Long-term Efficacy of Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease: A 5-year Follow-up Study in China.
- Author:
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
1
Author Information
- Publication Type:Journal Article
- MeSH: Aged; China; Deep Brain Stimulation; methods; Female; Follow-Up Studies; Humans; Male; Middle Aged; Parkinson Disease; therapy; Quality of Life; Subthalamic Nucleus; Treatment Outcome
- From: Chinese Medical Journal 2015;128(18):2433-2438
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDSubthalamic 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.
METHODSTen 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.
RESULTSIn 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.
CONCLUSIONSSTN 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.