title: Improvement of Advanced Parkinson's Disease Manifestations with Deep Brain Stimulation of the Subthalamic Nucleus: A Single Institution Experience.
abstract: We present our experience at the University of Illinois at Chicago (UIC) in deep brain stimulation (DBS) of the subthalamic nucleus (STN), describing our surgical technique, and reporting our clinical results, and morbidities. Twenty patients with advanced Parkinson's disease (PD) who underwent bilateral STN-DBS were studied. Patients were assessed preoperatively and followed up for one year using the Unified Parkinson's Disease Rating Scale (UPDRS) in "on" and "off" medication and "on" and "off" stimulation conditions. At one-year follow-up, we calculated significant improvement in all the motor aspects of PD (UPDRS III) and in activities of daily living (UPDRS II) in the "off" medication state. The "off" medication UPDRS improved by 49.3%, tremors improved by 81.6%, rigidity improved by 50.0%, and bradykinesia improved by 39.3%. The "off" medication UPDRS II scores improved by 73.8%. The Levodopa equivalent daily dose was reduced by 54.1%. The UPDRS IVa score (dyskinesia) was reduced by 65.1%. The UPDRS IVb score (motor fluctuation) was reduced by 48.6%. Deep brain stimulation of the STN improves the cardinal motor manifestations of the idiopathic PD. It also improves activities of daily living, and reduces medication-induced complications.
authors.affiliation: Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL 60612, USA. dr_a_rabie@hotmail.com.|Department of Neurosurgery, Alexandria University, Alexandria, Egypt. dr_a_rabie@hotmail.com.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Rabie
authors.affiliation: Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA. lverhage@rush.edu.
authors.forename: Leo
authors.initials: L
authors.lastname: Verhagen Metman
authors.affiliation: Department of Neurosurgery, Alexandria University, Alexandria, Egypt. mazenfakhry56@yahoo.com.
authors.forename: Mazen
authors.initials: M
authors.lastname: Fakhry
authors.affiliation: Department of Neurology, Alexandria University, Alexandria, Egypt. af_eassa@yahoo.com.
authors.forename: Ayman Youssef Ezeldin
authors.initials: AY
authors.lastname: Eassa
authors.affiliation: Department of Neurosurgery, Alexandria University, Alexandria, Egypt. waelfouad_67@hotmail.com.
authors.forename: Wael
authors.initials: W
authors.lastname: Fouad
authors.affiliation: Department of Neurosurgery, Tanta University, Tanta, Egypt. ahmedshakal@yahoo.com.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Shakal
authors.affiliation: Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL 60612, USA. kslavin@uic.edu.
authors.forename: Konstantin V
authors.initials: KV
authors.lastname: Slavin
keywords: Parkinson’s disease; clinical outcome; deep brain stimulation; neuromodulation; subthalamic nucleus