title: Greater improvement in LRRK2 G2019S patients undergoing Subthalamic Nucleus Deep Brain Stimulation compared to non-mutation carriers.
abstract: BACKGROUND
  Bilateral subthalamic nucleus deep brain stimulation (STN-DBS) of parkinson's disease (PD) patients has demonstrated to improve motor performance and to reduce dopa-induced dyskinesia. An association between the occurrence of dyskinesias and LRRK2 (leucine-rich repeat kinase 2) G2019S gene mutations has recently been suggested. The aim of this study is to discover the impact of the G2019S mutation (with high incidence in the authors' native Algeria) on the symptom response of PD in patients who underwent STN-DBS.
  
  
  METHODS
  We carried out a comparative statistical study for the clinical evaluation and neuropsychological assessment of 27 Algerian PD STN-DBS patients, both G2019S mutation carriers (MC) and non-carriers (NC). A multiple correspondence analysis (MCA) was then conducted to compare the results with those from groups of individuals with similar modalities.
  
  
  RESULTS
  The MCA revealed that MC and NC PD patients showed two different patterns of clinical evaluations. The group of idiopathic patients showed some differences compared to the clinical evaluations, depending on gender. No association was found between the G2019S mutation and the Mini Mental State Examination scores (MMSE), and MC patients appeared more susceptible to dyskinesia than NC patients. In NC patients, we found two cases with Parkin mutations who had a different "honeymoon" period and different initial symptoms. The results showed considerable improvement of motor unified parkinson's disease rating scale III (UPDRS-III) in a situation of stimulation without medication in the MC patients with a percentage of improvement (51.1 %) over the required 30 % compared to the NC patients (25.5 %). The same result was observed for the Schwab and England's activities of daily living scale (S and E scale), which thus demonstrated a greater effectiveness of DBS for MC patients than for NC patients. However, the Hoehn and Yahr scale (H and Y Scale) showed the same significance in a situation of stimulation for MC and NC patients. In this later group, the best scores of UPDRS-III were observed for patients with the Parkin mutation before they underwent surgery.
  
  
  CONCLUSIONS
  This study shows that surgical treatment probably has a more significant impact on LRRK2 G2019S MC than on idiopathic patients.
authors.affiliation: Laboratory of Behavioral and Cognitive Neuroscience, FSB, University of Science and Technology Houari Boumediene, El Alia, Bab Ezzouar, BP 32, 16111, Algiers, Algeria. sayad_massiva@yahoo.fr.|Department of BPO, Faculty of SNV, Blida 1 University, BP 270, 09000, Blida, Algeria. sayad_massiva@yahoo.fr.
authors.forename: Massiva
authors.initials: M
authors.lastname: Sayad
authors.affiliation: Laboratory of Behavioral and Cognitive Neuroscience, FSB, University of Science and Technology Houari Boumediene, El Alia, Bab Ezzouar, BP 32, 16111, Algiers, Algeria. zouambia26@gmail.com.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Zouambia
authors.affiliation: Department of Neurology, CHU Ben Aknoun, 16000, Algiers, Algeria. chaouch_malika@hotmail.com.
authors.forename: Malika
authors.initials: M
authors.lastname: Chaouch
authors.affiliation: Department of Neurology, CHU Ben Aknoun, 16000, Algiers, Algeria. ferratfarida@yahoo.fr.
authors.forename: Farida
authors.initials: F
authors.lastname: Ferrat
authors.affiliation: Department of Neurosurgery, Mohamed-Seghir Nekkache Military Hospital, Djasr Kasentina, Algiers, Algeria. mus.neuro@gmail.com.
authors.forename: Mustapha
authors.initials: M
authors.lastname: Nebbal
authors.affiliation: Department of Neurology, Mohamed-Seghir Nekkache Military Hospital, Djasr Kasentina, Algiers, Algeria. m-bendini@hotmail.fr.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Bendini
authors.affiliation: UMR S 1127 PaInserm U 1127, Sorbonne University, UPMC Univ Paris 06, Paris, France. suzanne.lesage@upmc.fr.|CNRS UMR 7225, Paris, France. suzanne.lesage@upmc.fr.|The Brain and Spinal Cord Institute, 75013, Paris, France. suzanne.lesage@upmc.fr.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Lesage
authors.affiliation: UMR S 1127 PaInserm U 1127, Sorbonne University, UPMC Univ Paris 06, Paris, France. alexis.brice@upmc.fr.|CNRS UMR 7225, Paris, France. alexis.brice@upmc.fr.|The Brain and Spinal Cord Institute, 75013, Paris, France. alexis.brice@upmc.fr.
authors.forename: Alexis
authors.initials: A
authors.lastname: Brice
authors.affiliation: Department of Chemistry, Blida 1 University, BP 270, 09000, Blida, Algeria. m.brahim.errahmani@univ-blida.dz.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Brahim Errahmani
authors.affiliation: Laboratory of Behavioral and Cognitive Neuroscience, FSB, University of Science and Technology Houari Boumediene, El Alia, Bab Ezzouar, BP 32, 16111, Algiers, Algeria. asselah.boualem@gmail.com.
authors.forename: Boualem
authors.initials: B
authors.lastname: Asselah
mesh_terms: D046690:Deep Brain Stimulation; D005260:Female; D006801:Humans; D000071158:Leucine-Rich Repeat Serine-Threonine Protein Kinase-2; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010300:Parkinson Disease / Q000235:genetics* / Q000601:surgery / Q000628:therapy*; D017346:Protein Serine-Threonine Kinases / Q000235:genetics*; D020531:Subthalamic Nucleus / Q000503:physiopathology*; D016896:Treatment Outcome
chemical_list: C495280:LRRK2 protein, human; D000071158:Leucine-Rich Repeat Serine-Threonine Protein Kinase-2; D017346:Protein Serine-Threonine Kinases
references.citation: N Engl J Med. 2000 May 25;342(21):1560-7
references.pmid: 10824074
references.citation: BMC Neurol. 2015;15:113
references.pmid: 26187628
references.citation: Zentralbl Neurochir. 2002;63(3):124-7
references.pmid: 12457339
references.citation: N Engl J Med. 2003 Nov 13;349(20):1925-34
references.pmid: 14614167
references.citation: Neurology. 2004 Jan 13;62(1 Suppl 1):S1-8
references.pmid: 14718675
references.citation: Eur J Neurol. 2004 Jul;11(7):451-4
references.pmid: 15257682
references.citation: Mov Disord. 1986;1(3):187-92
references.pmid: 3504244
references.citation: Neurol Clin. 1992 May;10(2):317-29
references.pmid: 1584176
references.citation: Stereotact Funct Neurosurg. 1994;62(1-4):76-84
references.pmid: 7631092
references.citation: Nature. 1998 Apr 9;392(6676):605-8
references.pmid: 9560156
references.citation: Lancet. 1998 Oct 24;352(9137):1355-6
references.pmid: 9802278
references.citation: Hum Mol Genet. 1999 Apr;8(4):567-74
references.pmid: 10072423
references.citation: Mov Disord. 1999 Jul;14(4):572-84
references.pmid: 10435493
references.citation: Neuron. 2004 Nov 18;44(4):595-600
references.pmid: 15541308
references.citation: Neuron. 2004 Nov 18;44(4):601-7
references.pmid: 15541309
references.citation: Am J Hum Genet. 2005 Apr;76(4):672-80
references.pmid: 15726496
references.citation: Arch Neurol. 2005 Aug;62(8):1250-5
references.pmid: 15956104
references.citation: Ann Neurol. 2005 Nov;58(5):784-7
references.pmid: 16240353
references.citation: J Neurol Neurosurg Psychiatry. 2005 Dec;76(12):1640-4
references.pmid: 16291886
references.citation: Arch Neurol. 2006 Jun;63(6):826-32
references.pmid: 16769863
references.citation: Mov Disord. 2006 Aug;21(8):1123-30
references.pmid: 16637023
references.citation: Parkinsonism Relat Disord. 2006 Oct;12(7):410-9
references.pmid: 16750929
references.citation: Mov Disord. 2007 Jan;22(1):119-22
references.pmid: 17080443
references.citation: Ann Neurol. 2007 Jan;61(1):47-54
references.pmid: 17187375
references.citation: Neurology. 2008 Apr 1;70(14):1186-91
references.pmid: 18378882
references.citation: Lancet Neurol. 2009 Jan;8(1):67-81
references.pmid: 19081516
references.citation: Neurology. 2009 Jul 21;73(3):206-12
references.pmid: 19620608
references.citation: Neurology. 2009 Jul 28;73(4):279-86
references.pmid: 19636047
references.citation: Neurodegener Dis. 2010;7(1-3):175-9
references.pmid: 20197701
references.citation: Parkinsonism Relat Disord. 2010 Dec;16(10):676-9
references.pmid: 20933457
references.citation: Acta Neurol Scand. 2011 Mar;123(3):201-6
references.pmid: 20545633
references.citation: J Neurol Neurosurg Psychiatry. 2011 May;82(5):569-73
references.pmid: 20935326
references.citation: J Neurol Neurosurg Psychiatry. 2011 Jul;82(7):754-60
references.pmid: 19465417
references.citation: Neurol Sci. 2013 Mar;34(3):383-6
references.pmid: 22437494
references.citation: Handb Clin Neurol. 2013;116:27-37
references.pmid: 24112882
references.citation: Handb Clin Neurol. 2013;116:129-46
references.pmid: 24112890
references.citation: Parkinsonism Relat Disord. 2013 Nov;19(11):1053-6
references.pmid: 23932063
references.citation: Mov Disord. 2013 Dec;28(14):1966-71
references.pmid: 24243757
references.citation: J Clin Neurosci. 2014 Jan;21(1):107-10
references.pmid: 24060625
references.citation: Parkinsonism Relat Disord. 2014 Aug;20(8):911-4
references.pmid: 24816003
references.citation: Neurology. 2002 Sep 24;59(6):932-4
references.pmid: 12297584