RESUMEN
INTRODUCTION: Subthalamic nucleus stimulation (SNE) is currently a reasonable treatment for patients with advanced Parkinson's disease (PD). Predictive factors for effective SNE have not yet been identified with precision. We have prospectively evaluated response to SNE in a series of patients with advanced PD to study the factors that influence clinical improvement after functional surgery. METHODS: We prospectively studied 20 patients with advanced PD (age: 59 +/-6.1; stage: 3.0+/-0.8) candidates for SNE. We studied these patients preoperatively and 6 months postoperatively according to Core Assessment Program for Intracerebral Transplantation (CAPIT) protocol including timed tests. CONCLUSIONS: We found a negative correlation between age and Unified Parkinson Disease Rating Scale (UPDRS) improvement; however, age did not correlate with timed tests improvement. In addition, preoperative severity (UPDRS and Hoehn-Yahr) did not correlate with UPDRS and timed tests improvement. In summary, age is a negative predictor for effective SNE.
Asunto(s)
Estimulación Encefálica Profunda , Enfermedad de Parkinson/terapia , Estimulación Encefálica Profunda/instrumentación , Estimulación Encefálica Profunda/métodos , Humanos , Persona de Mediana Edad , Enfermedad de Parkinson/cirugía , Estudios Prospectivos , Prótesis e ImplantesRESUMEN
Introducción. Actualmente la estimulación subtalámica (EST) es una opción terapéutica razonable para pacientes con enfermedad de Parkinson (EP) avanzada. No se conocen con precisión los factores pronósticos de la respuesta a la EST. Hemos evaluado prospectivamente la respuesta a la EST en una serie de pacientes con EP avanzada para estudiar qué factores inciden en la mejoría clínica tras la cirugía funcional. Métodos. Estudiamos prospectivamente 20 pacientes con EP avanzada (edad: 59±6,1 años; estadio: 3±0,8) candidatos a cirugía funcional mediante EST. La evaluación prequirúrgica y posquirúrgica (a los 6 meses) se realizó según el protocolo Core Assessment Program for Intracerebral Transplantation (CAPIT) incluyendo pruebas cronometradas.Conclusiones. Hallamos una correlación significativa (negativa) entre la edad y la mejoría de la Unified Parkinson Disease Rating Scale (UPDRS) total tras la cirugía. Sin embargo, la mejoría en las pruebas cronometradas no se correlacionó con la edad. Por otra parte, el estado funcional prequirúrgico (UPDRS y estadio Hoehn-Yahr) tampoco se correlacionó con la respuesta a la EST. En resumen, la edad es un factor predictivo negativo en la mejoría tras la EST
Introduction. Subthalamic nucleus stimulation (SNE) is currently a reasonable treatment for patients with advanced Parkinson`s disease (PD). Predictive factors for effective SNE have not yet been identified with precision. We have prospectively evaluated resonse to SNE in a series of patients with advanced PD to study the factors that influence clinical improvement after functional surgery. Methods. We prospectively studied 20 patients with advanced PD (age: 59+-6.1; stage: 3.0+-0.8) candidates for SNE. We studied these patients preoperatively and 6 months postoperatively according to Core Assessment Program for Intracerebral Transplantation (CAPIT) protocol including timed tests. Conclusions. We found a negative correlation between age and Unified Parkinson Disease Rating Scale (UPDRS) improvement. In addition, preoperative severity (UPDRS and Hoehn-Yahr) did not correlate with UPDRS and timed tests improvement. In summary, age is a negative predictor for effective SNE