Xiao-Ying Zhu1, Tian-Hong Pan2, William G Ondo3, Joohi Jimenez-Shahed2, Yun-Cheng Wu4. 1. Department of Neurology, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, PR China. 2. Parkinson's Disease Center and Movement Disorder Clinic, Department of Neurology, Baylor College of Medicine, Houston 77030, TX, USA. 3. Department of Neurology, University of Texas Health Science Center Houston, Houston, TX, USA. 4. Department of Neurology, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, PR China. Electronic address: yunchw@medmail.com.cn.
Abstract
OBJECTIVE: The aim of this study was to analyze outcomes after 1 year of bilateral STN deep brain stimulation (DBS) in relatively young-onset patients with multiple system atrophy-Parkinsonism (MSA-P). BACKGROUND: The efficacy of DBS has been demonstrated in idiopathic Parkinson's disease. However, the experience with DBS in relatively young-onset MSA-P is limited and controversial. METHODS: Information about the demographic and clinical data from five MSA patients treated with STN DBS was entered into a database and analyzed. RESULTS: Five patients with relatively young-onset MSA (mean age at onset 42.2±2.2 years, 3 women, 2 men) have been treated with bilateral STN stimulators, the mean duration between DBS surgery and disease onset was 7.0±3.5 years. All of the patients had dyskinesia and postural instability, and subjective benefit from levodopa. During the 6 months after surgery, the clinical status of three patients improved with a decrease of dyskinesia. However, by 1 year, the symptoms reappeared and progressed in all patients. Overall, the mean "off" medication UPDRS-III score worsened 23.5±15.3 1 year after surgery and the levodopa dosage was not reduced. CONCLUSIONS: This data does not support the use of STN DBS for relatively young-onset MSA-P.
OBJECTIVE: The aim of this study was to analyze outcomes after 1 year of bilateral STN deep brain stimulation (DBS) in relatively young-onset patients with multiple system atrophy-Parkinsonism (MSA-P). BACKGROUND: The efficacy of DBS has been demonstrated in idiopathic Parkinson's disease. However, the experience with DBS in relatively young-onset MSA-P is limited and controversial. METHODS: Information about the demographic and clinical data from five MSA patients treated with STN DBS was entered into a database and analyzed. RESULTS: Five patients with relatively young-onset MSA (mean age at onset 42.2±2.2 years, 3 women, 2 men) have been treated with bilateral STN stimulators, the mean duration between DBS surgery and disease onset was 7.0±3.5 years. All of the patients had dyskinesia and postural instability, and subjective benefit from levodopa. During the 6 months after surgery, the clinical status of three patients improved with a decrease of dyskinesia. However, by 1 year, the symptoms reappeared and progressed in all patients. Overall, the mean "off" medication UPDRS-III score worsened 23.5±15.3 1 year after surgery and the levodopa dosage was not reduced. CONCLUSIONS: This data does not support the use of STN DBS for relatively young-onset MSA-P.