Session Information
Date: Monday, June 5, 2017
Session Title: Surgical Therapy: Parkinson’s Disease
Session Time: 1:45pm-3:15pm
Location: Exhibit Hall C
Objective: We investigated factors determining the motor outcome of STN DBS in patients with Parkinson disease (PD).
Background: The STN DBS has revolutionized the management of patients with advanced PD. The improvement of motor scores after STN DBS is often, but not always, predicted by levodopa response before DBS.
Methods: We studied 21 PD patients who underwent bilateral STN DBS (age=58±9 years; UPDRS III score=51.3± 12.2). Levodopa response tests were performed before DBS surgery and about one year after DBS using the same dose of levodopa. The magnitude of levodopa response was obtained by subtracting UPDRS III scores at med-on/stim-off from the scores at med-off/stim-off. Response to DBS stimulation was assessed at med-off state about one year after DBS. The magnitude of stimulation response was obtained by subtracting UPDRS III scores at stim-on/med-off from the scores at stim-off/med-off. Levodopa-equivalent dose was 1,271±402 mg/d before DBS, 596±334 mg/d after STN DBS(p<0.001).
Results: Improvement of motor scores after DBS, which shows highly significant correlation with the levodopa response before DBS (p<0.001), was attributed to the following three factors: baseline changes, levodopa response, and stimulation response. Post-DBS baseline motor scores at stim-off/med-off were significantly lower than the pre-DBS baseline motor scores at med-off (39.1±16.1 vs 51.4±12.2; p=0.003). The post-DBS levodopa response at stim-off was significantly lower than the pre-DBS levodopa response (25.4±16.1 vs 37.7±10.6; p=0.004). The post-DBS stimulation response at med-off were 4.29±3.55. Multiple regression of the pre-DBS levodopa response against the three factors showed significant correlations with the baseline changes, and the post-DBS levodopa response (p=0.006, r=0.654), but not with the stimulation response.
Conclusions: As reported previously, our data showed highly significant correlation between the pre-DBS levodopa response and DBS-induced improvement of motor scores. Furthermore, we found that STN DBS had induced significant changes in baseline motor scores, the magnitude of which was proportional to the pre-DBS levodopa response when the post-DBS levodopa response was taken into account.
To cite this abstract in AMA style:
C. Lee, E.J. Choi, S.-C. Park, J.K. Lee. Factors determining the motor outcome of STN DBS in PD patients: Evidence for Dual Actions [abstract]. Mov Disord. 2017; 32 (suppl 2). https://www.mdsabstracts.org/abstract/factors-determining-the-motor-outcome-of-stn-dbs-in-pd-patients-evidence-for-dual-actions/. Accessed June 14, 2025.« Back to 2017 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/factors-determining-the-motor-outcome-of-stn-dbs-in-pd-patients-evidence-for-dual-actions/