Session Information
Date: Saturday, October 6, 2018
Session Title: Surgical Therapy: Parkinson's Disease
Session Time: 1:45pm-3:15pm
Location: Hall 3FG
Objective: Our aim is to compare motor clinical benefits after acute levodopa challenge test, with those obtained further with deep brain stimulation (DBS).
Background: DBS is an effective and generally safe treatment option for Parkinson disease, in patients carefully selected. Acute levodopa challenge test is commonly used in preoperative study in order to preview the potential benefit that could be obtained with surgery [1,2].
Methods: Retrospective study, including all the patients who went through DBS surgery for PD consecutively during a 5-year period. Motor evaluation was done using Unified Parkinson’s Disease Rating Scale (UPDRS) part III, comparing results in three periods: levodopa challenge test with a supra-maximal dose, 24-48h after DBS and one year after DBS. SPSS version 24 was used for statistical analysis.
Results: A total of 118 patients were included. The mean age at surgery was 59 years and the median disease duration at surgery was 11 years. Parkinson’s disease phenotype was predominantly akinetic-rigid (62%). DBS target was STN in 90%. The mean UPDRS part III score after acute levodopa challenge test was 14,01 ± 6,8 and one year after DBS was 14,42 ± 7,2 (p=1,000). There were no differences regarding gender (p=.575), disease duration (p=.692), DBS target (p=.991), disease phenotype (p=.248) and need of medical treatment after surgery (p=.102). Those with less disease duration (p=.007) and STN group (p<.001) showed UPDRS-III scores lower than de opposite group.
Conclusions: in our experience, acute levodopa challenge test can accurately select those patients who will get maximum benefit with surgery, encouraging to maintain that preoperative test in our clinical practice. The benefits were replicated in all categories used in the study.
References: 1- Lozano CS, Tam J, Lozano AM. The changing landscape of surgery for Parkinson’s Disease.Mov Disord. 2018 Jan;33(1):36-47. 2- Lilleeng B, Gjerstad M, Baardsen R, Dalen I, Larsen JP.Motor symptoms after deep brain stimulation of the subthalamic nucleus.Acta Neurol Scand. 2015 May;131(5):298-304.
To cite this abstract in AMA style:
D. Fitas, M.J. Rosas, J. Parada Lima, C. Reis, P. Linhares, R. Vaz. Comparative results between preoperative acute levodopa challenge test and deep brain stimulation [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/comparative-results-between-preoperative-acute-levodopa-challenge-test-and-deep-brain-stimulation/. Accessed May 13, 2025.« Back to 2018 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/comparative-results-between-preoperative-acute-levodopa-challenge-test-and-deep-brain-stimulation/