Subthalamic Nucleus Deep Brain Stimulation for Parkinson Disease in Hong Kong: A Prospective Territory-Wide 2-Year Follow-Up Study.
OBJECTIVE
We assessed the effects of bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) in patients with Parkinson disease at the 1-year and 2-year follow-up evaluations. Unified Parkinson's Disease Rating Scale (UPDRS) motor score at "off" medication ("on" DBS) and quality-of-life assessments (39-item Parkinson's Disease Questionnaire [PDQ-39]) were conducted. The percentage of awake "on" time and awake "off" time and levodopa requirement were also assessed.


METHODS
A 2-year prospective study was conducted of 25 consecutive patients from 3 DBS referral centers in Hong Kong. The patients were treated with bilateral stimulation of the STN. Assessments were performed at 1 year and 2 years after DBS and were compared with the baseline.


RESULTS
The 2-year outcome assessments were completed by 18 patients. The mean UPDRS motor score improvement was 57% in the first year and 45% in the second year. PDQ-39 showed significant improvement in quality of life for 2 consecutive years. The levodopa requirement decreased 63% in the first year and 55.9% in the second year. The awake "on" time was doubled in the first year and sustained in the second year. Awake "off" time was reduced from 28.1% to 5.9% in the first year and returned to 10.6% in the second year. Improvement of UPDRS motor score, reduction in awake "off" time, and decrease of daily levodopa dosage all were main factors correlated with the improvement in PDQ-39 summary index.


CONCLUSIONS
The effects of STN DBS in patients with Parkinson disease in Hong Kong were satisfactory. The results showed that reduction in UPDRS motor score, awake "off"-time, and daily levodopa dosage were the major drivers of overall improvement in PDQ-39.
Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, Hong Kong. Electronic address: tmdanny@surgery.cuhk.edu.hk.
Danny T M
DT
Chan
Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, Hong Kong.
Cannon X L
CX
Zhu
Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, Hong Kong.
Claire K Y
CK
Lau
Department of Neurosurgery, Queen Elizabeth Hospital, Hong Kong.
Tak L
TL
Poon
Department of Neurosurgery, Queen Elizabeth Hospital, Hong Kong.
Fung C
FC
Cheung
Department of Neurosurgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong.
Michael
M
Lee
Division of Neurosurgery, Department of Surgery, Queen Mary Hospital, Hong Kong.
Benedict
B
Taw
Division of Neurosurgery, Department of Surgery, Queen Mary Hospital, Hong Kong.
Kwan N
KN
Hung
Department of Neurosurgery, Queen Elizabeth Hospital, Hong Kong.
Priscilla
P
Choi
Division of Neurology, Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong.
Mandy
M
AuYeung
Division of Neurology, Department of Medicine and Therapeutics, Queen Elizabeth Hospital, Hong Kong.
Germaine
G
Chan
Division of Neurology, Department of Medicine and Therapeutics, Queen Elizabeth Hospital, Hong Kong.
Yuk F
YF
Cheung
Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong.
Anne Y Y
AY
Chan
Division of Neurology, Department of Medicine and Therapeutics, Alice Ho Miu Ling Nethersole Hospital, Hong Kong.
Jonas H M
JH
Yeung
Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Hong Kong.
Vincent C T
VC
Mok
Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, Hong Kong.
Wai S
WS
Poon
D000328:Adult; D000368:Aged; D046690:Deep Brain Stimulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D010300:Parkinson Disease / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D015995:Prevalence; D011446:Prospective Studies; D020127:Recovery of Function; D012307:Risk Factors; D020531:Subthalamic Nucleus; D016896:Treatment Outcome
Deep brain stimulation; Quality of life; Subthalamic nucleus