Unilateral Subthalamic Nucleus Stimulation in the Treatment of Asymmetric Parkinson"s Disease with Early Motor Complications.
OBJECTIVE
The aim of this study was to assess the results of unilateral subthalamic nucleus (STN) stimulation for the treatment of Parkinson"s disease (PD) with marked asymmetry of parkinsonian motor symptoms and early motor complications.


METHODS
The clinical series consisted of 32 consecutive PD patients, in whom unilateral STN stimulation was performed. All patients were assessed according to the Unified Parkinson"s Disease Rating Scale (UPDRS), and Hoehn and Yahr staging. The patients were assessed preoperatively, and at 12, and 24 months after unilateral STN stimulation. 22 patients were followed for 2 years.


RESULTS
Medication off/stimulation on total UPDRS motor scores were improved by 29% when compared to the baseline medication off motor scores. The contralateral motor scores improved by 49%, whereas the axial motor scores by 18% in medication off/stimulation on condition. The duration and severity of levodopa induced dyskinesia were reduced respectively by 73% and by 77%. The daily levodopa dose was decreased by only 10%.


CONCLUSIONS
Unilateral STN stimulation is a safe and effective procedure for selected patients with marked asymmetry Parkinson"s disease motor symptoms and early motor complications.
Postgraduate Medical Center, Department of Neurosurgery, Warsaw, Poland.
Michal
M
Sobstyl
Miroslaw
M
Zabek
Artur
A
Zaczynski
Wojciech
W
Gorecki
Zbigniew
Z
Mossakowski
Grazyna
G
Brzuszkiewicz-Kuzmicka
D000359:Aftercare; D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage* / Q000009:adverse effects; D046690:Deep Brain Stimulation / Q000379:methods*; D004409:Dyskinesia, Drug-Induced / Q000628:therapy*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000503:physiopathology* / Q000628:therapy*; D020531:Subthalamic Nucleus; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D007980:Levodopa