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Effect of Subthalamic Deep Brain Stimulation on Levodopa-Induced Dyskinesia in Parkinson's Disease.
Yonsei Med J. 2015 Sep; 56(5):1316-21.YM

Abstract

PURPOSE

To evaluate the effect of bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) on levodopa-induced peak-dose dyskinesia in patients with Parkinson's disease (PD).

MATERIALS AND METHODS

A retrospective review was conducted on patients who underwent STN DBS for PD from May 2000 to July 2012. Only patients with levodopa-induced dyskinesia prior to surgery and more than 1 year of available follow-up data after DBS were included. The outcome measures included the dyskinesia subscore of the Unified Parkinson's Disease Rating Scale (UPDRS) part IV (items 32 to 34 of UPDRS part IV) and the levodopa equivalent daily dose (LEDD). The patients were divided into two groups based on preoperative to postoperative LEDD change at 12 months after the surgery: Group 1, LEDD decrease >15%; Group 2, all other patients. Group 2 was further divided by the location of DBS leads.

RESULTS

Of the 100 patients enrolled, 67 were in Group 1, while those remaining were in Group 2. Twelve months after STN DBS, Groups 1 and 2 showed improvements of 61.90% and 57.14%, respectively, in the dyskinesia subscore. Group 1 was more likely to experience dyskinesia suppression; however, the association between the groups and dyskinesia suppression was not statistically significant (p=0.619). In Group 2, dyskinesia was significantly decreased by stimulation of the area above the STN in 18 patients compared to stimulation of the STN in 15 patients (p=0.048).

CONCLUSION

Levodopa-induced dyskinesia is attenuated by STN DBS without reducing the levodopa dosage.

Authors+Show Affiliations

Division of Stereotactic and Functional Neurosurgery, Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea.Division of Stereotactic and Functional Neurosurgery, Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea.Division of Stereotactic and Functional Neurosurgery, Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea.Division of Stereotactic and Functional Neurosurgery, Department of Neurosurgery, Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea. JCHANG@yuhs.ac.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26256974

Citation

Kim, Ji Hee, et al. "Effect of Subthalamic Deep Brain Stimulation On Levodopa-Induced Dyskinesia in Parkinson's Disease." Yonsei Medical Journal, vol. 56, no. 5, 2015, pp. 1316-21.
Kim JH, Chang WS, Jung HH, et al. Effect of Subthalamic Deep Brain Stimulation on Levodopa-Induced Dyskinesia in Parkinson's Disease. Yonsei Med J. 2015;56(5):1316-21.
Kim, J. H., Chang, W. S., Jung, H. H., & Chang, J. W. (2015). Effect of Subthalamic Deep Brain Stimulation on Levodopa-Induced Dyskinesia in Parkinson's Disease. Yonsei Medical Journal, 56(5), 1316-21. https://doi.org/10.3349/ymj.2015.56.5.1316
Kim JH, et al. Effect of Subthalamic Deep Brain Stimulation On Levodopa-Induced Dyskinesia in Parkinson's Disease. Yonsei Med J. 2015;56(5):1316-21. PubMed PMID: 26256974.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of Subthalamic Deep Brain Stimulation on Levodopa-Induced Dyskinesia in Parkinson's Disease. AU - Kim,Ji Hee, AU - Chang,Won Seok, AU - Jung,Hyun Ho, AU - Chang,Jin Woo, PY - 2014/09/05/received PY - 2014/11/18/revised PY - 2014/12/04/accepted PY - 2015/8/11/entrez PY - 2015/8/11/pubmed PY - 2016/1/26/medline KW - Deep brain stimulation KW - Parkinson disease KW - dyskinesias KW - subthalamic nucleus SP - 1316 EP - 21 JF - Yonsei medical journal JO - Yonsei Med J VL - 56 IS - 5 N2 - PURPOSE: To evaluate the effect of bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) on levodopa-induced peak-dose dyskinesia in patients with Parkinson's disease (PD). MATERIALS AND METHODS: A retrospective review was conducted on patients who underwent STN DBS for PD from May 2000 to July 2012. Only patients with levodopa-induced dyskinesia prior to surgery and more than 1 year of available follow-up data after DBS were included. The outcome measures included the dyskinesia subscore of the Unified Parkinson's Disease Rating Scale (UPDRS) part IV (items 32 to 34 of UPDRS part IV) and the levodopa equivalent daily dose (LEDD). The patients were divided into two groups based on preoperative to postoperative LEDD change at 12 months after the surgery: Group 1, LEDD decrease >15%; Group 2, all other patients. Group 2 was further divided by the location of DBS leads. RESULTS: Of the 100 patients enrolled, 67 were in Group 1, while those remaining were in Group 2. Twelve months after STN DBS, Groups 1 and 2 showed improvements of 61.90% and 57.14%, respectively, in the dyskinesia subscore. Group 1 was more likely to experience dyskinesia suppression; however, the association between the groups and dyskinesia suppression was not statistically significant (p=0.619). In Group 2, dyskinesia was significantly decreased by stimulation of the area above the STN in 18 patients compared to stimulation of the STN in 15 patients (p=0.048). CONCLUSION: Levodopa-induced dyskinesia is attenuated by STN DBS without reducing the levodopa dosage. SN - 1976-2437 UR - https://www.unboundmedicine.com/medline/citation/26256974/Effect_of_Subthalamic_Deep_Brain_Stimulation_on_Levodopa_Induced_Dyskinesia_in_Parkinson's_Disease_ L2 - https://www.eymj.org/DOIx.php?id=10.3349/ymj.2015.56.5.1316 DB - PRIME DP - Unbound Medicine ER -