The Effect of Subthalamic Nucleus Stimulation in Patients with Advanced Idiopathic Parkinson's Disease

Kim, Won Chan; Oh, Seung Hun; Kim, Hyun Sook; Lyoo, Chul Hyoung; Lee, Jin Goo; Chang, Jin Woo; Lee, Myung Sik

Abstract

BACKGROUND: To determine the efficacy and safety of subthalamic nucleus (STN) stimulation in patients with advanced Parkinson's disease (PD).
METHODS
In 5 patients with PD, we evaluated the effect of bilateral STN stimula-tion. Using the Unified PD Rating Scale (UPDRS), Clinical Dyskinesia Rating Scale, Activities of Daily Living(ADL) Score and patient's diary, we evaluated the patients before and at one, three and 12 months after surgery. We examined the patients while they were drug "off" and "on".
RESULTS
While patients were "off", stimulation induced a signifi-cant reduction in the UPDRS part III score by 46% at 12 months after the operation, compared to the baseline state. During drug "on" state, levodopa-induced dyskinesias were reduced by 88% at 12 months after the operation. Off-peri-od dystonia was reduced by 45% at 12 months after the operation. ADL scores also improved after the stimulation. Patients' diaries showed significant reduction in the "off" period while awake (73% reduction at 12 months). The daily dose of levodopa was reduced by 56% at 12 months after the operation. There was no significant complication related to the surgical procedure or electrical stimulation.
CONCLUSIONS
We conclude that STN stimulation is an effective and safe treatment strategy for the patients with advanced PD.