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Prognostic factors of subthalamic stimulation in Parkinson's disease: a comparative study between short- and long-term effects.
- Source :
-
Stereotactic and functional neurosurgery [Stereotact Funct Neurosurg] 2009; Vol. 87 (4), pp. 241-8. Date of Electronic Publication: 2009 Jun 26. - Publication Year :
- 2009
-
Abstract
- Background/aims: Bilateral subthalamic nucleus deep brain stimulation (STN-DBS) has been shown to have long-term benefits in Parkinson's disease (PD). Through analyzing different variables, this study identified prognostic factors for the short- and long-term effects of STN-DBS.<br />Methods: Thirty-six PD patients underwent bilateral STN-DBS. Clinical evaluations were performed 1 month before and 3 months after surgery, with additional follow-up examinations for a mean of 31.3 months.<br />Results: There was a trend for long-term STN-DBS-induced improvements in the Unified Parkinson's Disease Rating Scale (UPDRS) part II and part III measures to be greater in younger patients. Preoperative levodopa responsiveness only led to consistent UPDRS part III improvement from STN-DBS at 3 months, and this predictive value did not exist in the long term. The preoperative levodopa response of tremor and axial symptoms in motor disability predicted long-term DBS effect only. Preoperative cognitive function positively correlated with postoperative improvement from DBS in UPDRS part III during long-term follow-up only.<br />Conclusions: The prognostic factors for STN-DBS benefit were different for short- and long-term follow-ups. Good prognostic factors for long-term STN-DBS for PD patients were good cognitive function and tremor dominance. Poor prognostic factors were related to older age and non-dopaminergic-responsive axial disability.<br /> (Copyright 2009 S. Karger AG, Basel.)
- Subjects :
- Adult
Age Factors
Aged
Antiparkinson Agents administration & dosage
Cognition
Female
Follow-Up Studies
Humans
Levodopa administration & dosage
Linear Models
Male
Middle Aged
Parkinson Disease drug therapy
Predictive Value of Tests
Prognosis
Sex Factors
Time Factors
Treatment Outcome
Tremor physiopathology
Tremor therapy
Deep Brain Stimulation
Parkinson Disease physiopathology
Parkinson Disease therapy
Subthalamic Nucleus physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1423-0372
- Volume :
- 87
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Stereotactic and functional neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 19556833
- Full Text :
- https://doi.org/10.1159/000225977