Frontiers in Neurology (Jul 2018)

Deep Brain Stimulation in Moroccan Patients With Parkinson's Disease: The Experience of Neurology Department of Rabat

  • Mounia Rahmani,
  • Maria Benabdeljlil,
  • Fouad Bellakhdar,
  • Mustapha El Alaoui Faris,
  • Mohamed Jiddane,
  • Khalil El Bayad,
  • Fatima Boutbib,
  • Rachid Razine,
  • Rachid Gana,
  • Moulay R. El Hassani,
  • Nizar El Fatemi,
  • Meryem Fikri,
  • Siham Sanhaji,
  • Hennou Tassine,
  • Imane El Alaoui Balrhiti,
  • Souad El Hadri,
  • Najwa Ech-Cherif Kettani,
  • Najia El Abbadi,
  • Mourad Amor,
  • Abdelmjid Moussaoui,
  • Afifa Semlali,
  • Saadia Aidi,
  • El Hachmia Ait Benhaddou,
  • Ali Benomar,
  • Ahmed Bouhouche,
  • Mohamed Yahyaoui,
  • Abdeslam El Khamlichi,
  • Abdessamad El Ouahabi,
  • Rachid El Maaqili,
  • Houyam Tibar,
  • Yasser Arkha,
  • Adyl Melhaoui,
  • Abdelhamid Benazzouz,
  • Wafa Regragui

DOI
https://doi.org/10.3389/fneur.2018.00532
Journal volume & issue
Vol. 9

Abstract

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Introduction: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is known as a therapy of choice of advanced Parkinson's disease. The present study aimed to assess the beneficial and side effects of STN DBS in Moroccan Parkinsonian patients.Material and Methods: Thirty five patients underwent bilateral STN DBS from 2008 to 2016 in the Rabat University Hospital. Patients were assessed preoperatively and followed up for 6 to 12 months using the Unified Parkinson's Disease Rating Scale in four conditions (stimulation OFF and ON and medication OFF and ON), the levodopa-equivalent daily dose (LEDD), dyskinesia and fluctuation scores and PDQ39 scale for quality of life (QOL). Postoperative side effects were also recorded.Results: The mean age at disease onset was 42.31 ± 7.29 years [28–58] and the mean age at surgery was 54.66 ± 8.51 years [34–70]. The median disease duration was 11.95 ± 4.28 years [5–22]. Sixty-three percentage of patients were male. 11.4% of patients were tremor dominant while 45.71 showed akinetic-rigid form and 42.90 were classified as mixed phenotype. The LEDD before surgery was 1200 mg/day [800-1500]. All patients had motor fluctuations whereas non-motor fluctuations were present in 61.80% of cases. STN DBS decreased the LEDD by 51.72%, as the mean LEDD post-surgery was 450 [188-800]. The UPDRS-III was improved by 52.27%, dyskinesia score by 66.70% and motor fluctuations by 50%, whereas QOL improved by 27.12%. Post-operative side effects were hypophonia (2 cases), infection (3 cases), and pneumocephalus (2 cases).Conclusion: Our results showed that STN DBS is an effective treatment in Moroccan Parkinsonian patients leading to a major improvement of the most disabling symptoms (dyskinesia, motor fluctuation) and a better QOL.

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