Objective: The aim of this study is to explore the effects of STN-DBS on the Parkinson’s disease patients with different progressive rates

Background: Studies indicate that motor complications will appear in 5-10 years after pharmacologic treatment in advanced Parkinson’s disease patients. However, in clinical, we found it appeared in3-4 years after the disease onset in some patients. Parkinson’s disease is a progressive neurodegenerative disorder, but the rates of progressive are different in individuals.

Methods: 43 patients from the first affiliated hospital of Kunming Medical University underwent bilateral STN-DBS during 2015 to 2017 were enrolled in this study. The index of progressive rates was calculated by the ratios of UPDRS-III scores and the years from disease onset. The patients were divided into fast (index≥8), medium (8>index≥5) and slow (index<5) progressive groups by the index. The outcomes were evaluated in off-medication /on-stimulation condition at 1st and 6th months after treatment by changes compared to the baseline in UPDRS part III total motor scores.

Results: Before DBS surgery, 1.UPDRS-III scores of slow progressive group (index=3.26±0.18, N=17, Scores=36.18±2.53) was significant lower than medium (index=6.56±0.20, N=16, Scores=59.75±3.58) and fast progressive (index=13.27±2.32, N=10, Scores=56.5±4.86) groups in L-dopa OFF condition (ANOVA, P<0.01, post-hoc test with LSD). 2. The sub-score of axial signs in fast progressive group (36.18±2.53) were significant higher than slow group (6.18±0.70) (ANOVA, P=0.019, post-hoc test with LSD). 3. There are no differences in the improvement of acute stepwise L-dopa challenge test in three groups (68.6±5.9%, 74.01±2.45%and 75.51±3.67%, respectively). And 4. There are no significant differences in the outcome of bilateral STN-DBS in off-medication /on-stimulation condition at the 1st month during three groups (77.95±3.48%, 78.30±2.59% and 75.44±2.84%, respectively). 5. However, at the 6th month, the outcome of DBS in the fast progressive group (47.56±6.48%) is poorer than the other two groups (69.23±3.4% and 65.04±3.03%) in off-medication /on-stimulation condition (ANOVA, P<0.01, post-hoc test with LSD).

Conclusions: The study indicates that bilateral STN-DBS is an effective treatment for advanced Parkinson’s patients. However, in the long term, the outcome in the patients whose symptoms progressive fast are not as good as slow progressive patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-effects-of-stn-dbs-on-the-parkinsons-disease-patients-with-different-progressive-rates/