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Acute Effects of Subthalamic Deep Brain Stimulation on Motor Outcomes in Parkinson's Disease; 13 Year Follow Up
Objective: Deep brain stimulation of the Subthalamic nucleus (STN-DBS) is a safe and well-established therapy for the management of refractory motor symptoms in Parkinson's disease (PD). Marked improvement in axial symptoms has been reported in the short term with STN-DBS but questions remain r...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6606731/ https://www.ncbi.nlm.nih.gov/pubmed/31293511 http://dx.doi.org/10.3389/fneur.2019.00689 |
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author | Zhou, Haiyan Wang, Linbin Zhang, Chencheng Qiu, Xian Hu, Wei van der Stelt, Odin Ramirez-Zamora, Adolfo Li, Dianyou |
author_facet | Zhou, Haiyan Wang, Linbin Zhang, Chencheng Qiu, Xian Hu, Wei van der Stelt, Odin Ramirez-Zamora, Adolfo Li, Dianyou |
author_sort | Zhou, Haiyan |
collection | PubMed |
description | Objective: Deep brain stimulation of the Subthalamic nucleus (STN-DBS) is a safe and well-established therapy for the management of refractory motor symptoms in Parkinson's disease (PD). Marked improvement in axial symptoms has been reported in the short term with STN-DBS but questions remain regarding the long-term efficacy of this intervention. We assessed the acute ON and OFF effects of STN-DBS in PD patients who have been treated with STN-DBS for over a decade. Methods: We assessed 11 patients with early-onset PD (9 men, 2 women; mean age, 57.1 ± 7.2 y; mean age at illness onset, 38.9 ± 7.5 y) managed with long-term bilateral STN-DBS (mean treatment duration, 13.4 ± 1.3 y). Motor symptoms were assessed by means of the Unified Parkinson's Disease Rating Scale (UPDRS)-III, Timed Up and Go test (TUG), and Hoehn-Yahr scale. Motor assessments in the medication ON and OFF states with stimulation ON and OFF conditions were documented and video recorded. Results: Patients showed a significant improvement in motor symptoms both in the off-medication and on-medication state by a 54% reduction (off-medication/on-stimulation vs. off-medication/off-stimulation) and a 48% reduction (on-medication/on-stimulation vs. on-medication/off-stimulation) in the total UPDRS-III score. Specifically, improvement in axial symptoms (off-medication: 51% reduction; on-medication: 44% reduction), including gait but not posture. Similarly, STN-DBS reduced TUG scores (off-medication: 70% reduction; on-medication: 47% reduction). Conclusions: On stimulation long-term, bilateral STN-DBS can improve appendicular and axial symptoms of patients with early-onset PD in the acute setting. |
format | Online Article Text |
id | pubmed-6606731 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-66067312019-07-10 Acute Effects of Subthalamic Deep Brain Stimulation on Motor Outcomes in Parkinson's Disease; 13 Year Follow Up Zhou, Haiyan Wang, Linbin Zhang, Chencheng Qiu, Xian Hu, Wei van der Stelt, Odin Ramirez-Zamora, Adolfo Li, Dianyou Front Neurol Neurology Objective: Deep brain stimulation of the Subthalamic nucleus (STN-DBS) is a safe and well-established therapy for the management of refractory motor symptoms in Parkinson's disease (PD). Marked improvement in axial symptoms has been reported in the short term with STN-DBS but questions remain regarding the long-term efficacy of this intervention. We assessed the acute ON and OFF effects of STN-DBS in PD patients who have been treated with STN-DBS for over a decade. Methods: We assessed 11 patients with early-onset PD (9 men, 2 women; mean age, 57.1 ± 7.2 y; mean age at illness onset, 38.9 ± 7.5 y) managed with long-term bilateral STN-DBS (mean treatment duration, 13.4 ± 1.3 y). Motor symptoms were assessed by means of the Unified Parkinson's Disease Rating Scale (UPDRS)-III, Timed Up and Go test (TUG), and Hoehn-Yahr scale. Motor assessments in the medication ON and OFF states with stimulation ON and OFF conditions were documented and video recorded. Results: Patients showed a significant improvement in motor symptoms both in the off-medication and on-medication state by a 54% reduction (off-medication/on-stimulation vs. off-medication/off-stimulation) and a 48% reduction (on-medication/on-stimulation vs. on-medication/off-stimulation) in the total UPDRS-III score. Specifically, improvement in axial symptoms (off-medication: 51% reduction; on-medication: 44% reduction), including gait but not posture. Similarly, STN-DBS reduced TUG scores (off-medication: 70% reduction; on-medication: 47% reduction). Conclusions: On stimulation long-term, bilateral STN-DBS can improve appendicular and axial symptoms of patients with early-onset PD in the acute setting. Frontiers Media S.A. 2019-06-26 /pmc/articles/PMC6606731/ /pubmed/31293511 http://dx.doi.org/10.3389/fneur.2019.00689 Text en Copyright © 2019 Zhou, Wang, Zhang, Qiu, Hu, van der Stelt, Ramirez-Zamora and Li. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neurology Zhou, Haiyan Wang, Linbin Zhang, Chencheng Qiu, Xian Hu, Wei van der Stelt, Odin Ramirez-Zamora, Adolfo Li, Dianyou Acute Effects of Subthalamic Deep Brain Stimulation on Motor Outcomes in Parkinson's Disease; 13 Year Follow Up |
title | Acute Effects of Subthalamic Deep Brain Stimulation on Motor Outcomes in Parkinson's Disease; 13 Year Follow Up |
title_full | Acute Effects of Subthalamic Deep Brain Stimulation on Motor Outcomes in Parkinson's Disease; 13 Year Follow Up |
title_fullStr | Acute Effects of Subthalamic Deep Brain Stimulation on Motor Outcomes in Parkinson's Disease; 13 Year Follow Up |
title_full_unstemmed | Acute Effects of Subthalamic Deep Brain Stimulation on Motor Outcomes in Parkinson's Disease; 13 Year Follow Up |
title_short | Acute Effects of Subthalamic Deep Brain Stimulation on Motor Outcomes in Parkinson's Disease; 13 Year Follow Up |
title_sort | acute effects of subthalamic deep brain stimulation on motor outcomes in parkinson's disease; 13 year follow up |
topic | Neurology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6606731/ https://www.ncbi.nlm.nih.gov/pubmed/31293511 http://dx.doi.org/10.3389/fneur.2019.00689 |
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