Serveur d'exploration sur la maladie de Parkinson

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Levodopa response in long‐term bilateral subthalamic stimulation for Parkinson's disease

Identifieur interne : 001030 ( Main/Exploration ); précédent : 001029; suivant : 001031

Levodopa response in long‐term bilateral subthalamic stimulation for Parkinson's disease

Auteurs : Panida Piboolnurak [Canada, Thaïlande] ; Anthony E. Lang [Canada] ; Andres M. Lozano [Canada] ; Janis M. Miyasaki [Canada] ; Jean A. Saint-Cyr [Canada] ; Yu-Yan W. Poon [Canada] ; William D. Hutchison [Canada] ; Jonathan O. Dostrovsky [Canada] ; Elena Moro [Canada]

Source :

RBID : ISTEX:95CF3584350283B4C5E922BD0F94DF07F5E79BDC

English descriptors

Abstract

Subthalamic nucleus deep brain stimulation (STN‐DBS) is effective in advanced Parkinson's disease (PD), but its effects on the levodopa response are unclear. We studied the levodopa response after long‐term STN‐DBS, STN‐DBS efficacy and predictive value of preoperative levodopa response to long‐term DBS benefit in 33 PD patients with bilateral STN‐DBS. Patients were assessed using the Unified Parkinson's Disease Rating Scale preoperatively (with and without medications) and postoperatively (without medications or stimulation, with only medications or stimulation, and with both medications and stimulation). Levodopa response significantly decreased postoperatively by 31.1% at 3 years and 32.3% at 5 years, possibly related to the reduction in medication requirement, direct STN stimulation effect or PD progression. STN‐DBS alone significantly improved motor scores (37.2% at 3 years and 35.1% at 5 years) and activities of daily living scores (27.1% at 3 years and 19.2% at 5 years). Anti‐PD drugs were significantly reduced by 47.9% at 3 years and 39.8% at 5 years. However, the magnitude of the preoperative response to levodopa did not predict DBS benefit at 3 and 5 years. © 2007 Movement Disorder Society

Url:
DOI: 10.1002/mds.21482


Affiliations:


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<div type="abstract" xml:lang="en">Subthalamic nucleus deep brain stimulation (STN‐DBS) is effective in advanced Parkinson's disease (PD), but its effects on the levodopa response are unclear. We studied the levodopa response after long‐term STN‐DBS, STN‐DBS efficacy and predictive value of preoperative levodopa response to long‐term DBS benefit in 33 PD patients with bilateral STN‐DBS. Patients were assessed using the Unified Parkinson's Disease Rating Scale preoperatively (with and without medications) and postoperatively (without medications or stimulation, with only medications or stimulation, and with both medications and stimulation). Levodopa response significantly decreased postoperatively by 31.1% at 3 years and 32.3% at 5 years, possibly related to the reduction in medication requirement, direct STN stimulation effect or PD progression. STN‐DBS alone significantly improved motor scores (37.2% at 3 years and 35.1% at 5 years) and activities of daily living scores (27.1% at 3 years and 19.2% at 5 years). Anti‐PD drugs were significantly reduced by 47.9% at 3 years and 39.8% at 5 years. However, the magnitude of the preoperative response to levodopa did not predict DBS benefit at 3 and 5 years. © 2007 Movement Disorder Society</div>
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