Long-term Efficacy of Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease: A 5-year Follow-up Study in China.

Abstract

BACKGROUND:

Subthalamic nucleus deep brain stimulation (STN DBS) is effective against advanced Parkinson's disease (PD), allowing dramatic improvement of Parkinsonism, in addition to a significant reduction in medication. Here we aimed to investigate the long-term effect of STN DBS in Chinese PD patients, which has not been thoroughly studied in China.

METHODS:

Ten PD patients were assessed before DBS and followed up 1, 3, and 5 years later using Unified Parkinson's Disease Rating Scale Part III (UPDRS III), Parkinson's Disease Questionnatire-39, Parkinson's Disease Sleep Scale-Chinese Version, Mini-mental State Examination, Montreal Cognitive Assessment, Hamilton Anxiety Scale and Hamilton Depression Scale. Stimulation parameters and drug dosages were recorded at each follow-up. Data were analyzed using the ANOVA for repeated measures.

RESULTS:

In the "off" state (off medication), DBS improved UPDRS III scores by 35.87% in 5 years, compared with preoperative baseline (P < 0.001). In the "on" state (on medication), motor scores at 5 years were similar to the results of preoperative levodopa challenge test. The quality of life is improved by 58.18% (P < 0.001) from baseline to 3 years and gradually declined afterward. Sleep, cognition, and emotion were mostly unchanged. Levodopa equivalent daily dose was reduced from 660.4 ± 210.1 mg at baseline to 310.6 ± 158.4 mg at 5 years (by 52.96%, P < 0.001). The average pulse width, frequency and amplitude at 5 years were 75.0 ± 18.21 μs, 138.5 ± 19.34 Hz, and 2.68 ± 0.43 V, respectively.

CONCLUSIONS:

STN DBS is an effective intervention for PD, although associated with a slightly diminished efficacy after 5 years. Compared with other studies, patients in our study required lower voltage and medication for satisfactory symptom control.

• Authors: Lu-Lu Jiang, Jin-Long Liu, Xiao-Li Fu, Wen-Biao Xian, Jing Gu, Yan-Mei Liu, Jing Ye, Jie Chen, Hao Qian, Shao-Hua Xu, Zhong Pei, Ling Chen
• Journal: Chinese medical journal (Chin Med J (Engl)) Vol. 128 Issue 18 Pg. 2433-8 (Sep 20 2015) ISSN: 2542-5641 [Electronic] China
• PMID: 26365958 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Aged
• China
• Deep Brain Stimulation (methods)
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Parkinson Disease (therapy)
• Quality of Life
• Subthalamic Nucleus
• Treatment Outcome