Category: Surgical Therapy: Parkinson's Disease
Objective: To evaluate the long-term outcomes of subthalamic nucleus deep brain stimulation (STN-DBS) in patients with Parkinson’s Disease (PD) up to 10 years after surgery.
Background: STN-DBS is a well-established treatment modality for PD to reduce time spent with dyskinesia and in the ‘OFF’ state. This study aims to contextualise these findings in an Asian population and report on the long-term outcomes of STN-DBS as observed at a tertiary referral centre in Singapore.
Method: A retrospective review of Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) sub and total scores, activities of daily living (ADLs), development of disease milestones, dopaminergic drug prescriptions, and adverse events of STN-DBS was conducted and compared between the pre-operative baseline and post-operative follow-ups.
Results: A total of ninety-four patients with PD who had undergone STN-DBS were recruited. Compared to the baseline, STN-DBS reduced time spent in the ‘OFF’ state at 1 year by 36.9% (p = 0.034) and 5 years by 40.9% (p = 0.006). Time spent with dyskinesia did not change significantly post-op. Dosage of dopaminergic medications was reduced up to 5 years by 35.1% (p < 0.001), and frequency of drug dosage was reduced up to 10 years by 36.3% (p = 0.024). Patient independence in ADLs did not change significantly post-op. UPDRS-II and UPDRS-III scores increased at 5 years and 10 years. The prevalence of frequent falls increased at 5 years. Surgery- and device-related adverse events were uncommon and generally not severe.
Conclusion: STN-DBS is effective at reducing motor complications of dopaminergic therapy up to 10 years post-op. STN-DBS also brings about a stable reduction in drug dosage and dose frequency during the same period. The risk profile of the procedure is favourable, with few severe side-effects. Worsening of MDS-UPDRS-II and III scores is likely a result of natural disease progression, but despite that there was no deterioration in patients’ independence in ADLs.
To cite this abstract in AMA style:
YZ. Cai, W. Li, Y. Zheng, A. Zhan, HL. Ng, Z. Xu, KY. Tay, WL. Au, L. Tan, WH. Ng, KR. Wan, S. Neo. Long-term outcomes after subthalamic nucleus deep brain stimulation (STN-DBS) in patients with Parkinson’s Disease (PD) in Singapore [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/long-term-outcomes-after-subthalamic-nucleus-deep-brain-stimulation-stn-dbs-in-patients-with-parkinsons-disease-pd-in-singapore/. Accessed September 7, 2024.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/long-term-outcomes-after-subthalamic-nucleus-deep-brain-stimulation-stn-dbs-in-patients-with-parkinsons-disease-pd-in-singapore/