Two‐year follow‐up of subthalamic deep brain stimulation in Parkinson's disease

Abstract

We studied 48 patients after bilateral subthalamic nucleus deep brain stimulation (STN‐DBS) who were evaluated 6 months after the surgical procedure using the Unified Parkinson's Disease Rating Scale (UPDRS) in a standardized levodopa test. Additional follow‐up was available in 32 patients after 12 months and in 20 patients after 24 months. At 6 months follow‐up, STN‐DBS reduced the UPDRS motor score by 50.9% compared to baseline. This improvement remained constant at 12 months with 57.5% and at 24 months with 57.3%. Relevant side effects after STN‐DBS included intraoperative subdural hematoma without neurological sequelae (n = 1), minor intracerebral bleeding with slight transient hemiparesis (n = 1), dislocation of impulse generator (n = 2), transient perioperative confusional symptoms (n = 7), psychotic symptoms (n = 2), depression (n = 5), hypomanic behaviour (n = 2), and transient manic psychosis (n = 1). One patient died because of heart failure during the first postoperative year. The current series demonstrates efficacy and safety of STN‐DBS beyond the first year after surgical procedure. Complications of STN‐DBS comprise a wide range of psychiatric adverse events which, however, were temporary. © 2003 Movement Disorder Society

Practice Parameter: Treatment of Parkinson disease with motor fluctuations and dyskinesia (an evidence-based review): [RETIRED]

“…There were 4 Class III studies [36][37][38][39] and 10 Class IV studies. [40][41][42][43][44][45][46][47][48][49] All studies examined bilateral DBS of the STN. Only the Class III studies are discussed in detail.…”

“…[36][37][38][39][40][41]43,44,[46][47][48][49] Only the Class II studies are discussed in detail. Although these studies were rated Class IV relative to Question 4 regarding efficacy, they earned grades of Class II relative to prognosis for Question 5.…”

Deep brain stimulation compared with bariatric surgery for the treatment of morbid obesity: a decision analysis study

“…The calculated incidence of complications associated with laparoscopic bariatric surgery, obtained from the case series, 4,8,10,17,28,38,44,45,52,74,77,82,83,91,120 is summarized in Table 1; complications associated with DBS studies are shown in Table 2. 6,7,9,12,16,20,26,27,31,37,39,47,[55][56][57][58][59][60][61]64,[67][68][69]71,78,80,81,84,[86][87][88][89][96][97]…”

Advances in the treatment of depression

“…205 It is important to recognize that these effects were observed in patients with Parkinson's disease treated with DBS. It is not yet clear what side effects may occur in non-Parkinsonian patients that undergo DBS surgery and long-term treatment-likely the potential for side effects will depend greatly on the precise stimulation site.…”