Short- and Long-Term Outcomes of Deep Brain Stimulation in Patients 70 Years and Older with Parkinson Disease.
BACKGROUND
Parkinson disease (PD) is a common neurodegenerative disease in elderly patients that may be treated with deep brain stimulation (DBS). DBS is an accepted surgical treatment in PD patients <70 years that demonstrates marked improvement in disease symptomology. Patients ≥70 years historically have been excluded from DBS therapy. Our objective is to evaluate the short- and long-term outcomes in patients with PD ≥70 years who underwent DBS at our center.


METHODS
In our single-center study, we retrospectively assessed a prospective registry of patients with PD treated with DBS who were ≥70 years old at the time of their procedure. Univariate analyses and 1-sample paired t test were used to evaluate data. Motor scores were evaluated with the Unified Parkinson's Disease Rating Scale III, and the effects on medication requirements were evaluated with levodopa equivalence daily doses (LEDD).


RESULTS
Thirty-seven patients were followed for an average of 42.2 months post-DBS. The average ages at diagnosis and at the time of DBS surgery were 63.05 years and 72.45 years, respectively. Significant reductions in the average Unified Parkinson's Disease Rating Scale III score were observed (preoperative 31.8; postoperative 15.6; P < 0.0001). Significant reductions in the average LEDD (preoperative 891.94 mg; postoperative 559.6 mg; P = 0.0008) and medication doses per day (preoperative 11.54; postoperative 7.97; P = 0.0112) also were present.


CONCLUSIONS
DBS is effective in treating elderly patients with PD. Patients experienced improvement in motor function, LEDD, and medication doses per day after DBS. Our results suggest that DBS is an effective treatment modality in elderly patients with PD.
Department of Neurosurgery, Ochsner Clinic Foundation, New Orleans, Louisiana, USA; Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA; Division of Neurosurgery, Department of Surgery, Jazan University, Jazan, Saudi Arabia. Electronic address: mmathkour@outlook.com.
Mansour
M
Mathkour
Department of Neurosurgery, Ochsner Clinic Foundation, New Orleans, Louisiana, USA; Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA.
Juanita
J
Garces
Department of Neurosurgery, Ochsner Clinic Foundation, New Orleans, Louisiana, USA; Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA.
Tyler
T
Scullen
Department of Neurosurgery, Ochsner Clinic Foundation, New Orleans, Louisiana, USA.
Joshua
J
Hanna
Department of Neurosurgery, Ochsner Clinic Foundation, New Orleans, Louisiana, USA; Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA.
Edison
E
Valle-Giler
Department of Neurosurgery, Ochsner Clinic Foundation, New Orleans, Louisiana, USA; Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA.
Lora
L
Kahn
Department of Neurosurgery, Ochsner Clinic Foundation, New Orleans, Louisiana, USA.
Teresa
T
Arrington
Department of Movement Disorders, Ochsner Clinic Foundation, New Orleans, Louisiana, USA.
David
D
Houghton
Department of Movement Disorders, Ochsner Clinic Foundation, New Orleans, Louisiana, USA.
Georgia
G
Lea
Department of Neurosurgery, Ochsner Clinic Foundation, New Orleans, Louisiana, USA; Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA.
Erin
E
Biro
Department of Neurosurgery, Ochsner Clinic Foundation, New Orleans, Louisiana, USA; Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA.
Cuong J
CJ
Bui
Department of Neurosurgery, Ochsner Clinic Foundation, New Orleans, Louisiana, USA; Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA.
Olawale A R
OA
Sulaiman
Department of Neurosurgery, Ochsner Clinic Foundation, New Orleans, Louisiana, USA; Department of Neurosurgery, Tulane Medical Center, New Orleans, Louisiana, USA.
Roger D
RD
Smith
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D046690:Deep Brain Stimulation / Q000379:methods / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
Deep brain stimulation; Elderly; Levodopa equivalence daily doses; Parkinson disease; Unified Parkinson's Disease Rating Scale