Francesco Cavallieri1,2,3, Valérie Fraix1,4, Francesco Bove1,5, Delia Mulas1,5,6, Manuela Tondelli7, Anna Castrioto1,4, Paul Krack8, Sara Meoni1,4, Emmanuelle Schmitt1, Eugénie Lhommée1, Amélie Bichon1, Pierre Pélissier1, Eric Chevrier1, Andrea Kistner1,4, Eric Seigneuret4,9, Stephan Chabardès4,9, Elena Moro1,4. 1. Movement Disorders Unit, University Hospital Center, Grenoble Alpes University, Grenoble, France. 2. Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy. 3. Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy. 4. Grenoble Institute of Neurosciences, UGA INSERM U1216, Grenoble, France. 5. Institute of Neurology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Catholic University of the Sacred Heart, Rome, Italy. 6. Neurology Unit, Mater Olbia Hospital, Olbia, Italy. 7. Neurology Unit, University Hospital Policlinico, Department of Biomedical, Metabolic, and Neural Science, Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy. 8. Department of Neurology, Center for Parkinson's Disease and Movement Disorders, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. 9. Division of Neurosurgery, Grenoble Alpes University Hospital Center, Grenoble, France.
Abstract
OBJECTIVE: This study was undertaken to identify preoperative predictive factors of long-term motor outcome in a large cohort of consecutive Parkinson disease (PD) patients with bilateral subthalamic nucleus deep brain stimulation (STN-DBS). METHODS: All consecutive PD patients who underwent bilateral STN-DBS at the Grenoble University Hospital (France) from 1993 to 2015 were evaluated before surgery, at 1 year (short-term), and in the long term after surgery. All available demographic variables, neuroimaging data, and clinical characteristics were collected. Preoperative predictors of long-term motor outcome were investigated by performing survival and univariate/multivariate Cox regression analyses. Loss of motor benefit from stimulation in the long term was defined as a reduction of less than 25% in the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III scores compared to the baseline off-medication scores. As a secondary objective, potential predictors of short-term motor outcome after STN-DBS were assessed by performing univariate and multivariate linear regression analyses. RESULTS: In the long-term analyses (mean follow-up = 8.4 ± 6.26 years, median = 10 years, range = 1-17 years), 138 patients were included. Preoperative higher frontal score and off-medication MDS-UPDRS part III scores predicted a better long-term motor response to stimulation, whereas the presence of vascular changes on neuroimaging predicted a worse motor outcome. In 357 patients with available 1-year follow-up, preoperative levodopa response, tremor dominant phenotype, baseline frontal score, and off-medication MDS-UPDRS part III scores predicted the short-term motor outcome. INTERPRETATION: Frontal lobe dysfunction, disease severity in the off-medication condition, and the presence of vascular changes on neuroimaging represent the main preoperative clinical predictors of long-term motor STN-DBS effects. ANN NEUROL 2021;89:587-597.
OBJECTIVE: This study was undertaken to identify preoperative predictive factors of long-term motor outcome in a large cohort of consecutive Parkinson disease (PD) patients with bilateral subthalamic nucleus deep brain stimulation (STN-DBS). METHODS: All consecutive PDpatients who underwent bilateral STN-DBS at the Grenoble University Hospital (France) from 1993 to 2015 were evaluated before surgery, at 1 year (short-term), and in the long term after surgery. All available demographic variables, neuroimaging data, and clinical characteristics were collected. Preoperative predictors of long-term motor outcome were investigated by performing survival and univariate/multivariate Cox regression analyses. Loss of motor benefit from stimulation in the long term was defined as a reduction of less than 25% in the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) part III scores compared to the baseline off-medication scores. As a secondary objective, potential predictors of short-term motor outcome after STN-DBS were assessed by performing univariate and multivariate linear regression analyses. RESULTS: In the long-term analyses (mean follow-up = 8.4 ± 6.26 years, median = 10 years, range = 1-17 years), 138 patients were included. Preoperative higher frontal score and off-medication MDS-UPDRS part III scores predicted a better long-term motor response to stimulation, whereas the presence of vascular changes on neuroimaging predicted a worse motor outcome. In 357 patients with available 1-year follow-up, preoperative levodopa response, tremor dominant phenotype, baseline frontal score, and off-medication MDS-UPDRS part III scores predicted the short-term motor outcome. INTERPRETATION:Frontal lobe dysfunction, disease severity in the off-medication condition, and the presence of vascular changes on neuroimaging represent the main preoperative clinical predictors of long-term motor STN-DBS effects. ANN NEUROL 2021;89:587-597.
Authors: Francesco Bove; Francesco Cavallieri; Anna Castrioto; Sara Meoni; Emmanuelle Schmitt; Amélie Bichon; Eugénie Lhommée; Pierre Pélissier; Andrea Kistner; Eric Chevrier; Eric Seigneuret; Stephan Chabardès; Franco Valzania; Valerie Fraix; Elena Moro Journal: Front Hum Neurosci Date: 2022-06-21 Impact factor: 3.473
Authors: Sara Marceglia; Costanza Conti; Oleg Svanidze; Guglielmo Foffani; Andres M Lozano; Elena Moro; Jens Volkmann; Mattia Arlotti; Lorenzo Rossi; Alberto Priori Journal: BMJ Open Date: 2022-01-03 Impact factor: 2.692
Authors: Alessandro Zampogna; Francesco Cavallieri; Francesco Bove; Antonio Suppa; Anna Castrioto; Sara Meoni; Pierre Pélissier; Emmanuelle Schmitt; Amélie Bichon; Eugénie Lhommée; Andrea Kistner; Stephan Chabardès; Eric Seigneuret; Valerie Fraix; Elena Moro Journal: NPJ Parkinsons Dis Date: 2022-09-24
Authors: Seung Hyun Lee; Mina Kim; Jooyoung Lee; Jae-Woo Kim; Mi Sun Kim; Sungyang Jo; Sang Ryong Jeon; Sun Ju Chung Journal: Sci Rep Date: 2022-10-07 Impact factor: 4.996