The LRRK2 G2019S mutation status does not affect the outcome of subthalamic stimulation in patients with Parkinson's disease.
BACKGROUND
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is an established therapy for advanced Parkinson's disease (PD). The most common genetic mutation associated with PD identified to date is the G2019S mutation of the LRRK2 gene, which is highly prevalent in the Ashkenazi Jewish population. The effect of STN-DBS surgery in patients carrying this mutation has not been systematically studied. We therefore performed a case-control study to evaluate the impact of the G2019S mutation status on the outcomes of bilateral STN-DBS.


METHODS
The study sample included 39 Jewish PD patients with bilateral STN-DBS. Thirteen patients (5 females) were G2019S mutation heterozygous. The control group consisted of 26 PD patients with bilateral STN-DBS, negative for the mutation, matched (2:1) for gender, age at PD onset, and disease duration at surgery. Clinical data including the Unified PD Rating Scale scores (UPDRS), levodopa equivalent daily dose (LEDD), and clinical global impression of change (CGIC) concerning both motor and neuropsychiatric outcome- were available at 3 time points (preoperative baseline, 6-12 months and 3 years postoperatively).


RESULTS
Implementing a linear mixed model, a significant improvement (p < 0.05) was found for the whole group concerning reduction in motor UPRDS (off state) and LEDD pre- vs. postoperatively, as expected. No difference in clinical outcome was found between carriers and matched non-carriers at baseline or at postoperative follow-up (up to 3 years).


CONCLUSIONS
In our study, STN-DBS outcomes were not influenced by the LRRK2 G2019S mutation, and thus knowledge of carrier status may not be relevant to the considerations of patient selection for surgery.
Department of Neurology, Chaim Sheba Medical Center, Tel Hashomer, Israel; Parkinson's disease and Movement Disorders Clinic, Chaim Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
Lior
L
Greenbaum
Simon D
SD
Israeli-Korn
Oren S
OS
Cohen
Sandra
S
Elincx-Benizri
Gilad
G
Yahalom
Evgenia
E
Kozlova
Hanna
H
Strauss
Noa
N
Molshatzki
Rivka
R
Inzelberg
Roberto
R
Spiegelmann
Zvi
Z
Israel
Sharon
S
Hassin-Baer
D000368:Aged; D015331:Cohort Studies; D046690:Deep Brain Stimulation / Q000639:trends*; D005260:Female; D006801:Humans; D007585:Jews / Q000235:genetics*; D000071158:Leucine-Rich Repeat Serine-Threonine Protein Kinase-2; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D010300:Parkinson Disease / Q000175:diagnosis / Q000235:genetics* / Q000628:therapy; D017346:Protein Serine-Threonine Kinases / Q000235:genetics*; D020531:Subthalamic Nucleus / Q000502:physiology*; D016896:Treatment Outcome
C495280:LRRK2 protein, human; D000071158:Leucine-Rich Repeat Serine-Threonine Protein Kinase-2; D017346:Protein Serine-Threonine Kinases
LRRK2; Parkinsons disease; STN-DBS