Francesco Bove1,2,3, Delia Mulas1,4, Francesco Cavallieri1,5,6, Anna Castrioto1,7, Stephan Chabardès7,8, Sara Meoni1,7,9, Emmanuelle Schmitt1,7, Amélie Bichon1,7, Enrico Di Stasio10,11, Andrea Kistner1,7, Pierre Pélissier1,7, Eric Chevrier1,7, Eric Seigneuret7,8, Paul Krack12, Valerie Fraix1,7, Elena Moro13,7. 1. Movement Disorders Unit, Division of Neurology, CHU Grenoble Alpes, Grenoble, France. 2. Neurology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 3. Department of Neurosciences, Università Cattolica del Sacro Cuore, Rome, Italy. 4. Institute of Neurology, Mater Olbia Hospital, Olbia, Italy. 5. Neurology Unit, Neuromotor and Rehabilitation Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy. 6. Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy. 7. Grenoble Institute of Neurosciences, University Grenoble Alpes, Inserm, U1216, Grenoble, France. 8. Division of Neurosurgery, Centre Hospitalier Universitaire (CHU), Grenoble Alpes University. 9. Department of Health Sciences, University of Milan, Milan, Italy. 10. Cheminstry, Biocheminstry and Clinical Molecular Biology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. 11. Institute of Biochemistry and Clinical Biochemistry, Università Cattolica del Sacro Cuore, Rome, Italy. 12. Department of Neurology, Bern University Hospital, Bern, Switzerland. 13. Movement Disorders Unit, Division of Neurology, CHU Grenoble Alpes, Grenoble, France elenamfmoro@gmail.com.
Abstract
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.
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.
Authors: Nicolaas I Bohnen; Alison J Yarnall; Rimona S Weil; Elena Moro; Mark S Moehle; Per Borghammer; Marc-André Bedard; Roger L Albin Journal: Lancet Neurol Date: 2022-02-04 Impact factor: 44.182
Authors: Francesco Bove; Danilo Genovese; Martina Petracca; Tommaso Tufo; Danila Pisani; Maria Rita Lo Monaco; Anna Rita Bentivoglio; Paolo Calabresi; Carla Piano Journal: NPJ Parkinsons Dis Date: 2022-06-29
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: Gian Pal; Graziella Mangone; Emily J Hill; Bichun Ouyang; Yuanqing Liu; Vanessa Lythe; Debra Ehrlich; Rachel Saunders-Pullman; Vicki Shanker; Susan Bressman; Roy N Alcalay; Priscilla Garcia; Karen S Marder; Jan Aasly; M Maral Mouradian; Samantha Link; Marc Rosenbaum; Sharlet Anderson; Bryan Bernard; Robert Wilson; Glenn Stebbins; William C Nichols; Marie-Laure Welter; Sepehr Sani; Mitra Afshari; Leo Verhagen; Rob M A de Bie; Tom Foltynie; Deborah Hall; Jean-Christophe Corvol; Christopher G Goetz Journal: Ann Neurol Date: 2022-01-25 Impact factor: 11.274
Authors: Anna Castrioto; Bettina Debû; Emilie Cousin; Pierre Pelissier; Eugénie Lhommée; Amélie Bichon; Emmanuelle Schmitt; Andrea Kistner; Sara Meoni; Eric Seigneuret; Stephan Chabardes; Paul Krack; Elena Moro; Valérie Fraix Journal: Eur J Neurol Date: 2022-06-24 Impact factor: 6.288
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