Stimulation of the globus pallidus internus in the treatment of Parkinson's disease: Long-term results of a monocentric cohort (original) (raw)

2019, Parkinsonism & Related Disorders

Background: Pallidal deep brain stimulation (DBS) has shown to be beneficial in patients with advanced levodopa-responsive Parkinson's disease (PD) in several short-term studies. However, reported long-term outcomes of pallidal DBS for PD are limited and contradictory. Methods: Eighteen consecutive PD patients were treated with unilateral or bilateral stimulation of the internal part of the globus pallidus (GPi). Assessments were carried out before and six months after neurosurgery, and annually thereafter for up to 16 years (mean follow-up time: 6 years). Primary outcomes included motor signs (Unified PD Rating Scale [UPDRS]-III), activities of daily living (ADL, UPDRS-II), and levodopa-induced motor complications (UPDRS-IV). Results: The results show that GPi stimulation improves levodopa-responsive PD motor signs (UPDRS-III), levodopa-induced motor complications (UPDRS-IV), and ADL (UPDRS-II) in advanced PD. Among motor signs, tremor showed the best response to pallidal stimulation. Levodopa-induced motor complications and tremor showed improvements for more than 10 years after neurosurgery. Conclusions: The overall findings in our cohort demonstrate that pallidal stimulation is effective in reducing parkinsonian motor signs (UPDRS-III), particularly in the 'off'-medication state. Although the beneficial effects on bradykinesia, rigidity and ADL may be limited to 5-6 years, the follow up results indicate that the improvements of levodopa-induced motor complications (UPDRS-IV) and tremor can be sustained for more than 10 years. report on long-term results (up to 16 years) in a cohort of 18 PD patients treated with pallidal DBS and prospectively followed at the University Hospital of Bern. 1.1. Patients Our cohort is a consecutive series of 18 patients (11 male and 7 female; mean age at time of surgery 64.8 ± 7.4 years) with advanced PD (mean disease duration at time of surgery 16.2 ± 6.8 years) who received unilateral (n = 4) or bilateral (n = 14) electrode implantations for DBS of the GPi at the University Hospital of Bern. The selection criteria for neurosurgery included: (i) advanced PD; (ii) good response

Sign up for access to the world's latest research.

checkGet notified about relevant papers

checkSave papers to use in your research

checkJoin the discussion with peers

checkTrack your impact

Loading...

Loading Preview

Sorry, preview is currently unavailable. You can download the paper by clicking the button above.