Short-term Efficacy Of Subthalamic Nucleus Deep Brain Stimulation For The Treatment Of Parkinson’s Disease

Objective: To study the short-term efficacy of subthalamic nucleus deep brain stimulation for the treatment of Parkinson’s disease.Materials and methods: Thirteen patients with Parkinson’s disease(PD)underwent bilateral subthalamic nucleus deep brain stimulation(STN-DBS)from March of 2014 to May of 2016 at the Tongji Hospital affiliated with the Tongji Medical College,Huazhong University of Science and Technology,China.The patients were followed up before the procedure and again 6 months after the procedure.The Hoehn-Yahr staging scale,the UPDRS-III Scale,the UPDRS-IV Scale,the Non-Movement Rating Scale(NMSS),Parkinson’s disease 39 quality of Life Questionnaire(PDQL-39),the Parkinson’s disease sleep scale(PDSS),the Mini-Mental State Examination(MMSE),Hamilton anxiety Scale(HAMA)and Hamilton depression Scale(HAMD)were used for the assessment of the severity of PD and movement functions,motor complications,the non-motor symptoms,quality of daily life,sleep,cognition,emotion,and so on.At the same time,the corresponding time of drug varieties,equivalent dose levodopa(LED),the control parameters,and the postoperative adverse reactions were recorded to evaluate the postoperative curative effect.Results:Eleven of the thirteen patients completed the follow-up,the result is as follows:(1)Motor function: Under the condition in which the patients did not take any medication,the total score on the Unified Parkinson’s Disease Rating Scale Part III(UPDRS-III)was significantly lower than that before the operation.The improvement rates of the major subscores for tremor,rigidity,bradykinesia,and axial signs were77%,72%,68%,and 57%,respectively.Under the condition in which the patients took medication,the improvement rates of the total UPDRS-III score and that ofrigidity were both 57%,but the subscores for tremor,bradykinesia,and axial signs were not significantly different compared to the preoperative conditions.(2)Motor complications consisted mostly of “on/off” fluctuations,of which the “off”duration and the “off” time severity scores were decreased significantly(P <0.001).(3)Postoperative quality of life was improved by 53% compared with the preoperative conditions.(4)The total score of non-motor symptoms was decreased compared with the preoperative score(P = 0.01).The improved symptoms included sleep disorders,urinary symptoms and hyperhidrosis.(5)The levo-dopa equivalent dose(LED)was decreased by 35.8% compared with the preoperative dose.Adverse reactions were mostly transient,with 1 case postoperative eyelid bruising and swelling and 1 case developing single-limb actional and postural tremor.Conclusions: STN-DBS had good short-term efficacy and was safe for the treatment of PD.It primarily improved patient core motor symptoms,motor complications,and general non-motor symptoms(mainly including sleep disorders,hyperhidrosis,and urinary system symptoms),as well as quality of life,and significantly reduced the LED.