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Five-year follow-up of 23 asymmetrical Parkinson's disease patients treated with unilateral subthalamic nucleus stimulation.

Liang J, Hu X, Zhou X, Jiang X, Cao Y, Wang L, Jin A, Liu J - Neural Regen Res (2012)

Bottom Line: However, total Unified Parkinson's Disease Rating Scale II, III and axial symptom scores were significantly lower with stimulation-on compared with the synchronous stimulation-off state in off-drug condition, and the motor symptoms of contralateral side limbs were effectively controlled.Only low Hoehn-Yahr stage was correlated with good long-term postoperative improvement in motor symptoms.The mean levodopa-equivalent daily dose after stimulation treatment was significantly lower than that before treatment, but dyskinesias became worse.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Changhai Hospital of the Second Military Medical University of Chinese PLA, Shanghai 200433, China.

ABSTRACT
In this study, 23 asymmetrical Parkinson's disease patients were treated with unilateral deep brain stimulation of the subthalamic nucleus and followed up for 5 years. At 5 years after stimulation treatment, Unified Parkinson's Disease Rating Scale II, III and axial symptom scores in the off-drug condition were significantly increased compared those at baseline. However, total Unified Parkinson's Disease Rating Scale II, III and axial symptom scores were significantly lower with stimulation-on compared with the synchronous stimulation-off state in off-drug condition, and the motor symptoms of contralateral side limbs were effectively controlled. Only low Hoehn-Yahr stage was correlated with good long-term postoperative improvement in motor symptoms. The mean levodopa-equivalent daily dose after stimulation treatment was significantly lower than that before treatment, but dyskinesias became worse. Our experimental findings indicate that unilateral deep brain stimulation of the subthalamic nucleus is an effective treatment for improving motor symptoms in well selected asymmetrical Parkinson's disease patients presenting no severe axial symptoms and dyskinesias.

No MeSH data available.


Related in: MedlinePlus

Improvements in Unified Parkinson's Disease Rating Scale (UPDRS) II & III scores at 1 and 5 years postoperatively analyzed by left- and right-side procedures.Although right-side procedures always produced greater improvements in symptoms than left-side procedures, no significant difference was found between them with Student's t-test (P = 0.207, 0.143, 0.172, 0.208 respectively). Data are expressed as mean ± SD.The improvement calculation was compared with baseline .
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Figure 1: Improvements in Unified Parkinson's Disease Rating Scale (UPDRS) II & III scores at 1 and 5 years postoperatively analyzed by left- and right-side procedures.Although right-side procedures always produced greater improvements in symptoms than left-side procedures, no significant difference was found between them with Student's t-test (P = 0.207, 0.143, 0.172, 0.208 respectively). Data are expressed as mean ± SD.The improvement calculation was compared with baseline .

Mentions: There were no significant differences in the degrees of improvements in UPDRS II and III scores at 1 and 5 years between procedure sides. At 1 year postoperation, although there was a trend toward lower H&Y stage being associated with better improvements, no significant difference was found between H&Y stages. At 5 years, lower H&Y stage was associated with significantly greater improvements in UPDRS II and III scores (P < 0.05). These results are shown in Figures 1 and 2.


Five-year follow-up of 23 asymmetrical Parkinson's disease patients treated with unilateral subthalamic nucleus stimulation.

Liang J, Hu X, Zhou X, Jiang X, Cao Y, Wang L, Jin A, Liu J - Neural Regen Res (2012)

Improvements in Unified Parkinson's Disease Rating Scale (UPDRS) II & III scores at 1 and 5 years postoperatively analyzed by left- and right-side procedures.Although right-side procedures always produced greater improvements in symptoms than left-side procedures, no significant difference was found between them with Student's t-test (P = 0.207, 0.143, 0.172, 0.208 respectively). Data are expressed as mean ± SD.The improvement calculation was compared with baseline .
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4308795&req=5

Figure 1: Improvements in Unified Parkinson's Disease Rating Scale (UPDRS) II & III scores at 1 and 5 years postoperatively analyzed by left- and right-side procedures.Although right-side procedures always produced greater improvements in symptoms than left-side procedures, no significant difference was found between them with Student's t-test (P = 0.207, 0.143, 0.172, 0.208 respectively). Data are expressed as mean ± SD.The improvement calculation was compared with baseline .
Mentions: There were no significant differences in the degrees of improvements in UPDRS II and III scores at 1 and 5 years between procedure sides. At 1 year postoperation, although there was a trend toward lower H&Y stage being associated with better improvements, no significant difference was found between H&Y stages. At 5 years, lower H&Y stage was associated with significantly greater improvements in UPDRS II and III scores (P < 0.05). These results are shown in Figures 1 and 2.

Bottom Line: However, total Unified Parkinson's Disease Rating Scale II, III and axial symptom scores were significantly lower with stimulation-on compared with the synchronous stimulation-off state in off-drug condition, and the motor symptoms of contralateral side limbs were effectively controlled.Only low Hoehn-Yahr stage was correlated with good long-term postoperative improvement in motor symptoms.The mean levodopa-equivalent daily dose after stimulation treatment was significantly lower than that before treatment, but dyskinesias became worse.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Changhai Hospital of the Second Military Medical University of Chinese PLA, Shanghai 200433, China.

ABSTRACT
In this study, 23 asymmetrical Parkinson's disease patients were treated with unilateral deep brain stimulation of the subthalamic nucleus and followed up for 5 years. At 5 years after stimulation treatment, Unified Parkinson's Disease Rating Scale II, III and axial symptom scores in the off-drug condition were significantly increased compared those at baseline. However, total Unified Parkinson's Disease Rating Scale II, III and axial symptom scores were significantly lower with stimulation-on compared with the synchronous stimulation-off state in off-drug condition, and the motor symptoms of contralateral side limbs were effectively controlled. Only low Hoehn-Yahr stage was correlated with good long-term postoperative improvement in motor symptoms. The mean levodopa-equivalent daily dose after stimulation treatment was significantly lower than that before treatment, but dyskinesias became worse. Our experimental findings indicate that unilateral deep brain stimulation of the subthalamic nucleus is an effective treatment for improving motor symptoms in well selected asymmetrical Parkinson's disease patients presenting no severe axial symptoms and dyskinesias.

No MeSH data available.


Related in: MedlinePlus