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Bilateral deep brain stimulation in Parkinson's disease: a multicentre study with 4 years follow-up.
Brain. 2005 Oct; 128(Pt 10):2240-9.B

Abstract

Deep brain stimulation (DBS) is associated with significant improvement of motor complications in patients with severe Parkinson's disease after some 6-12 months of treatment. Long-term results in a large number of patients have been reported only from a single study centre. We report 69 Parkinson's disease patients treated with bilateral DBS of the subthalamic nucleus (STN, n = 49) or globus pallidus internus (GPi, n = 20) included in a multicentre study. Patients were assessed preoperatively and at 1 year and 3-4 years after surgery. The primary outcome measure was the change in the 'off' medication score of the Unified Parkinson's Disease Rating Scale motor part (UPDRS-III) at 3-4 years. Stimulation of the STN or GPi induced a significant improvement (50 and 39%; P < 0.0001) of the 'off' medication UPDRS-III score at 3-4 years with respect to baseline. Stimulation improved cardinal features and activities of daily living (ADL) (P < 0.0001 and P < 0.02 for STN and GPi, respectively) and prolonged the 'on' time spent with good mobility without dyskinesias (P < 0.00001). Daily dosage of levodopa was significantly reduced (35%) in the STN-treated group only (P < 0.001). Comparison of the improvement induced by stimulation at 1 year with 3-4 years showed a significant worsening in the 'on' medication motor states of the UPDRS-III, ADL and gait in both STN and GPi groups, and speech and postural stability in the STN-treated group. Adverse events (AEs) included cognitive decline, speech difficulty, instability, gait disorders and depression. These were more common in patients treated with DBS of the STN. No patient abandoned treatment as a result of these side effects. This experience, which represents the first multicentre study assessing the long-term efficacy of either STN or GPi stimulation, shows a significant and substantial clinically important therapeutic benefit for at least 3-4 years in a large cohort of patients with severe Parkinson's disease.

Authors+Show Affiliations

Department of Neurology and Neurosurgery, Clinica Universitaria and Medical School, University of Navarra and CIMA, Pamplona, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study

Language

eng

PubMed ID

15975946

Citation

Rodriguez-Oroz, M C., et al. "Bilateral Deep Brain Stimulation in Parkinson's Disease: a Multicentre Study With 4 Years Follow-up." Brain : a Journal of Neurology, vol. 128, no. Pt 10, 2005, pp. 2240-9.
Rodriguez-Oroz MC, Obeso JA, Lang AE, et al. Bilateral deep brain stimulation in Parkinson's disease: a multicentre study with 4 years follow-up. Brain. 2005;128(Pt 10):2240-9.
Rodriguez-Oroz, M. C., Obeso, J. A., Lang, A. E., Houeto, J. L., Pollak, P., Rehncrona, S., Kulisevsky, J., Albanese, A., Volkmann, J., Hariz, M. I., Quinn, N. P., Speelman, J. D., Guridi, J., Zamarbide, I., Gironell, A., Molet, J., Pascual-Sedano, B., Pidoux, B., Bonnet, A. M., ... Van Blercom, N. (2005). Bilateral deep brain stimulation in Parkinson's disease: a multicentre study with 4 years follow-up. Brain : a Journal of Neurology, 128(Pt 10), 2240-9.
Rodriguez-Oroz MC, et al. Bilateral Deep Brain Stimulation in Parkinson's Disease: a Multicentre Study With 4 Years Follow-up. Brain. 2005;128(Pt 10):2240-9. PubMed PMID: 15975946.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bilateral deep brain stimulation in Parkinson's disease: a multicentre study with 4 years follow-up. AU - Rodriguez-Oroz,M C, AU - Obeso,J A, AU - Lang,A E, AU - Houeto,J-L, AU - Pollak,P, AU - Rehncrona,S, AU - Kulisevsky,J, AU - Albanese,A, AU - Volkmann,J, AU - Hariz,M I, AU - Quinn,N P, AU - Speelman,J D, AU - Guridi,J, AU - Zamarbide,I, AU - Gironell,A, AU - Molet,J, AU - Pascual-Sedano,B, AU - Pidoux,B, AU - Bonnet,A M, AU - Agid,Y, AU - Xie,J, AU - Benabid,A-L, AU - Lozano,A M, AU - Saint-Cyr,J, AU - Romito,L, AU - Contarino,M F, AU - Scerrati,M, AU - Fraix,V, AU - Van Blercom,N, Y1 - 2005/06/23/ PY - 2005/6/25/pubmed PY - 2005/12/31/medline PY - 2005/6/25/entrez SP - 2240 EP - 9 JF - Brain : a journal of neurology JO - Brain VL - 128 IS - Pt 10 N2 - Deep brain stimulation (DBS) is associated with significant improvement of motor complications in patients with severe Parkinson's disease after some 6-12 months of treatment. Long-term results in a large number of patients have been reported only from a single study centre. We report 69 Parkinson's disease patients treated with bilateral DBS of the subthalamic nucleus (STN, n = 49) or globus pallidus internus (GPi, n = 20) included in a multicentre study. Patients were assessed preoperatively and at 1 year and 3-4 years after surgery. The primary outcome measure was the change in the 'off' medication score of the Unified Parkinson's Disease Rating Scale motor part (UPDRS-III) at 3-4 years. Stimulation of the STN or GPi induced a significant improvement (50 and 39%; P < 0.0001) of the 'off' medication UPDRS-III score at 3-4 years with respect to baseline. Stimulation improved cardinal features and activities of daily living (ADL) (P < 0.0001 and P < 0.02 for STN and GPi, respectively) and prolonged the 'on' time spent with good mobility without dyskinesias (P < 0.00001). Daily dosage of levodopa was significantly reduced (35%) in the STN-treated group only (P < 0.001). Comparison of the improvement induced by stimulation at 1 year with 3-4 years showed a significant worsening in the 'on' medication motor states of the UPDRS-III, ADL and gait in both STN and GPi groups, and speech and postural stability in the STN-treated group. Adverse events (AEs) included cognitive decline, speech difficulty, instability, gait disorders and depression. These were more common in patients treated with DBS of the STN. No patient abandoned treatment as a result of these side effects. This experience, which represents the first multicentre study assessing the long-term efficacy of either STN or GPi stimulation, shows a significant and substantial clinically important therapeutic benefit for at least 3-4 years in a large cohort of patients with severe Parkinson's disease. SN - 1460-2156 UR - https://www.unboundmedicine.com/medline/citation/15975946/Bilateral_deep_brain_stimulation_in_Parkinson's_disease:_a_multicentre_study_with_4_years_follow_up_ L2 - https://academic.oup.com/brain/article-lookup/doi/10.1093/brain/awh571 DB - PRIME DP - Unbound Medicine ER -