OBJECTIVE: To measure the effect of deep brain stimulation (DBS) of the subthalamic nucleus in patients with advanced Parkinson's disease. DESIGN: Open label follow up using blinded ratings of videotaped neurological examinations. PATIENTS: 30 patients with advanced Parkinson's disease (19 male, 11 female; mean age 58.8 years; mean disease duration 12.8 years), complicated by intractable wearing off motor fluctuations and dopaminergic dyskinesias. MAIN OUTCOME MEASURES: Unified Parkinson's disease rating scale (UPDRS), part III (motor), score at one year, from blinded reviews of videotaped neurological examinations. Secondary outcomes included the other UPDRS subscales, Hoehn and Yahr scale, activities of daily living (ADL) scale, mini-mental state examination (MMSE), estimates of motor fluctuations and dyskinesia severity, drug intake, and patient satisfaction questionnaire. RESULTS: Subthalamic nucleus stimulation was associated with a 29.5% reduction in motor scores at one year (p<0.0001). The only important predictors of improvement in UPDRS part III motor scores were the baseline response to dopaminergic drugs (p = 0.015) and the presence of tremor (p = 0.027). Hoehn and Yahr scores and ADL scores in the "on" and "off" states did not change, nor did the mean MMSE score. Weight gain occurred in the year after surgery, from (mean) 75.8 kg to 78.5 kg (p = 0.028). Duration of daily wearing off episodes was reduced by 69%. Dyskinesia severity was reduced by 60%. Drug requirements (in levodopa equivalents) declined by 30%. CONCLUSIONS: The 30% improvement in UPDRS motor scores was a more modest result than previously reported. DBS did not improve functional capacity independent of drug use. Its chief benefits were reduction in wearing off duration and dyskinesia severity.
OBJECTIVE: To measure the effect of deep brain stimulation (DBS) of the subthalamic nucleus in patients with advanced Parkinson's disease. DESIGN: Open label follow up using blinded ratings of videotaped neurological examinations. PATIENTS: 30 patients with advanced Parkinson's disease (19 male, 11 female; mean age 58.8 years; mean disease duration 12.8 years), complicated by intractable wearing off motor fluctuations and dopaminergic dyskinesias. MAIN OUTCOME MEASURES: Unified Parkinson's disease rating scale (UPDRS), part III (motor), score at one year, from blinded reviews of videotaped neurological examinations. Secondary outcomes included the other UPDRS subscales, Hoehn and Yahr scale, activities of daily living (ADL) scale, mini-mental state examination (MMSE), estimates of motor fluctuations and dyskinesia severity, drug intake, and patient satisfaction questionnaire. RESULTS: Subthalamic nucleus stimulation was associated with a 29.5% reduction in motor scores at one year (p<0.0001). The only important predictors of improvement in UPDRS part III motor scores were the baseline response to dopaminergic drugs (p = 0.015) and the presence of tremor (p = 0.027). Hoehn and Yahr scores and ADL scores in the "on" and "off" states did not change, nor did the mean MMSE score. Weight gain occurred in the year after surgery, from (mean) 75.8 kg to 78.5 kg (p = 0.028). Duration of daily wearing off episodes was reduced by 69%. Dyskinesia severity was reduced by 60%. Drug requirements (in levodopa equivalents) declined by 30%. CONCLUSIONS: The 30% improvement in UPDRS motor scores was a more modest result than previously reported. DBS did not improve functional capacity independent of drug use. Its chief benefits were reduction in wearing off duration and dyskinesia severity.
Authors: L Lopiano; M Rizzone; B Bergamasco; A Tavella; E Torre; P Perozzo; M C Valentini; M Lanotte Journal: Neurology Date: 2001-02-27 Impact factor: 9.910
Authors: C R Freed; P E Greene; R E Breeze; W Y Tsai; W DuMouchel; R Kao; S Dillon; H Winfield; S Culver; J Q Trojanowski; D Eidelberg; S Fahn Journal: N Engl J Med Date: 2001-03-08 Impact factor: 91.245
Authors: Tanya Simuni; Jurg L Jaggi; Heather Mulholland; Howard I Hurtig; Amy Colcher; Andrew D Siderowf; Bernard Ravina; Brett E Skolnick; Reid Goldstein; Matthew B Stern; Gordon H Baltuch Journal: J Neurosurg Date: 2002-04 Impact factor: 5.115
Authors: S Thobois; P Mertens; M Guenot; M Hermier; H Mollion; M Bouvard; G Chazot; E Broussolle; M Sindou Journal: J Neurol Date: 2002-05 Impact factor: 4.849
Authors: M L Welter; J L Houeto; S Tezenas du Montcel; V Mesnage; A M Bonnet; B Pillon; I Arnulf; B Pidoux; D Dormont; P Cornu; Y Agid Journal: Brain Date: 2002-03 Impact factor: 13.501
Authors: W M M Schüpbach; N Chastan; M L Welter; J L Houeto; V Mesnage; A M Bonnet; V Czernecki; D Maltête; A Hartmann; L Mallet; B Pidoux; D Dormont; S Navarro; P Cornu; A Mallet; Y Agid Journal: J Neurol Neurosurg Psychiatry Date: 2005-12 Impact factor: 10.154
Authors: V Fraix; J-L Houeto; C Lagrange; C Le Pen; P Krystkowiak; D Guehl; C Ardouin; M-L Welter; F Maurel; L Defebvre; A Rougier; A-L Benabid; V Mesnage; M Ligier; S Blond; P Burbaud; B Bioulac; A Destée; P Cornu; P Pollak Journal: J Neurol Neurosurg Psychiatry Date: 2006-04 Impact factor: 10.154
Authors: R R Goodman; B Kim; S McClelland; P B Senatus; L M Winfield; S L Pullman; Q Yu; B Ford; G M McKhann Journal: J Neurol Neurosurg Psychiatry Date: 2006-01 Impact factor: 10.154
Authors: Swen Hesse; Karl Strecker; Dirk Winkler; Julia Luthardt; Christoph Scherfler; Annegret Reupert; Christian Oehlwein; Henryk Barthel; Jens-Peter Schneider; Florian Wegner; Philipp Meyer; Jürgen Meixensberger; Osama Sabri; Johannes Schwarz Journal: J Neurol Date: 2008-05-02 Impact factor: 4.849
Authors: M Capecci; R A Ricciuti; D Burini; V G Bombace; L Provinciali; M Iacoangeli; M Scerrati; M G Ceravolo Journal: J Neurol Neurosurg Psychiatry Date: 2005-06 Impact factor: 10.154
Authors: Julio Fernández-Mendoza; Beatriz Lozano; Fernando Seijo; Elena Santamarta-Liébana; Maria José Ramos-Platón; Antonio Vela-Bueno; Fernando Fernández-González Journal: Sleep Date: 2009-09 Impact factor: 5.849