Side‐effects of subthalamic stimulation in Parkinson's disease: clinical evolution and predictive factors
Identifieur interne : 000134 ( France/Analysis ); précédent : 000133; suivant : 000135Side‐effects of subthalamic stimulation in Parkinson's disease: clinical evolution and predictive factors
Auteurs : D. Guehl [France] ; E. Cuny [France] ; A. Benazzouz [France] ; A. Rougier [France] ; F. Tison [France] ; S. Machado [France] ; D. Grabot [France] ; C. Gross [France] ; B. Bioulac [France] ; P. Burbaud [France]Source :
- European Journal of Neurology [ 1351-5101 ] ; 2006-09.
English descriptors
Abstract
Chronic bilateral high‐frequency stimulation of the subthalamic nucleus (STN) is an alternative treatment for disabling forms of Parkinson's disease when on–off fluctuations and levodopa‐induced dyskinesias compromise patients’ quality of life. The aim of this study was to assess the evolution of side‐effects during the first year of follow‐up and search for clinical predictive factors accounting for their occurrence. We compared the frequency of side‐effects at 3 and 12 months after surgery in a cohort of 44 patients. The off‐medication scores of Unified Parkinson's Disease Rating Scale (UPDRS) II, III, axial symptoms, disease duration and age at surgery were retained for correlation analysis. Dysarthria/hypophonia, weight gain and postural instability were the most frequent chronic side‐effects. Whereas dysarthria/hypophonia remained stable over time, weight gain and postural instability increased during the first year post‐op. High axial and UPDRS II scores at surgery were predictive of dysarthria/hypophonia. Age and axial score at surgery were positively correlated with postural instability. Despite the occurrence of side‐effects, the benefit/side‐effects ratio of STN stimulation was largely positive during the first year of follow‐up. Age, intensity of axial symptoms and UDPRS II off‐medication score before surgery are predictive factors of dysarthria/hypophonia and postural instability after surgery.
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DOI: 10.1111/j.1468-1331.2006.01405.x
Affiliations:
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The aim of this study was to assess the evolution of side‐effects during the first year of follow‐up and search for clinical predictive factors accounting for their occurrence. We compared the frequency of side‐effects at 3 and 12 months after surgery in a cohort of 44 patients. The off‐medication scores of Unified Parkinson's Disease Rating Scale (UPDRS) II, III, axial symptoms, disease duration and age at surgery were retained for correlation analysis. Dysarthria/hypophonia, weight gain and postural instability were the most frequent chronic side‐effects. Whereas dysarthria/hypophonia remained stable over time, weight gain and postural instability increased during the first year post‐op. High axial and UPDRS II scores at surgery were predictive of dysarthria/hypophonia. Age and axial score at surgery were positively correlated with postural instability. 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