PLoS ONE (Jan 2014)

The "brittle response" to Parkinson's disease medications: characterization and response to deep brain stimulation.

  • Daniel Martinez-Ramirez,
  • Juan Giugni,
  • Vinata Vedam-Mai,
  • Aparna Wagle Shukla,
  • Irene A Malaty,
  • Nikolaus R McFarland,
  • Ramon L Rodriguez,
  • Kelly D Foote,
  • Michael S Okun

Journal volume & issue
Vol. 9, no. 4
p. e94856


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ObjectiveFormulate a definition and describe the clinical characteristics of PD patients with a "brittle response" (BR) to medications versus a "non-brittle response" (NBR), and characterize the use of DBS for this population.MethodsAn UF IRB approved protocol used a retrospective chart review of 400 consecutive PD patients presenting to the UF Center for Movement Disorders and Neurorestoration. Patient records were anonymized and de-identified prior to analysis. SPSS statistics were used to analyze data.ResultsOf 345 included patients, 19 (5.5%) met criteria for BR PD. The BR group was comprised of 58% females, compared to 29% in the NBR group (P = .008). The former had a mean age of 63.4 compared to 68.1 in the latter. BR patients had lower mean weight (63.5 vs. 79.6, P = ConclusionBR PD occurred more commonly in female patients with a low body weight. Patients with longer disease duration and longer duration of LD therapy were also at risk. The BR group responded well to DBS.