Subthalamic Nucleus Deep Brain Stimulation for Parkinson Disease in Hong Kong: A Prospective Territory-Wide 2-Year Follow-Up Study

World Neurosurg. 2016 Sep:93:229-36. doi: 10.1016/j.wneu.2016.06.002. Epub 2016 Jun 11.

Abstract

Objective: We assessed the effects of bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) in patients with Parkinson disease at the 1-year and 2-year follow-up evaluations. Unified Parkinson's Disease Rating Scale (UPDRS) motor score at "off" medication ("on" DBS) and quality-of-life assessments (39-item Parkinson's Disease Questionnaire [PDQ-39]) were conducted. The percentage of awake "on" time and awake "off" time and levodopa requirement were also assessed.

Methods: A 2-year prospective study was conducted of 25 consecutive patients from 3 DBS referral centers in Hong Kong. The patients were treated with bilateral stimulation of the STN. Assessments were performed at 1 year and 2 years after DBS and were compared with the baseline.

Results: The 2-year outcome assessments were completed by 18 patients. The mean UPDRS motor score improvement was 57% in the first year and 45% in the second year. PDQ-39 showed significant improvement in quality of life for 2 consecutive years. The levodopa requirement decreased 63% in the first year and 55.9% in the second year. The awake "on" time was doubled in the first year and sustained in the second year. Awake "off" time was reduced from 28.1% to 5.9% in the first year and returned to 10.6% in the second year. Improvement of UPDRS motor score, reduction in awake "off" time, and decrease of daily levodopa dosage all were main factors correlated with the improvement in PDQ-39 summary index.

Conclusions: The effects of STN DBS in patients with Parkinson disease in Hong Kong were satisfactory. The results showed that reduction in UPDRS motor score, awake "off"-time, and daily levodopa dosage were the major drivers of overall improvement in PDQ-39.

Keywords: Deep brain stimulation; Quality of life; Subthalamic nucleus.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Deep Brain Stimulation / methods*
  • Female
  • Follow-Up Studies
  • Hong Kong
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Movement Disorders / diagnosis
  • Movement Disorders / etiology
  • Movement Disorders / prevention & control*
  • Parkinson Disease / complications
  • Parkinson Disease / diagnosis*
  • Parkinson Disease / therapy*
  • Prevalence
  • Prospective Studies
  • Recovery of Function*
  • Risk Factors
  • Subthalamic Nucleus*
  • Treatment Outcome