Category: Surgical Therapy: Parkinson's Disease
Objective: To identify the effect of DBS of bilateral STN or bilateral GPi on different motor parameters of PD
Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) and globus pallidus internus (GPi) represents a breakthrough therapy that improves motor symptoms, “off” time and patient’s quality of life of Parkinson’s disease (PD); however, experience of its use in developing countries is uncommonly shared.
Method: Patients with idiopathic PD who underwent DBS were recruited. MDS-UPDRS-part III was done preoperative and 6 months postoperative to assess for DBS impact on PD cardinal motor features.
Results: 25 PD patients underwent DBS (20 STN, 5 GPi) from 2018 to 2013. Number of DBS cases tripled after inclusion of DBS in general insurance. Main indications included motor fluctuation (22, 88%), levodopa induced dyskinesia (7, 28%) and tremors (7, 28%). Side effects included intraoperative seizures (1 patient), postoperative severe chest infection (1 patient), infection around the battery (1 patient) and stimulation related (reversible, 12 patients) including dyskinesia, numbness, hypomania, pain and imbalance.
Motor outcome of 17 patients (80% males) was analyzed. The mean age and age of onset were 60 years and 50 years old, respectively, while median duration of illness was 8.5 years. At 6 months follow-up, we found significant improvement in all motor aspects of PD (UPDRS III) in the “off” medication state. There was highly significant improvement regarding total motor UPDRS score, axial score, tremors, rigidity, bradykinesia, postural instability and gait difficulty, and Hohn & Yahr scales compared to preoperative scores (p< 0.01). Moreover, there was a significant decrease of Levodopa Equivalent Daily Dose (LEDD) compared to preoperative scores (p< 0.05).
Conclusion: DBS improves all cardinal motor manifestations of idiopathic PD. Coverage of DBS in general insurance promoted its use in Egypt. Efforts need to be done to surmount challenges of availability and affordability in developing countries.
To cite this abstract in AMA style:
S. Abdelaziz, A. Shalash, E. Hamid, Z. Yossry, M. Alkarras, D. Elheraby, Y. Salah, M. Essam, H. Radwan. Effect of Deep Brain Stimulation on the Motor Profile of Parkinson’s Disease in Egypt; A Developing Country Experience [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/effect-of-deep-brain-stimulation-on-the-motor-profile-of-parkinsons-disease-in-egypt-a-developing-country-experience/. Accessed June 15, 2025.« Back to 2023 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-deep-brain-stimulation-on-the-motor-profile-of-parkinsons-disease-in-egypt-a-developing-country-experience/