J Korean Neurosurg Soc.  2013 Aug;54(2):118-124. 10.3340/jkns.2013.54.2.118.

Factors Related to Outcomes of Subthalamic Deep Brain Stimulation in Parkinson's Disease

• Kim HY
• Chang WS
• Kang DW
• Sohn YH
• Lee MS
• Chang JW

• KMID: 1814248
• DOI: http://doi.org/10.3340/jkns.2013.54.2.118

Abstract

OBJECTIVE
Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective treatment of choice for patients with advanced idiopathic Parkinson's disease (PD) who have motor complication with medication. The objectives of this study are to analyze long-term follow-up data of STN DBS cases and to identify the factors related to outcomes.
METHODS
Fifty-two PD patients who underwent STN DBS were followed-up for more than 3 years. The Unified Parkinsons Disease Rating Scale (UPDRS) and other clinical profiles were assessed preoperatively and during follow-up. A linear regression model was used to analyze whether factors predict the results of STN DBS. We divided the study individuals into subgroups according to several factors and compared subgroups.
RESULTS
Preoperative activity of daily living (ADL) and the magnitude of preoperative levodopa response were shown to predict the improvement in UPDRS part II without medication, and preoperative ADL and levodopa equivalent dose (LED) were shown to predict the improvement in UPDRS part II with medication. In UPDRS part III with medication, the magnitude of preoperative levodopa response was a predicting factor.
CONCLUSION
The intensity of preoperative levodopa response was a strong factor for motor outcome. And preoperative ADL and LED were strong factors for ADL improvement. More vigorous studies should be conducted to elucidate how levodopa-induced motor complications are ameliorated after STN DBS.

Keyword

Subthalamic nucleus; Deep brain stimulation; Parkinson's disease

MeSH Terms

Activities of Daily Living
Deep Brain Stimulation
Follow-Up Studies
Humans
Levodopa
Linear Models
Parkinson Disease
Subthalamic Nucleus
Levodopa

Figure

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  Fig. 1 The clinical outcomes after bilateral subthalamic nucleus stimulation. *All 52 patients were evaluated.

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  Fig. 2 More improvement in Unified Parkinson's Disease Rating Scale part III score (only without medication) is shown as stronger response to levodopa preoperatively (p=0.034).

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