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Updated: Sep 9, 2025
Controlling Parkinson's Disease With Adaptive Deep Brain Stimulation
Published on: July 16, 2014
Analysis of DBS Outcome by MDS-UPDRS Severity Levels: Comparison with Changes on MDS-UPDRS III
Sergio A Castillo-Torres1, Ivonne Cruz1, Malco Rossi1,2
1Servicio de Movimientos Anormales, Departamento de Neurología, Fleni, Buenos Aires, Argentina.
Background:
MDS-UPDRS Severity Levels (SLs), derived from clinician- and patient-rated scales, remain underused to evaluate response to subthalamic deep brain stimulation (STN-DBS) in patients with Parkinson's disease (PD).
Objectives:
To evaluate MDS-UPDRS SL as markers of STN-DBS response.
Methods:
SLs were categorized as mild, moderate, or severe using established cut-off points for Parts II, III Off, and IV. Improvement was defined as a decrease in at least one SL. Part III Off improvement was correlated to quality-of-life scales and used to predict SL improvement using ROC Curve analysis.
Results:
A total of 51 patients (34.1% female, aged 58.9 ± 10.2 years, disease duration 12.3 ± 4.1 years) were evaluated 12 months after surgery. MDS-UPDRS III Off changes over 30% predicted SL improvements in MDS-UPDRS II (AUC = 0.83, p = 0.015) and IV (AUC = 0.89, p = 0.001).
Conclusion:
Our findings suggest that improvement in MDS-UPDRS SL are potential markers of STN-DBS response. With an MDS-UPDRS part III improvement around 30% predicting SL improvement.
Insights
Severity Levels (SLs) from the Movement Disorder Society-Unified Parkinson
Area of Science:
- Neurology
- Neurosurgery
- Biomedical Engineering
Background:
- Subthalamic deep brain stimulation (STN-DBS) is a treatment for Parkinson's disease (PD).
- MDS-UPDRS Severity Levels (SLs) are underutilized for assessing STN-DBS treatment response.
- Standardized evaluation of STN-DBS efficacy is crucial for patient management.
Purpose of the Study:
- To evaluate the utility of MDS-UPDRS SLs as markers for STN-DBS response in PD patients.
- To establish a predictive relationship between specific MDS-UPDRS part improvements and overall SL changes.
- To enhance the assessment of STN-DBS outcomes using established clinical scales.
Main Methods:
- MDS-UPDRS SLs (Parts II, III Off, IV) were categorized as mild, moderate, or severe.
- Improvement was defined as a reduction in at least one SL category.
- Receiver Operating Characteristic (ROC) curve analysis correlated Part III Off improvement with SL improvements in Parts II and IV.
Main Results:
- A 30% improvement in MDS-UPDRS Part III Off scores predicted SL improvements in Part II (AUC=0.83, p=0.015).
- A 30% improvement in MDS-UPDRS Part III Off scores predicted SL improvements in Part IV (AUC=0.89, p=0.001).
- These findings were based on 51 PD patients evaluated 12 months post-STN-DBS surgery.
Conclusions:
- Improvement in MDS-UPDRS SLs can serve as potential markers for STN-DBS response.
- Approximately 30% improvement in MDS-UPDRS Part III Off scores is a key predictor of SL improvement.
- This study validates the use of MDS-UPDRS SLs for a more comprehensive evaluation of STN-DBS outcomes in Parkinson's disease.
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