Objective: Assessment of the dynamics of the clinical manifestations of dofamine dysregulation syndrome (DDS)  and the severity of dyskinesias in patients with Parkinson`s Disease (PD) on the background of DBS STN in comparison with the control group of patients receiving only drug treatment.

Background: DDS is a complication of dopaminergic therapy of PD, which is manifested by compulsive dopaminergic drugs. The relationship between DBS STN and DDS in patients with PD is not well understood. DBS STN may improve, worsen or not affect clinical symptoms of DDS. Levodopa-induced dyskinesias, which are not amenable to correction with adequate drug therapy, are one of the main indications for neurostimulation in PD.

Method: The main group consisted of 20 PD patients on the background of DBS STN, in which in the preoperative period there were symptoms of DDS. The comparison group included 20 patients on the background of DBS STN, who had no symptoms of DDS before surgery. The control group consisted of 20 PD patients with DDS, who received only drug therapy. The following scales were used: Questionnarie for Impulsivi-Compulsive Disorders in Parkinson’s Disease (Weintraub et al., 2009), UPDRS (Christofer et al., 2008), scale PDQ-39.

Results: Drug dyskinesias in the main group of patients decreased by half in the first six months after surgery and remained low in the first and second year of observation (60%). In the comparison group, the overall score of the IV section of the UPDRS scale also decreased by almost half (47%) six months after the operation and remained at this level with little dynamics in the first and second years of the study. In the control group, motor complications increased significantly throughout the observation period. Nine patients showed complete regression of the symptoms of DDS. The remaining 11 patients noted a desire to increase the frequency of taking the drugs, but they followed the regimen and doses prescribed by them in the clinic.

Conclusion: DBS STN leads to a significant regression of drug peak-dose dyskinesia. The possibility of a significant reduction in the LEDD index in patients with DDS with the administration of high daily doses of dopaminergic agents without subsequent recurrence of compulsive medication for two years of observation was also confirmed.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/dopamine-dysregulation-syndrome-and-levodopa-induced-dyskinesias-in-patients-with-parkinsons-disease-on-the-background-of-deep-stimulation-of-the-subthalamic-nucleus/