Objective: We report a case of Parkinson’s disease patient with SNCA duplication, who showed excellent response in both motor and non-motor symptoms after bilateral subthalamic stimulation.

Background: Even though deep brain stimulation (DBS) in subthalamic nucleus (STN) was reported to have good response on motor symptoms in PD patients with alpha-synuclein gene (SNCA) duplication, no study investigated non-motor response after STN DBS.

Methods: A 37-year-old woman presented with resting tremor in left leg and hand, and was diagnosed as PD with SNCA duplication. Although she demonstrated dramatic response from dopaminergic medications, she gradually had experienced wearing-off and levodopa-induced dyskinesia. At the age of 45, bilateral STN DBS was performed. We compared motor and non-motor symptoms at 3 years after DBS surgery from those at pre-DBS work-up.

Results: Our patient showed excellent response in motor symptoms after DBS. Levodopa equivalent daily dose was reduced from 1450 mg/day to 730 mg/day. The patient had to take medication 7-8 times a day because of wearing off, but did not complain of any off time nor dyskinesia after DBS. In terms of non-motor symptoms, total score of non-motor symptom assessment scale for PD was reduced from 20 to 4. In particular, sleep/fatigue and excessive sweating were much improved among NMSS domains. Additionally, score of Beck’s anxiety inventory was also reduced after DBS surgery from 13 to 0.

Conclusions: We identified a case of excellent response on both motor and non-motor symptoms to bilateral STN DBS in PD patient with SNCA duplication. Based on our case, STN DBS could be regarded to have excellent effect on non-motor symptoms as well as motor symptoms.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/excellent-non-motor-responses-after-bilateral-subthalamic-deep-brain-stimulation-in-parkinsons-disease-patient-with-snca-duplication/