Effects of bilateral stimulation of the subthalamic nucleus in patients with severe Parkinson's disease and motor fluctuations

被引:164
|
作者
Ostergaard, K
Sunde, N
Dupont, E
机构
[1] Aarhus Univ Hosp, Dept Neurol, DK-8000 Aarhus C, Denmark
[2] Aarhus Univ Hosp, Dept Neurosurg, DK-8000 Aarhus, Denmark
关键词
Parkinson's disease; on-off phenomenon; dyskinesias; motor score; activities of daily living (ADL); deep brain stimulation; nucleus subthalamicus;
D O I
10.1002/mds.10188
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
We present the efficacy and side effects of bilateral deep brain stimulation (DBS) of the subthalamic nuclei (STN) performed with a more simplified surgical procedure than described by the Grenoble group. A consecutive series of 26 patients with advanced and levodopa-responsive Parkinson's disease and motor complications was evaluated using the Unified Parkinson's Disease Rating Scale (UPDRS) part I-VI, timed tests, and a patient diary for 2 days concerning on-off phenomenon and dyskinesias. At 3 months, evaluation of stimulation by the UPDRS motor score was performed in a double-blind manner and a significant improvement of 57% was found. The results 12 months after surgery off medication showed significant improvement in both UPDRS motor score and activities of daily living of 64% and, oil medication, a significant reduction of 86% in duration of dyskinesias and 83% in duration of off-periods. Reduction in medication was less than for other groups, probably because we used smaller doses of levodopa before the operation. No serious side effects were encountered. When the patients are carefully selected and followed up, bilateral DBS of STN is a significant progress in treatment of advanced idiopathic Parkinson's disease with levodopa-induced motor complications. (C) 2002 Movement Disorder Society.
引用
收藏
页码:693 / 700
页数:8
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