Reduced levodopa-induced complications after 5 years of subthalamic stimulation in Parkinson’s disease: a second honeymoon

The purpose of this paper is to describe the effect of 5 years of subthalamic nucleus deep brain stimulation (STN DBS) on levodopa-induced complications, both in everyday life and during an acute challenge with levodopa. Thirty three patients were evaluated during an acute levodopa challenge before...

Full description

Saved in:
Bibliographic Details
Published in:Journal of neurology 2009-10, Vol.256 (10), p.1736-1741
Main Authors: Simonin, Clemence, Tir, M., Devos, D., Kreisler, A., Dujardin, K., Salleron, J., Delval, A., Blond, S., Defebvre, L., Destée, A., Krystkowiak, P.
Format: Article
Language:English
Subjects:
Antiparkinson Agents - adverse effects
Antiparkinson Agents - therapeutic use
Biological and medical sciences
Deep Brain Stimulation
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Dopamine
Drug dosages
Dyskinesia
Dyskinesia, Drug-Induced - therapy
Dystonia
Dystonia - chemically induced
Dystonia - therapy
Electrodes
Follow-Up Studies
Hospitals
Humans
Levodopa - adverse effects
Levodopa - therapeutic use
Medical sciences
Medicine
Medicine & Public Health
Neurology
Neuroradiology
Neurosciences
Original Communication
Parkinson Disease - drug therapy
Parkinson Disease - therapy
Parkinson's disease
Severity of Illness Index
Subthalamic Nucleus
Surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The purpose of this paper is to describe the effect of 5 years of subthalamic nucleus deep brain stimulation (STN DBS) on levodopa-induced complications, both in everyday life and during an acute challenge with levodopa. Thirty three patients were evaluated during an acute levodopa challenge before surgery and then 1 and 5 years afterwards (both off stim and on stim ), using the UPDRS III scale and the CAPSIT-PD scales for dystonia and peak-dose dyskinesia. The UPDRS IV scale was used to assess motor complications in everyday life. The levodopa daily dose and DBS parameters were also recorded. Levodopa-induced complications in everyday life (UPDRS IV) and during an acute levodopa challenge had improved markedly after 1 year (both on and off stim ) and still further at 5 years. Peak-dose dyskinesia decreased between the 1- and 5-year measurements. STN DBS decreases levodopa-induced motor complications over the long term. This phenomenon may be explained by (a) overall stabilization of the basal ganglia network and (b) striatal synaptic changes. Our results suggest that DBS leads to both qualitative and quantitative modulations in the corticostriatal loops.
ISSN:0340-5354
1432-1459
DOI:10.1007/s00415-009-5195-2