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Long-Term Results of a Multicenter Study on Subthalamic and Pallidal Stimulation in Parkinson's Disease

Moro, Elena; Lozano, Andres M.; Pollak, Pierre; Agid, Yves; Rehncrona, Stig LU ; Volkmann, Jens; Kulisevsky, Jaime; Obeso, Jose A.; Albanese, Alberto and Hariz, Marwan I., et al. (2010) In Movement Disorders 25(5). p.578-586
Abstract
We report the 5 to 6 year follow-up of a multicenter study of bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) in advanced Parkinson's disease (PD) patients. Thirty-live STN patients and 16 GPi patienis were assessed at 5 to 6 years after DBS surgery. Primary outcome measure was the stimulation effect on the motor Unified Parkinson's Disease Rating Scale (UPDRS) assessed with a prospective cross-over double-blind assessment without medications (stimulation was randomly switched on or off). Secondary outcomes were motor UPDRS changes with unblinded assessments in off- and on-medication states with and without stimulation, activities of daily living (ADL), anti-PD medications, and... (More)
We report the 5 to 6 year follow-up of a multicenter study of bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) in advanced Parkinson's disease (PD) patients. Thirty-live STN patients and 16 GPi patienis were assessed at 5 to 6 years after DBS surgery. Primary outcome measure was the stimulation effect on the motor Unified Parkinson's Disease Rating Scale (UPDRS) assessed with a prospective cross-over double-blind assessment without medications (stimulation was randomly switched on or off). Secondary outcomes were motor UPDRS changes with unblinded assessments in off- and on-medication states with and without stimulation, activities of daily living (ADL), anti-PD medications, and dyskinesias. In double-blind assessment, both STN and GPi DBS were significantly effective in improving the motor UPDRS scores (STN. P < 0.0001, 45.4%; GPi, P = 0.008, 20.0%) compared with of regardless of the sequence of stimulation. In open assessment. both STN- and GPi-DBS significantly improved the off-medication motor UPDRS when compared with before surgery (STN. P < 0.001, 50.5%; GPi, P = 0.002, 35.6%). Dyskinesias and ADL were significantly improved in both groups. Anti-PD medications were significantly reduced only in the STN group. Adverse events were more frequent in the STN group. These results confirm the long-term efficacy of STN and GPi DBS advanced PD. Although the surgical targets were not randomized, there was a trend to 1 better outcome of motor signs in the STN-DBS patients and fewer adverse events in the GPi-DBS group. (C) 2010 Movement Disorder Society (Less)
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publication status
published
subject
keywords
subthalamic nucleus, globus pallidus internus, Parkinson's disease, deep brain stimulation
in
Movement Disorders
volume
25
issue
5
pages
578 - 586
publisher
John Wiley & Sons
external identifiers
  • wos:000277250600009
  • scopus:77951234550
ISSN
0885-3185
DOI
10.1002/mds.22735
language
English
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yes
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d79dc53a-7e1c-4c8f-a929-351867001264 (old id 1619311)
date added to LUP
2010-06-23 14:07:22
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2018-06-10 03:28:46
@article{d79dc53a-7e1c-4c8f-a929-351867001264,
  abstract     = {We report the 5 to 6 year follow-up of a multicenter study of bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) in advanced Parkinson's disease (PD) patients. Thirty-live STN patients and 16 GPi patienis were assessed at 5 to 6 years after DBS surgery. Primary outcome measure was the stimulation effect on the motor Unified Parkinson's Disease Rating Scale (UPDRS) assessed with a prospective cross-over double-blind assessment without medications (stimulation was randomly switched on or off). Secondary outcomes were motor UPDRS changes with unblinded assessments in off- and on-medication states with and without stimulation, activities of daily living (ADL), anti-PD medications, and dyskinesias. In double-blind assessment, both STN and GPi DBS were significantly effective in improving the motor UPDRS scores (STN. P &lt; 0.0001, 45.4%; GPi, P = 0.008, 20.0%) compared with of regardless of the sequence of stimulation. In open assessment. both STN- and GPi-DBS significantly improved the off-medication motor UPDRS when compared with before surgery (STN. P &lt; 0.001, 50.5%; GPi, P = 0.002, 35.6%). Dyskinesias and ADL were significantly improved in both groups. Anti-PD medications were significantly reduced only in the STN group. Adverse events were more frequent in the STN group. These results confirm the long-term efficacy of STN and GPi DBS advanced PD. Although the surgical targets were not randomized, there was a trend to 1 better outcome of motor signs in the STN-DBS patients and fewer adverse events in the GPi-DBS group. (C) 2010 Movement Disorder Society},
  author       = {Moro, Elena and Lozano, Andres M. and Pollak, Pierre and Agid, Yves and Rehncrona, Stig and Volkmann, Jens and Kulisevsky, Jaime and Obeso, Jose A. and Albanese, Alberto and Hariz, Marwan I. and Quinn, Niall P. and Speelman, Jans D. and Benabid, Alim L. and Fraix, Valerie and Mendes, Alexandre and Welter, Marie-Laure and Houeto, Jean-Luc and Cornu, Philippe and Dormont, Didier and Törnqvist, Anna Lena and Ekberg, Ron and Schnitzler, Alfons and Timmermann, Lars and Wojtecki, Lars and Gironell, Andres and Rodriguez-Oroz, Maria C. and Guridi, Jorge and Bentivoglio, Anna R. and Contarino, Maria F. and Romito, Luigi and Scerrati, Massimo and Janssens, Marc and Lang, Anthony E.},
  issn         = {0885-3185},
  keyword      = {subthalamic nucleus,globus pallidus internus,Parkinson's disease,deep brain stimulation},
  language     = {eng},
  number       = {5},
  pages        = {578--586},
  publisher    = {John Wiley & Sons},
  series       = {Movement Disorders},
  title        = {Long-Term Results of a Multicenter Study on Subthalamic and Pallidal Stimulation in Parkinson's Disease},
  url          = {http://dx.doi.org/10.1002/mds.22735},
  volume       = {25},
  year         = {2010},
}