Bove, Francesco; Mulas, Delia; Cavallieri, Francesco; Castrioto, Anna; Chabardès, Stephan; Meoni, Sara; Schmitt, Emmanuelle; Bichon, Amélie; Di Stasio, Enrico; Kistner, Andrea; Pélissier, Pierre; Chevrier, Eric; Seigneuret, Eric; Krack, Paul; Fraix, Valerie; Moro, Elena (2021). Long-term Outcomes (15 Years) After Subthalamic Nucleus Deep Brain Stimulation in Patients With Parkinson Disease. Neurology, 97(3), e254-e262. American Academy of Neurology 10.1212/WNL.0000000000012246
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OBJECTIVE
To evaluate the effects of deep brain stimulation of the subthalamic nucleus (STN-DBS) in Parkinson disease (PD) patients on motor complications beyond 15 years after surgery.
METHODS
Data about motor complications, quality of life (QoL), activities of daily living, the UPDRS motor scores, dopaminergic treatment, stimulation parameters, and side effects of STN-DBS were retrospectively retrieved and compared between before surgery, at 1 year and beyond 15 years after bilateral STN-DBS.
RESULTS
Fifty-one patients with 17.06 ± 2.18 years STN-DBS follow-up were recruited. Compared to baseline, the time spent with dyskinesia and the time spent in the off state were reduced by 75% (p<0.001) and by 58.7% (p<0.001), respectively. Moreover, dopaminergic drugs were reduced by 50.6% (p<0.001). The PDQL total score, and the emotional function and social function domains improved of 13.8% (p=0.005), 13.6% (p=0.01) and 29.9% (p<0.001), respectively. Few and mostly manageable device-related adverse events were observed during the follow-up.
CONCLUSIONS
STN-DBS is still effective beyond 15 years from the intervention, notably with significant improvement in motor complications and stable reduction of dopaminergic drugs. Furthermore, despite the natural continuous progression of PD with worsening of levodopa-resistant motor and non-motor symptoms over the years, STN-DBS patients could maintain an improvement in QoL.
CLASSIFICATION OF EVIDENCE
This study provides Class IV evidence that, for patients with PD, STN-DBS remains effective at treating motor complications 15 years after surgery.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology |
UniBE Contributor: |
Krack, Paul |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1526-632X |
Publisher: |
American Academy of Neurology |
Language: |
English |
Submitter: |
Chantal Kottler |
Date Deposited: |
27 Jul 2021 09:45 |
Last Modified: |
21 Dec 2023 00:10 |
Publisher DOI: |
10.1212/WNL.0000000000012246 |
PubMed ID: |
34078713 |
BORIS DOI: |
10.48350/157656 |
URI: |
https://boris.unibe.ch/id/eprint/157656 |
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