Objective: This is one of the first studies investigating the progression of disease and mortality of patients with Parkinson’s Disease (PD) 8-15 years after Deep Brain Stimulation surgery of the subthalamic nucleus (STN-DBS).

Background: STN-DBS is a well-established therapy and the most effective treatment of PD motor symptoms. Patients have better motor function in late stage PD, but it is not clear whether STN-DBS delays disease progression.

Method: Patients who underwent STN-DBS surgery between 2001 and 2008 have been included for the long-term follow-up (n=81). The results of the long-term treatment effect will be available in another publication. Patients were clinically assessed before surgery and at follow-ups one year after surgery, and 8-15 years after surgery. At the clinical evaluations patients were shortly hospitalized and rated by the UPDRS with (ON) and without (OFF) stimulation and medicine. Time of death and the cause of death was registered.

Results: Analyzed using mixed model procedure the mean OFF UPDRS 3 scores was 43.8 at baseline, 48.5 one year after surgery and 57.9 8-15 years after surgery. This corresponds to a significant disease progression of 10.8 % between baseline and one year after surgery (p=0.003), 32.4 % between baseline and 8-15 years after surgery (p<0.0001) and 13.4 % between one and 8-15 years after surgery (p=0.003). The average annual slope between the baseline and the one-year UPDRS is therefore 3.4 (7.8 %), 1.2 (2.7 %) between baseline and the long-term follow-up, and 0.73 (1.3 %) between the one and long-term follow-up. The motor disease progression according to the OFF UPDRS was smaller than previously described in a general PD population. 43 out of 81 of the patients died before the long-term follow-up. The mean age at death was 71.3 (range: 52.7 to 85.2) years of age. Patients lived as long as a general PD population [1].

Conclusion: The disease progression according to the motor UPDRS was smaller than previously described in a general PD population. No difference was found according to live expectancy. Patients who receive STN-DBS surgery are a relatively selected group and therefore we cannot draw any final conclusions on the effect of STN-DBS on progression of disease without a matching control group. Further research is needed on this subject.

References: 1. Ishihara, L.S., et al., Estimated life expectancy of Parkinson’s patients compared with the UK population. J Neurol Neurosurg Psychiatry, 2007. 78(12): p. 1304-9.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/does-deep-brain-stimulation-in-parkinsons-disease-change-disease-progression-in-the-long-run/