Chronic subthalamic nucleus stimulation reduces medication requirements in Parkinson’s disease

Abstract

Parkinsonian signs can be controlled by bilateral high-frequency STN stimulation. The procedure is well tolerated. On-state dyskinesias were greatly reduced, probably due to the reduction of total antiparkinsonian medication. Bilateral high-frequency STN stimulation compensated for drug reduction and elicited dyskinesias, which differ from those observed following dopaminergic medication. ADL improved significantly, suggesting that some motor tasks performed during everyday chores, and that are not taken into account in the UPDRS motor score, also improved.

Evaluation of healthcare utilization and health status of patients with Parkinson's disease treated with deep brain stimulation of the subthalamic nucleus

“…The improvement of both the motor score (UPDRS III) and the activities of daily living score (UPDRS II), was paralleled by an increase of the Schwab and England score up to 50 % six months after the surgical procedure which reflected the higher level of independence. These data are in accordance with recently published results from clinical studies [7,22,24,27].…”

“…In contrast to the expenditure due to in-and out-patient treatment, the costs for drug treatment following DBS-STN were reduced. Previous studies have shown that the mean dosage of levodopa as well as the mean dosage of dopamine agonists could be reduced following DBS-STN [22,27]. Furthermore, one study reported that in nine out of ten patients the expensive treatment with apomorphine could be discontinued 12 months following continuous high-frequency stimulation [24].…”

“…Although only one patient in this study returned to full-time employment following DBS-STN, we have several patients who were able to return to a regular working role. Furthermore, a recent study described "that women reported a striking improvement in coping with domestic chores and social life [27]. Five housewives regained the ability to cook, wash, iron and take care of the family.…”

“…Bilateral deep brain stimulation (DBS) of the subthalamic nucleus produces a dramatic reversal in all cardinal motor signs in PD patients, who are off their medications [30], but also provide improvements in the on-medication state [22]. In addition, subthalamic nucleus stimulation reduces medication requirements for PD patients [27].…”

Effect of bilateral subthalamic nucleus stimulation on parkinsonian gait

“…Since 1993, clinical reports have shown that subthalamic nucleus (STN) stimulation can greatly alleviate the main motor signs and symptoms of PD, including gait [25][26][27][29][30]. Yokoyama et al [38] focused on the poss Abstract Clinical reports show that bilateral subthalamic nucleus (STN) stimulation is effective in improving parkinsonian gait.…”