Deep brain stimulation for early-stage Parkinson's disease: an illustrative case.
Neuromodulation
; 14(6): 515-21; discussion 521-2, 2011.
Article
em En
| MEDLINE
| ID: mdl-21939467
ABSTRACT
OBJECTIVES:
Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective intervention in advanced Parkinson's disease (PD), but its efficacy and safety in early PD are unknown. We are conducting a randomized pilot trial investigating DBS in early PD. This report describes one participant who received bilateral STN-DBS. MATERIALS ANDMETHODS:
Thirty subjects have been randomized to either optimal drug therapy (ODT) or DBS + ODT. Microelectrode recordings from the STN and substantia nigra are collected at implantation. The Unified Parkinson's Disease Rating Scale Motor Subscale (UPDRS-III) is administered in the ON and OFF states semi-annually and neuropsychological function and quality of life are assessed annually. We describe a 54-year-old man with a two-year history of PD who was randomized to DBS + ODT and followed for two years.RESULTS:
The subject showed a lower STN to substantia nigra ratio of neuronal activity than advanced PD patients, and higher firing rate than non-PD patients. The subject's total UPDRS and UPDRS-III scores improved during the two-year follow-up, while his OFF UPDRS-III score and levodopa equivalent daily dose increased. Quality of life, verbal fluency, and verbal learning improved. He did not experience any serious adverse events.CONCLUSIONS:
This report details the first successful application of bilateral STN-DBS for early-stage PD during a clinical trial.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Doença de Parkinson
/
Estimulação Encefálica Profunda
Tipo de estudo:
Clinical_trials
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Observational_studies
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Prognostic_studies
Limite:
Aged
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Humans
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Male
/
Middle aged
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article