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Bilateral deep brain stimulation in Parkinson's disease: a multicentre study with 4 years follow-up
Open accessAbstract
Deep brain stimulation (DBS) is associated with significant improvement of motor complications in patients with severe Parkinson's disease after some 6-12 months of treatment. Long-term results in a large number of patients have been reported only from a single study centre. We report 69 Parkinson's disease patients treated with bilateral DBS of the subthalamic nucleus (STN, n = 49) or globus pallidus internus (GPi, n = 20) included in a multicentre study. Patients were assessed preoperatively and at 1 year and 3-4 years after surgery. The primary outcome measure was the change in the 'off' medication score of the Unified Parkinson's Disease Rating Scale motor part (UPDRS-III) at 3-4 years. Stimulation of the STN or GPi induced a significant improvement (50 and 39%; P < 0.0001) of the 'off' medication UPDRS-III score at 3-4 years with respect to baseline. Stimulation improved cardinal features and activities of daily living (ADL) (P < 0.0001 and P < 0.02 for STN and GPi, respectively) and prolonged the 'on' time spent with good mobility without dyskinesias (P < 0.00001). Daily dosage of levodopa was significantly reduced (35%) in the STN-treated group only (P < 0.001). Comparison of the improvement induced by stimulation at 1 year with 3-4 years showed a significant worsening in the 'on' medication motor states of the UPDRS-III, ADL and gait in both STN and GPi groups, and speech and postural stability in the STN-treated group. Adverse events (AEs) included cognitive decline, speech difficulty, instability, gait disorders and depression. These were more common in patients treated with DBS of the STN. No patient abandoned treatment as a result of these side effects. This experience, which represents the first multicentre study assessing the long-term efficacy of either STN or GPi stimulation, shows a significant and substantial clinically important therapeutic benefit for at least 3-4 years in a large cohort of patients with severe Parkinson's disease.
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Citations
Cites
Deep brain stimulation for movement disorders: morbidity and mortality in 109 patients
Umemura, A., Jaggi, J. L., Hurtig, H. I., Siderowf, A. D., Colcher, A., Stern, M. B., & Baltuch, G. H. (2003) · Journal of Neurosurgery · doi:10.3171/jns.2003.98.4.0779 · Cited by 279
Cited by
Deep brain stimulation of the subthalamic nucleus for the treatment of Parkinson's disease
Benabid, A. L., Chabardes, S., Mitrofanis, J., & Pollak, P. (2009) · The Lancet Neurology · doi:10.1016/s1474-4422(08)70291-6 · Cited by 1,285
Self-citationGreenberg, B. D., Gabriels, L. A., Malone, D. A., Rezai, A. R., Friehs, G. M., Okun, M. S., Shapira, N. A., Foote, K. D., Cosyns, P. R., Kubu, C. S., et al. (2010) · Molecular Psychiatry · doi:10.1038/mp.2008.55 · Cited by 867
Ten-Year Outcome of Subthalamic Stimulation in Parkinson Disease: A Blinded Evaluation
Castrioto, A. (2011) · Archives of Neurology · doi:10.1001/archneurol.2011.182 · Cited by 455
Current approaches to the treatment of Parkinson’s disease
Jankovic, J. (2008) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s2006 · Cited by 342
Deep Brain Stimulation for Neurologic and Neuropsychiatric Disorders
Wichmann, T., & DeLong, M. R. (2006) · Neuron · doi:10.1016/j.neuron.2006.09.022 · Cited by 331
Metadata
- Authors
- Rodriguez-Oroz, M. C., Obeso, J. A., Lang, A. E., Houeto, J.-L., Pollak, P., Rehncrona, S., Kulisevsky, J., Albanese, A., Volkmann, J., Hariz, M. I., Quinn, N. P., Speelman, J. D., Guridi, J., Zamarbide, I., Gironell, A., Molet, J., Pascual-Sedano, B., Pidoux, B., Bonnet, A. M., Agid, Y., Xie, J., Benabid, A.-L., Lozano, A. M., Saint-Cyr, J., Romito, L., Contarino, M. F., Scerrati, M., Fraix, V., & Van Blercom, N.
- Venue
- Brain
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-06-23
- Volume
- 128
- Issue
- 10
- Pages
- 2240-2249
- ISSN
- 0006-8950 (ISSN-L)
- 1460-2156
- OpenAlex
- W2124227727
- Cited by
- 1,057
- References
- 1
- FWCI
- 42.76
- Type
- journal article
- Language
- en
- Open access
- bronze
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- The paper
- Rodriguez-Oroz, M. C., Obeso, J. A., Lang, A. E., Houeto, J.-L., Pollak, P., Rehncrona, S., Kulisevsky, J., Albanese, A., Volkmann, J., Hariz, M. I., Quinn, N. P., Speelman, J. D., Guridi, J., Zamarbide, I., Gironell, A., Molet, J., Pascual-Sedano, B., Pidoux, B., Bonnet, A. M., . . . Van Blercom, N. (2005). Bilateral deep brain stimulation in Parkinson's disease: a multicentre study with 4 years follow-up. Brain. https://doi.org/10.1093/brain/awh571
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
