Maria Antonietta Volonté1, Giacomo Clarizio1, Sebastiano Galantucci1, Pietro Giuseppe Scamarcia1, Rosalinda Cardamone1, Lina Raffaella Barzaghi2, Monica Falautano1, Pietro Mortini2, Giancarlo Comi3, Massimo Filippi4,5,6,7,8. 1. Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. 2. Neurosurgery and Radiosurgery Gamma Knife Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. 3. Vita-Salute San Raffaele University, Milan, Italy. 4. Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. filippi.massimo@hsr.it. 5. Vita-Salute San Raffaele University, Milan, Italy. filippi.massimo@hsr.it. 6. Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy. filippi.massimo@hsr.it. 7. Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy. filippi.massimo@hsr.it. 8. Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy. filippi.massimo@hsr.it.
Abstract
BACKGROUND: Parkinson's disease (PD) is the second most common neurodegenerative disorder, affecting both motor and non-motor systems. Deep brain stimulation of the subthalamic nucleus (STN-DBS) has been an approved treatment for PD for more than 30 years, but few data are available regarding its long-term effectiveness. OBJECTIVE: The aim of this study is to evaluate patients' outcome, both from a motor and non-motor perspective, 9 to 14 years after DBS implantation. We have investigated patients with advanced PD and treated with STN-DBS, in relation to key clinical features of PD. METHODS: 18 patients were assessed both retrospectively and prospectively. They underwent motor examination, neuropsychological evaluation and questionnaires on the quality of life, preoperatively, as well as 1, 9 and 14 years after DBS surgery. All patients were implanted with STN-DBS at San Raffaele Hospital between 2004 and 2010. RESULTS: 13 males and five females underwent DBS implantation with a mean PD duration of 11 years. Stimulation significantly improved med-off/stim-on condition up to 9 years, compared to the preoperative off state, and med-on/stim-on condition at 14 years, compared to med-on/stim-off state. Long term improvement specifically involved tremor and rigidity, as well as dopaminergic daily dose. At the same time, STN-DBS had no long-lasting effect on axial symptoms and cognitive functions. CONCLUSIONS: STN-DBS remains an effective therapy for advanced PD, also over the years. Despite the underlying progression of the disease, this treatment extends the period in which the overall quality of life is still acceptable.
BACKGROUND:Parkinson's disease (PD) is the second most common neurodegenerative disorder, affecting both motor and non-motor systems. Deep brain stimulation of the subthalamic nucleus (STN-DBS) has been an approved treatment for PD for more than 30 years, but few data are available regarding its long-term effectiveness. OBJECTIVE: The aim of this study is to evaluate patients' outcome, both from a motor and non-motor perspective, 9 to 14 years after DBS implantation. We have investigated patients with advanced PD and treated with STN-DBS, in relation to key clinical features of PD. METHODS: 18 patients were assessed both retrospectively and prospectively. They underwent motor examination, neuropsychological evaluation and questionnaires on the quality of life, preoperatively, as well as 1, 9 and 14 years after DBS surgery. All patients were implanted with STN-DBS at San Raffaele Hospital between 2004 and 2010. RESULTS: 13 males and five females underwent DBS implantation with a mean PD duration of 11 years. Stimulation significantly improved med-off/stim-on condition up to 9 years, compared to the preoperative off state, and med-on/stim-on condition at 14 years, compared to med-on/stim-off state. Long term improvement specifically involved tremor and rigidity, as well as dopaminergic daily dose. At the same time, STN-DBS had no long-lasting effect on axial symptoms and cognitive functions. CONCLUSIONS:STN-DBS remains an effective therapy for advanced PD, also over the years. Despite the underlying progression of the disease, this treatment extends the period in which the overall quality of life is still acceptable.
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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