Objective: Camptocormia (CC) as a syndrome often is a major burden for patients with Parkinson’s Disease (PD). In the absence of response to levodopa (except the few responders) in addition to some other insufficient therapeutic approaches, an attempt at therapy with Deep brain stimulation (DBS) seemed to achieve significant improvement of body posture in CC. The previous work done so far focused on short term effects of DBS on CC; the long term perspective has been neglected to date. In this clinical trial, we attempt to analyze these long term effects of DBS on PD patients with CC.

Background: Besides other predictive factors, especially the exact timing of treatment with DBS depending on its short duration to the onset of CC in PD proved to be key. Therefore, reasonable and sustainable arguments need to be found to start DBS treatment earlier than generally proposed. The long term analyses could give us further insight into therapy optimization.

Method: In this retrospective study, we interviewed 12 patients with idiopathic PD who also suffered from CC and underwent bilateral DBS of the subthalamic nucleus (STN) to treat superficial PD symptoms. Results from the same cohort answering to the newly modified questionnaire were compared. Comparisons of measured bending angel in posture were made using video footage recorded before and after the surgery.

Results: In the first postoperative analysis 6-64 months after DBS, 10 patients showed  improvement in their posture, whereas 2 did not. In the follow up analysis an additional 65-76 months later, 5 of the initially improved patients maintained their condition, while deterioration was observed in 5 patients. 3 of them still showed an improvement of the bending angle compared to the state before neurostimulation. In the 2 patients who had not improved initially, the situation remained unchanged.

Conclusion: Consequently, those who initially show an improvement in their CC after DBS can also benefit from it in the long term. In individual cases, deterioration may occur again later, recognizable risk factor was the presence of CC at the cervicothoracic junction before treatment with DBS. This result may help in deciding future treatment with DBS. Prospective studies are still needed.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/long-term-effects-of-deep-brain-stimulation-on-camptocormia-in-parkinsons-disease/