Long-Term Medication Profiles in Parkinson's Disease under Subthalamic Deep Brain Stimulation: A Controlled Study

Mov Disord Clin Pract. 2024 Jul;11(7):855-860. doi: 10.1002/mdc3.14065. Epub 2024 May 7.

Abstract

Background: Subthalamic deep brain stimulation (STN-DBS) reduces antiparkinsonian medications in Parkinson's disease (PD) compared with the preoperative state. Longitudinal and comparative studies on this effect are lacking.

Objective: To compare longitudinal trajectories of antiparkinsonian medication in STN-DBS treated patients to non-surgically treated control patients.

Methods: We collected retrospective information on antiparkinsonian medication from PD patients that underwent subthalamic DBS between 1999 and 2010 and control PD patients similar in age at onset and baseline, sex-distribution, and comorbidities.

Results: In 74 DBS patients levodopa-equivalent daily dose (LEDD) were reduced by 33.9-56.0% in relation to the preoperative baseline over the 14-year observational period. In 61 control patients LEDDs increased over approximately 10 years, causing a significant divergence between groups. The largest difference amongst single drug-classes was observed for dopamine agonists.

Conclusion: In PD patients, chronic STN-DBS was associated with a lower LEDD compared with control patients over 14 years.

Keywords: deep brain stimulation (DBS); levodopa equivalent daily dose (LEDD); medication; nucleus subthalamicus (STN).

MeSH terms

  • Aged
  • Antiparkinson Agents* / administration & dosage
  • Antiparkinson Agents* / therapeutic use
  • Deep Brain Stimulation* / methods
  • Female
  • Humans
  • Levodopa / administration & dosage
  • Levodopa / therapeutic use
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Parkinson Disease* / drug therapy
  • Parkinson Disease* / therapy
  • Retrospective Studies
  • Subthalamic Nucleus*
  • Treatment Outcome

Substances

  • Antiparkinson Agents
  • Levodopa