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In the medication-off state,turning the timulators on resulted in improvement in mean total Unified Parkinson's Disease Rating Scale(IPDRS) motor score by 58%including the following improvements in composite scores:akinesia 57%,rigidity 52%,tremor 82%,and gait and postural stability 49%.Additionally,the medication-off state improved 17%without stimulation,possibly as a result of electrode insertion alone or carry- over of chronic stimulation.In the medication-on,stimulation-on state,all major features of parkinsonism improved and total UPDRS motor score improved 41%compared with before surgery.Activities of daily living were improved while off medication 30%,and levodopa-induced dyskinesia were reduced 83%while total drug dosage was decreased 40%.With chronic stimulation,patients reported that the percentage of time spent in the"on" state(without dyskinesia)was increased from 26%to 52%and"off"time decreased from 30%to 6%.Operative complications including cognitive worsening were not uncommon.STN DBS is a promising new surgical option for the treatment of advanced PD.The marked clinical benefits obtained in these severely disabled patients outweighed the adverse effects. |
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cognition
disability rating scale,neurological
iatrogenic neurologic disorders
neurologic complications of,surgery
Parkinson disease
Parkinson disease,fluctuations in
Parkinson disease,surgical treatment of
Parkinson disease,treatment of
review article
stimulation,deep brain
subthalamic nucleus
subthalamic nucleus deep brain stimulation
treatment of neurologic disorder
tremor,surgical treatment of
tremor,thalamic stimulation for suppression of
Unified Parkinson Rating Scale
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