Objective: Assessment of the dynamics of dopamine dysregulation syndrome in patients with Parkinson`s disease after deep brain stimulation of the subthalamic nucleus compared with the control group of patients who performed only pharmacotherapy, aimed at correcting the motor and affective disorders.

Background: Dopamine dysregulation syndrome (DDS) – is a complication of dopaminergic therapy of Parkinson’s disease (PD), manifested compulsive intake of dopaminergic drugs. Deep brain stimulation may improve, worsen or have no effect on existing clinical symptoms of DDS. Furthermore, it can first occur postoperatively.

Methods: We observed 24 patients with advanced PD. The main group consisted of 8 patients PD after DBS STN, who in the preoperative period had clinical signs of DDS. The control group consisted of 16 patients with PD DDS, who received only conservative medical therapy. The average age of patients-54.5+12.5 and 64+7.4 years, disease duration-9,7+3,4+2,6 and 12 years, the average dose of levodopa-1570 + 922 and 1323+300 mg/day and average duration of treatmen-8.7+3.2 and 10.5+3.4 years, respectively, in patients of main and control group. Neurological and behavioral evaluation included following scales: unified rating scale of Parkinson’s disease, quality of life scale in patients with Parkinson’s disease (scale PDQ-39,1987) and the Schwab&England activities of daily living scale  (Schwab JA, England AC,1969), part IV of the UPDRS, the definition of the equivalent daily dose of levodopa (LEDD,Smith et al.,2010), Spielberg scales for assessment of anxiety (STAI, Spilberger Ch.D.,1972) and the Hamilton depression Rating scale (HDRS,1952).

Results: Follow-up observation of PD patients of the main group confirmed the possibility of a substantial reduction LEDD daily dose with a full regression compulsive taking the drugs for two years of observation, as well as improving the quality of life, activities of daily living, reducing the severity of motor fluctuations and drug dyskinesias of advanced PD. Patients in the control group tended to increase significantly the dose of dopaminergic therapy and preservation of clinical signs of the DDS with low adherence to therapy.

Conclusions: Based on our data, we can conclude that DBS STN can lead to regression of symptoms of DDS, possibly due to a significant reduction in doses of drugs due to improved motor manifestations of PD.

« Back to 2017 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/dynamic-of-symptoms-of-dopamine-dysregulation-syndrome-after-deep-brain-stimulation-in-patients-with-parkinsons-disease/