Annals, Academy of Medicine, Singapore (Aug 2024)

Long-term outcomes of subthalamic nucleus deep brain stimulation for Parkinson’s disease in Singapore

  • Yi Zhan Cai,
  • Yilong Zheng,
  • Wei Li,
  • Seyed Ehsan Saffari,
  • Hwee Lan Ng,
  • Angela Zhan,
  • Zheyu Xu,
  • Kay Yaw Tay,
  • Wing Lok Au,
  • Wai Hoe Ng,
  • Louis Chew Seng Tan,
  • Kai Rui Wan,
  • Shermyn Neo

DOI
https://doi.org/10.47102//annals-acadmedsg.2023374
Journal volume & issue
Vol. 53, no. 8
pp. 481 – 489

Abstract

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Introduction: Subthalamic nucleus deep brain stimulation (STN-DBS) is a proven treatment modality for Parkinson’s disease (PD), reducing dyskinesia and time spent in the “OFF” state. This study evaluates the long-term outcomes of STN-DBS in PD patients up to 10 years post-surgery in Singapore. Method: We conducted a retrospective review of Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) scores, activities of daily living (ADLs), disease milestones, dopaminergic drug prescriptions, and adverse events in patients before and after STN-DBS surgery. Results: A total of 94 PD patients who underwent bilateral STN-DBS were included. STN-DBS reduced time in the “OFF” state by 36.9% at 1 year (P=0.034) and 40.9% at 5 years (P=0.006). Time with dyskinesia did not significantly change. Levodopa equivalent daily dose was reduced by 35.1% by 5 years (P less than 0.001). MDS-UPDRS-II and III scores increased from 5 years post-DBS by 40.5% and 35.4%, respectively. Independence in ADLs decreased, though not significantly. The prevalence of frequent falls increased at 5 years. Surgery- and device-related adverse events were uncommon and generally mild. Conclusion: STN-DBS provides sustained relief from motor complications and reduced medication requirements in PD patients in Singapore. This study highlights STN-DBS as an effective treatment option, significantly enhancing the quality of life for those with PD.