Long-term Efficacy of Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease

作者：Lulu Jiang, Jinlong Liu, Xiaoli Fu, Wenbiao Xian, Jing Gu, Yanmei Liu, Jing bo Ye, Jie Chen, Hao Ran Qian, Shaohua Xu, Zhong Pei, Ling Chen · 发表于：Chinese Medical Journal · 年份：2015 · DOI：10.4103/0366-6999.164925 · 被引用次数：55 · 研究领域：Neurological disorders and treatments、Parkinson's Disease Mechanisms and Treatments、Restless Legs Syndrome Research

BACKGROUND: Subthalamic nucleus deep brain stimulation (STN DBS) is effective against advanced Parkinson's disease (PD), allowing dramatic improvement of Parkinsonism, in addition to a significant reduction in medication. Here we aimed to investigate the long-term effect of STN DBS in Chinese PD patients, which has not been thoroughly studied in China. METHODS: Ten PD patients were assessed before DBS and followed up 1, 3, and 5 years later using Unified Parkinson's Disease Rating Scale Part III (UPDRS III), Parkinson's Disease Questionnatire-39, Parkinson's Disease Sleep Scale-Chinese Version, Mini-mental State Examination, Montreal Cognitive Assessment, Hamilton Anxiety Scale and Hamilton Depression Scale. Stimulation parameters and drug dosages were recorded at each follow-up. Data were analyzed using the ANOVA for repeated measures. RESULTS: In the "off" state (off medication), DBS improved UPDRS III scores by 35.87% in 5 years, compared with preoperative baseline (P < 0.001). In the "on" state (on medication), motor scores at 5 years were similar to the results of preoperative levodopa challenge test. The quality of life is improved by 58.18% (P < 0.001) from baseline to 3 years and gradually declined afterward. Sleep, cognition, and emotion were mostly unchanged. Levodopa equivalent daily dose was reduced from 660.4 ± 210.1 mg at baseline to 310.6 ± 158.4 mg at 5 years (by 52.96%, P < 0.001). The average pulse width, frequency and amplitude at 5 years were 75.0 ± 18.21 ...