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Two-year follow-up on the effect of unilateral subthalamic deep brain stimulation in highly asymmetric Parkinson's disease.
Mov Disord. 2009 Feb 15; 24(3):329-35.MD

Abstract

Although bilateral subthalamic deep brain stimulation (STN DBS) provides greater relief from the symptoms of Parkinson's disease (PD) than unilateral STN DBS, it has been suggested that unilateral STN DBS may be a reasonable treatment option in selected patients, especially those with highly asymmetric PD. In previous studies on the effect of unilateral STN DBS, the asymmetry of PD symptoms was not prominent and the mean follow-up durations were only 3 to 12 months. In this study, we report our findings in a series of 8 patients with highly asymmetric PD who were treated with unilateral STN DBS and were followed for 24 months. Serial changes in Unified Parkinson's Disease Rating Scale (UPDRS) motor score and subscores in the ipsilateral, contralateral, and axial body parts were analyzed. Unilateral STN DBS improved the UPDRS motor score and the contralateral subscore in the on-medication state for 5 nonfluctuating patients and in the off-medication state for 3 fluctuating patients. However, the ipsilateral subscore progressively worsened and reversed asymmetry became difficult to manage, which led to compromised medication and stimulator adjustment. At 24 months, all the patients were considering the second-side surgery. Our results suggest that bilateral STN DBS should be considered even in highly asymmetric PD.

Authors+Show Affiliations

Department of Neurology, Inje University Ilsan Paik Hospital, Goyang-Si, Gyeonggi-Do, Korea.No 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
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19006187

Citation

Kim, Han-Joon, et al. "Two-year Follow-up On the Effect of Unilateral Subthalamic Deep Brain Stimulation in Highly Asymmetric Parkinson's Disease." Movement Disorders : Official Journal of the Movement Disorder Society, vol. 24, no. 3, 2009, pp. 329-35.
Kim HJ, Paek SH, Kim JY, et al. Two-year follow-up on the effect of unilateral subthalamic deep brain stimulation in highly asymmetric Parkinson's disease. Mov Disord. 2009;24(3):329-35.
Kim, H. J., Paek, S. H., Kim, J. Y., Lee, J. Y., Lim, Y. H., Kim, D. G., & Jeon, B. S. (2009). Two-year follow-up on the effect of unilateral subthalamic deep brain stimulation in highly asymmetric Parkinson's disease. Movement Disorders : Official Journal of the Movement Disorder Society, 24(3), 329-35. https://doi.org/10.1002/mds.22211
Kim HJ, et al. Two-year Follow-up On the Effect of Unilateral Subthalamic Deep Brain Stimulation in Highly Asymmetric Parkinson's Disease. Mov Disord. 2009 Feb 15;24(3):329-35. PubMed PMID: 19006187.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Two-year follow-up on the effect of unilateral subthalamic deep brain stimulation in highly asymmetric Parkinson's disease. AU - Kim,Han-Joon, AU - Paek,Sun Ha, AU - Kim,Ji-Young, AU - Lee,Jee-Young, AU - Lim,Yong Hoon, AU - Kim,Dong Gyu, AU - Jeon,Beom S, PY - 2008/11/14/pubmed PY - 2009/7/28/medline PY - 2008/11/14/entrez SP - 329 EP - 35 JF - Movement disorders : official journal of the Movement Disorder Society JO - Mov Disord VL - 24 IS - 3 N2 - Although bilateral subthalamic deep brain stimulation (STN DBS) provides greater relief from the symptoms of Parkinson's disease (PD) than unilateral STN DBS, it has been suggested that unilateral STN DBS may be a reasonable treatment option in selected patients, especially those with highly asymmetric PD. In previous studies on the effect of unilateral STN DBS, the asymmetry of PD symptoms was not prominent and the mean follow-up durations were only 3 to 12 months. In this study, we report our findings in a series of 8 patients with highly asymmetric PD who were treated with unilateral STN DBS and were followed for 24 months. Serial changes in Unified Parkinson's Disease Rating Scale (UPDRS) motor score and subscores in the ipsilateral, contralateral, and axial body parts were analyzed. Unilateral STN DBS improved the UPDRS motor score and the contralateral subscore in the on-medication state for 5 nonfluctuating patients and in the off-medication state for 3 fluctuating patients. However, the ipsilateral subscore progressively worsened and reversed asymmetry became difficult to manage, which led to compromised medication and stimulator adjustment. At 24 months, all the patients were considering the second-side surgery. Our results suggest that bilateral STN DBS should be considered even in highly asymmetric PD. SN - 1531-8257 UR - https://www.unboundmedicine.com/medline/citation/19006187/Two_year_follow_up_on_the_effect_of_unilateral_subthalamic_deep_brain_stimulation_in_highly_asymmetric_Parkinson's_disease_ L2 - https://doi.org/10.1002/mds.22211 DB - PRIME DP - Unbound Medicine ER -