Category: Parkinson’s Disease: Clinical Trials
Objective: To investigate the influence of stimulus induced dyskinesia (SID) on the therapeutic outcome of globus pallidus internus (GPi) deep brain stimulation (DBS) for the treatment of advanced Parkinson’s disease (PD).
Background: GPi DBS showed better effect on levodopa-induced dyskinesia (LID) compared to subthalamic nucleus (STN) DBS in previous studies. In a recent study, dorsal GPi stimulation may be associated with SID that may mimic LID, contrary to ventral GPi stimulation which may suppress dyskinesia. However, little is known about clinical implication of SID in GPi DBS for advanced PD patients.
Method: We retrospectively analyzed the clinical data of patients with advanced PD who underwent bilateral GPi DBS surgery between April 2013 and November 2018. PD patients who experienced SID during initial DBS programming were identified (n=8). Age and sex matched controls who did not experienced SID (n=16) during DBS were selected. Unified Parkinson’s Disease Rating Scale (UPDRS) part III and part IV scores, levodopa equivalent dose (LED) and DBS programming parameters at initial post-operative programming period and 12 months after DBS surgery were assessed.
Results: The UPDRS part III and IV scores did not differ significantly between the two groups at 12 months after surgery. The mean change of UPDRS III under off-medication and on-stimulation (M-S+) state compared with off-medication and off-stimulation (M-S-) state was significantly improved in PD patients without SID than those with SID (P=0.022). The mean amplitude of initial DBS programming in PD patients with SID were significantly lower than those of PD patients without SID (P=0.002). There was no significant difference in other DBS parameters between the two groups at 12 months after surgery. The LED was not significantly different between the two groups at 12 months after surgery.
Conclusion: PD patients with SID induced by GPi DBS had different therapeutic outcome and DBS programming parameters compared with those without SID. These results may provide useful information for the prediction of therapeutic outcome and programming parameters of GPi DBS in advanced PD patients.
To cite this abstract in AMA style:S.H Lee, K.W Park, S.Y Jo, Y.S Hwang, M.S Kim, S.R Jeon, S.J Chung. Clinical Implication of Stimulus Induced Dyskinesia in Pallidal Deep Brain Stimulation for Advanced Parkinson’s Disease [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/clinical-implication-of-stimulus-induced-dyskinesia-in-pallidal-deep-brain-stimulation-for-advanced-parkinsons-disease/. Accessed December 7, 2023.
« Back to MDS Virtual Congress 2020
MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-implication-of-stimulus-induced-dyskinesia-in-pallidal-deep-brain-stimulation-for-advanced-parkinsons-disease/