Long-term benefits in quality of life provided by bilateral subthalamic stimulation in patients with Parkinson disease

Lyons, Kelly E.; Pahwa, Rajesh

doi:10.3171/jns.2005.103.2.0252

Cited by 76 publications

(52 citation statements)

References 10 publications

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“…65 In support of this finding, the physical markers for quality of life are reported to improve significantly, but other aspects such as mental, emotional well-being, social support, cognition, and communication show no improvement. 66,67 The improvement in quality of life is maintained over time.…”

Section: Beneficial Effectsupporting

confidence: 60%

“…Quality of life improves after STN DBS, 56,[63][64][65][66][67] and this improvement correlates with motor benefit. 65 In support of this finding, the physical markers for quality of life are reported to improve significantly, but other aspects such as mental, emotional well-being, social support, cognition, and communication show no improvement.…”

Section: Beneficial Effectmentioning

confidence: 99%

“…66,67 The improvement in quality of life is maintained over time. 64,65 The caregiver's quality of life can also improve. 64 Nevertheless, two studies have Studies were selected on the basis of a larger number of patients and longer duration of follow-up.…”

Section: Beneficial Effectmentioning

confidence: 99%

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Deep Brain Stimulation for Parkinson’s Disease

2008

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Summary:The surgical treatment of Parkinson's disease has been through a revival phase over the last 20 years with the development of deep brain stimulation (DBS). Thalamic DBS was developed first and has proven to be a very effective treatment for tremor. The limitation is the lack of effect on other symptoms. Other targets were therefore investigated, and the procedure was applied to the subthalamic nucleus (STN) and the internal globus pallidus (GPi). STN stimulation can improve a wide range of symptoms and is currently the preferred target for many patients. Nevertheless, the morbidity seems higher than with other targets, and the selection criteria have to be quite strict. When STN DBS is not advised, thalamic DBS remains an option for patients with severe tremor, and GPi stimulation for those with severe dyskinesias. DBS remains a symptomatic treatment for a limited number of patients; it does not seem to alter the disease progression, and many patients are not suitable. There is, therefore, the need for further research into other targets and other approaches.

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Section: Beneficial Effectsupporting

confidence: 60%

Section: Beneficial Effectmentioning

confidence: 99%

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Deep Brain Stimulation for Parkinson’s Disease

2008

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“…Details of the procedure were described previously (14). The stimulation was initiated after 4 weeks.…”

Section: Methodsmentioning

confidence: 99%

Quality of life and depressive symptoms in parkinson's disease after subthalamic deep brain stimulation. a 2-year follow-up study

Tykocki¹,

Szalecki²,

Koziara³

et al. 2012

Turkish Neurosurgery

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AIm:To assess the correlation between quality of life (QoL), depressive symptoms and motor signs in patients with Parkinson disease after subthalamic deep brain stimulation (DBS STN). mAterIAl and methOds: 74 patients, average age 55.6 ± 7 and duration of disease 12.3 years± 3.8, treated with l STN DBS for PD were included in the study. All patients were evaluated with (UPDRS III), (PDQ-39) (BDI) at baseline and at 6, 12, and 24-month follow up. All patients were also stratified into three groups depending on UPDRS III improvement (<30%, 30-60%, >60%). BulGulAr: Tüm ölçeklerdeki puanlar başlangıca göre önemli ölçüde azaldı. PDQ-39'daki iyileşme 6 ayda %43,3 BDI'da %25,3 ; UPDRS-III %55,5 bulundu. 24 ayda motor sonuçlar QoL sırasıyla %15,6 ve %19,6 bozuldu. BDI değişmeden kaldı. PDQ-39 için başlangıçtaki ortalama skorlar grup I'da 67,4 ± 29,7; II 64,8±32,0; III 53,4±22,0 ve BDI için, grup I'de 17,4±12,04; II 14,0±9,7; III-15,1±10,55. Puanlar 6 aylık takipte DBS'de önemli ölçüde azaldı ve ortalama değişim şöyleydi: PDQ-39, grup I %42,7, II-%40,7, III %51,6; BDI grup I %23, II %28,1, III %23,3. sOnuÇ: DBS STN sonrasında PD'de depresif belirtiler, motor bulgularda azalma ve QoL'de artış yakından ilişkilidir. QoL artışı önemli ölçüde motor belirtilere bağlıdır.

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“…In most patients, DBS alleviates parkinsonian motor signs, shortens 'off' periods, and reduces druginduced dyskinesias, dystonia, and motor fluctuations (Rodriguez-Oroz et al, 2004;Anderson et al, 2005;Weaver et al, 2005;Portman et al, 2006;Bronstein et al, 2011). In general, both GPi-and STN-DBS are more effective than medical management alone to alleviate motor deficits in patients with advanced PD (Just and Ostergaard, 2002;Martinez-Martin et al, 2002;Troster et al, 2003;Lezcano et al, 2004;Diamond and Jankovic, 2005;Erola et al, 2005;Halbig et al, 2005;Lyons and Pahwa, 2005;Deuschl et al, 2006;Rodrigues et al, 2007a, b;Montel and Bungener, 2009;Weaver et al, 2009b;Zahodne et al, 2009). In contrast to patients with GPi-DBS, those with STN-DBS are often able to substantially reduce the medication doses (Breit et al, 2004; …”

Section: Current Surgical Targetsmentioning

confidence: 99%

Parkinson's Disease Therapeutics: New Developments and Challenges Since the Introduction of Levodopa

Smith

Wichmann

Factor

et al. 2011

Neuropsychopharmacol

194

137

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The demonstration that dopamine loss is the key pathological feature of Parkinson's disease (PD), and the subsequent introduction of levodopa have revolutionalized the field of PD therapeutics. This review will discuss the significant progress that has been made in the development of new pharmacological and surgical tools to treat PD motor symptoms since this major breakthrough in the 1960s. However, we will also highlight some of the challenges the field of PD therapeutics has been struggling with during the past decades. The lack of neuroprotective therapies and the limited treatment strategies for the nonmotor symptoms of the disease (ie, cognitive impairments, autonomic dysfunctions, psychiatric disorders, etc.) are among the most pressing issues to be addressed in the years to come. It appears that the combination of early PD nonmotor symptoms with imaging of the nigrostriatal dopaminergic system offers a promising path toward the identification of PD biomarkers, which, once characterized, will set the stage for efficient use of neuroprotective agents that could slow down and alter the course of the disease.

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Long-term benefits in quality of life provided by bilateral subthalamic stimulation in patients with Parkinson disease

Abstract: Improvements in quality of life following bilateral DBS of the STN are maintained in the long term. These improvements are strongly correlated with improvements in motor function, primarily with regard to bradykinesia.

Cited by 76 publications

References 10 publications

Deep Brain Stimulation for Parkinson’s Disease

Deep Brain Stimulation for Parkinson’s Disease

Quality of life and depressive symptoms in parkinson's disease after subthalamic deep brain stimulation. a 2-year follow-up study

Parkinson's Disease Therapeutics: New Developments and Challenges Since the Introduction of Levodopa

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