Interdisciplinary Neurosurgery (Mar 2022)
Effect of bilateral deep brain stimulation on the subthalamic nucleus on patients with Parkinson's disease: An observational and non-blinded study
Abstract
Objective: This study analyzed the influence of subthalamic nucleus deep brain stimulation (DBS) in motor parameters and patients' quality of life with Parkinson's disease (PD) evaluated before and after 12 months of the surgical procedure. Methods: A cohort of 20 patients with PD who underwent DBS implantation in the subthalamic nucleus was included. Pre and on-DBS postoperative data in on and off-medication periods related to motor functions and quality of life, from the application of validated scales, were collected to verify possible relationships between changes in these parameters and the surgical procedure. Results: A significant decrease in the Hoehn and Yahr scale disease stage and in the levodopa equivalent dose (p < 0.001) was verified in the off-medication period when we compared baseline and post-12 months data. A significant decrease in dyskinesias (p = 0.009) was observed during the on-medication period by evaluating the UDysRS scale. Concerning motor functions verified through the UPDRS-III scale, it was obtained a significant reduction in total scores (p = 0.001), besides a decrease in rigidity scores for upper and lower limbs (p < 0.05) during the on-medication period. During the off-medication period, scores of UPDRS-III demonstrated a significant decrease, except for the ones related to speech and amplitude of resting tremor. Regarding the quality-of-life assessment, scores obtained from PDQ-39 showed that, after 12 months of electrode implantation, there was a significant decrease in mobility, daily living activity, and stigma parameters (p < 0.05). Conclusions: Results obtained allow us to conclude that DBS of the subthalamic nucleus in patients with PD improves motor function in both on and off-medication periods, improvement of the disease stage in the off-medication period, with no change in the on-medication period, also an improvement in the patient's self-reported quality of life and a significant reduction in the dose of L-DOPA.
