Factors Related to Outcomes of Subthalamic Deep Brain Stimulation in Parkinson's Disease.
10.3340/jkns.2013.54.2.118
- Author:
Hae Yu KIM
1
;
Won Seok CHANG
;
Dong Wan KANG
;
Young Ho SOHN
;
Myung Sik LEE
;
Jin Woo CHANG
Author Information
1. Department of Neurosurgery, Brain Korea 21 Project for Medical Science, Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea. jchang@yuhs.ac
- Publication Type:Original Article
- Keywords:
Subthalamic nucleus;
Deep brain stimulation;
Parkinson's disease
- MeSH:
Activities of Daily Living;
Deep Brain Stimulation;
Follow-Up Studies;
Humans;
Levodopa;
Linear Models;
Parkinson Disease;
Subthalamic Nucleus
- From:Journal of Korean Neurosurgical Society
2013;54(2):118-124
- CountryRepublic of Korea
- Language:English
-
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.
