyskinesias / Q000209:etiology / Q000628:therapy; D056344:Executive Function / Q000502:physiology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007980:Levodopa / Q000627:therapeutic use; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications / Q000628:therapy*; D011788:Quality of Life; D012189:Retrospective Studies; D016037:Single-Blind Method; D020531:Subthalamic Nucleus / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D007980:Levodopa