Five-Year Outcomes of Bilateral Subthalamic Nucleus Stimulation in Japanese Patients with Parkinson’s Disease
Atsushi Umemura1,2, Miwako Miyata3, Yuichi Oka4, Kenji Okita5, Genko Oyama6, Yasushi Shimo1,6, Nobutaka Hattori6
1Department of Research and Therapeutics for Movement Disorders, Juntendo University Graduate School of Medicine, Tokyo, Japan.
2Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan.
3Health Assistant Information Technology Course, Department of Human Care Engineering, Faculty of Health Science, Nihon Fukushi University, Aichi, Japan.
4Department of Neurosurgery, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
5Department of Neurology, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
6Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan.
DOI: 10.4236/apd.2015.42004   PDF   HTML   XML   3,791 Downloads   5,131 Views   Citations

Abstract

Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is widely performed for medically refractory Parkinson’s disease (PD). Several western studies have examined the long-term outcomes of STN DBS. However, the long-term outcomes in Japanese patients have not been reported. Methods: We studied the long-term outcomes of STN DBS in Japanese patients with PD. Fifty-five consecutive patients treated with bilateral STN DBS were followed for 5 years after surgery. Each patient underwent Unified Parkinson’s Disease Rating Scale assessments preoperatively and 1 and 5 years after surgery. Results: Twelve patients (22%) were lost to follow up within 5 years. Among them, 7 died and 5 became bed ridden because of PD deterioration. In the 43 patients followed for 5 years, STN DBS significantly improved motor function. The cardinal motor symptoms of tremor, rigidity, and bradykinesia in medication-on periods were significantly better than baseline 5 years after DBS. However, axial motor symptoms of speech, gait and postural stability gradually deteriorated and significantly worsened 5 years after DBS. Motor complications, including dyskinesia and motor fluctuations, significantly improved after DBS with a marked reduction in dopaminergic medication. These effects were maintained 5 years after DBS. Frequently, persisting adverse effects included apraxia of eyelid opening and dysarthria. Conclusions: STN DBS significantly improved motor symptoms in patients with advanced PD. These effects were maintained over 5 years in most patients. However, some showed rapid PD progression even after STN DBS. Other treatments for the axial symptoms and disease progression are needed in long-term PD treatment.

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Umemura, A. , Miyata, M. , Oka, Y. , Okita, K. , Oyama, G. , Shimo, Y. and Hattori, N. (2015) Five-Year Outcomes of Bilateral Subthalamic Nucleus Stimulation in Japanese Patients with Parkinson’s Disease. Advances in Parkinson's Disease, 4, 21-27. doi: 10.4236/apd.2015.42004.

Conflicts of Interest

The authors declare no conflicts of interest.

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