title: One-year Outcome of Bilateral Subthalamic Stimulation in Parkinson Disease: An Eastern Experience.
abstract: BACKGROUND
  Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is widely accepted as a treatment for advanced Parkinson disease (PD). However, published studies were conducted mainly in Western centers and recruited small numbers of patients. This study presents 1-year outcomes in Taiwanese patients with PD.
  
  
  METHODS
  Sixty-two consecutive patients underwent STN-DBS surgery during a 7-year period. Their median drug-off Hoehn and Yahr stage was 3 and mean illness history was 8 years. Clinical outcomes were evaluated by the change in drug-off/DBS-on Unified Parkinson Disease Rating Scale (UPDRS) scores relative to presurgical drug-off baseline and change in daily levodopa-equivalent dose (LED).
  
  
  RESULTS
  After 1 year of DBS therapy, patients showed significant improvements with a clinically high effect size in cardinal signs, particularly in tremor (63%). Posture instability was also improved, whereas speech dysfunction was hardly corrected. The LED need was significantly reduced, therefore preoperative drug-induced complications were prominently (51%) ameliorated after surgery and drug-induced dyskinesia was remarkably (63%) diminished. No serious adverse effects were encountered after surgery. Overall, motor functions declined by 15% within 1 year in drug-off state.
  
  
  CONCLUSIONS
  Bilateral STN-DBS therapy provided effective and sustained benefits to Eastern patients with PD over a 1-year period.
authors.affiliation: Department of Neurosurgery, China Medical University Hospital, China Medical University, Taichung, Taiwan. Electronic address: tsmchiou@pchome.com.tw.
authors.forename: Shang-Ming
authors.initials: SM
authors.lastname: Chiou
authors.affiliation: Department of Neurology, China Medical University Hospital, China Medical University, Taichung, Taiwan.
authors.forename: Yu-Chin
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Neurosurgery, China Medical University Hospital, China Medical University, Taichung, Taiwan.
authors.forename: Hsiang-Ming
authors.initials: HM
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects / Q000627:therapeutic use; D015331:Cohort Studies; D046690:Deep Brain Stimulation / Q000379:methods*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000628:therapy; D006801:Humans; D007980:Levodopa / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D010300:Parkinson Disease / Q000628:therapy*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013064:Speech Disorders / Q000209:etiology / Q000628:therapy; D020531:Subthalamic Nucleus; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Deep brain stimulation; Effect size; Levodopa; Parkinson disease; Prognosis; Subthalamic nucleus