Objective: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is widely accepted as a treatment for advanced Parkinson’s disease (PD). However, published studies were conducted mainly in Western centers. We report results of our initial experience in the surgical management of idiopathic Parkinson’s disease with bilateral subthalamic nucleus (STN) deep brain stimulation (DBS).

Background: Deep brain stimulation has become a well-established symptomatic treatment for Parkinson’s disease during the last 25 years. Besides improving motor symptoms and long-term motor complications, positive effects on patient mobility, activities of daily living, emotional well-being and health-related quality of life have been recognized. Several deep brain nuclei have been stimulated, producing a wide range of effects on the motor and non-motor symptoms of Parkinson’s disease. Long-term, high-quality evidence is available for stimulation of the subthalamic nucleus and globus pallidus internus, both of which uniformly improve motor features. However, the STN has become the primary target in most DBS centers because of a more profound anti-akinetic effect allowing the reduction of medication by some 50-60%.

Methods: 20 patients with idiopathic Parkinson’s disease (iPD) were treated with STN-DBS in this study. Operative details, outcome, and complications were recorded and analyzed.

Results: 20 patients (11 males & 9 females) were treated with subthalamic nucleus (STN) deep brain stimulation (DBS). The efficacy of STN-DBS was calculated as the percentage improvement of UPDRS-III total score from baseline to postoperative conditions. 15/20 patients (75%) had good outcome (50-75% improvement in off UPDRS III) and 5/20 patients had fair outcome (25-50% improvement in off UPDRS III). There were no cases that exhibited excellent or poor outcome. Postoperative mean L- Dopa equivalent dose (LED) was reduced by 69.7% postoperatively. The mean rate of improvement of postoperative L Dopa induced dyskinesia score was 79.2%. The mean rate of improvement of off duration subscore was 76.8%. Operative complications were noted in 4/20 patients (20%). They were transient in 2/4 patients (50%).

Conclusions: STN-DBS is a very effective therapy for Parkinson’s disease. In appropriate patients, motor improvement is accompanied by a reduced necessity for medication.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/bilateral-subthalamic-nucleus-deep-brain-stimulation-stn-dbs-in-the-management-of-idiopathic-parkinsons-disease-results-of-our-first-20-cases/