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Predictors of effective bilateral subthalamic nucleus stimulation for PD
P D Charles1, N Van Blercom, P Krack
1Department of Clinical and Biological Neurosciences, Joseph Fourier University, Grenoble, France.
Neurology
|September 26, 2002
Summary
Younger age and levodopa responsiveness predict successful deep brain stimulation of the subthalamic nucleus (STN-DBS) in Parkinson's disease (PD) patients with severe motor issues. Symptoms improving with levodopa medication are most likely to benefit from STN-DBS.
Area of Science:
- Neurosurgery
- Neurology
- Movement Disorders
Background:
- Parkinson's disease (PD) is a progressive neurodegenerative disorder.
- Severe motor complications significantly impact PD patients' quality of life.
- Subthalamic nucleus deep brain stimulation (STN-DBS) is an established treatment for advanced PD.
Purpose of the Study:
- To determine predictors of successful bilateral STN-DBS in PD patients.
- To identify patient characteristics associated with favorable outcomes after STN-DBS.
Main Methods:
- Analysis of pre- and postoperative Unified Parkinson's Disease Rating Scale (UPDRS) scores.
- Retrospective study of 54 patients undergoing bilateral STN-DBS.
- Correlation of patient demographics and levodopa response with UPDRS outcomes.
Main Results:
- Younger patient age was a significant predictor of a positive response to STN-DBS.
- Preoperative responsiveness to levodopa predicted a favorable outcome.
- PD symptoms that improved with levodopa challenge were likely to improve with STN-DBS.
Conclusions:
- Younger age and levodopa responsiveness are key factors for successful STN-DBS in PD.
- Levodopa challenge can predict symptom improvement following STN-DBS.
- STN-DBS is an effective therapy for select PD patients with motor complications.