Session Information
Date: Wednesday, September 25, 2019
Session Title: Surgical Therapy
Session Time: 1:15pm-2:45pm
Location: Les Muses Terrace, Level 3
Objective: To investigate whether the magnitude of improvement in motor scores of the Unified Parkinson´s Disease Rating Scale (UPDRS III) at the preoperative L-dopa challenge can predict the degree of decrease in doses of dopaminergic medication at one year following subthalamic nucleus deep brain stimulation (STN DBS).
Background: STN DBS is established as surgical treatment of advanced Parkinson´s disease (PD) and most often leads to reduction in medication dosage. While improvement of UPDRS III scores at the preoperative L-dopa test may predict the improvement of UPDRS III by STN DBS, it is not known if the % of medication reduction postoperatively correlates with the % decrease of UPDRS III scores at the preoperative L-dopa challenge.
Method: Nineteen consecutive PD patients received bilateral STN DBS. The % improvement of UPDRS III at the preoperative L-dopa test and at 1 year follow up, as well as the Levodopa equivalent daily doses (LEDD) preoperatively and at 1 year were recorded. The % decrease in LEDD at one year was correlated with the % UPDRS improvement at the preoperative L-dopa test, and with the % decrease of UPDRS scores in on-stimulation off-medication (on-stim off-med) condition at 1 year.
Results: At the preoperative L-dopa challenge UPDRS III improved by 59.8% (from 35±10 to 14.2, p=0.0003). At 1 year post DBS, the UPDRS III on-stim off-med improved by 42.8% compared to baseline (from 35±10 to 19, p=0.0003), and LEDD decreased by 24 %. compared to LEDD at baseline ( from 1418±468mg to 971±348mg, p= 0.001). However, the % decrease of LEDD at one year did not correlate with the % improvement of UPDRS III at the preoperative L-dopa test, (cc = -0.2, p=ns), nor with the % improvement of UPDRS III off-med on-stim at 1 year post STN DBS (cc = -0.03, p=ns).
Conclusion: The % improvement of UPDRS III at the L-dopa test preoperatively did not predict the % decrease of medication at one year post STN DBS. Also, there was no correlation between the % decrease of LEDD and the % improvement of UPDRS III at one year following STN DBS.
To cite this abstract in AMA style:
A. Fredricks, G-M. Hariz, J. Linder, L. Eriksson, L. Forsgren, M. Hariz, P. Blomstedt. Does the magnitude of improvement of UPDRS III at the preoperative L-dopa test predict the degree of medication decrease one year after subthalamic nucleus Deep Brain Stimulation? [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/does-the-magnitude-of-improvement-of-updrs-iii-at-the-preoperative-l-dopa-test-predict-the-degree-of-medication-decrease-one-year-after-subthalamic-nucleus-deep-brain-stimulation/. Accessed June 15, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/does-the-magnitude-of-improvement-of-updrs-iii-at-the-preoperative-l-dopa-test-predict-the-degree-of-medication-decrease-one-year-after-subthalamic-nucleus-deep-brain-stimulation/