Category: Surgical Therapy: Parkinson's Disease
Objective: To track the degree and longevity of motor benefit achieved with STN DBS at our center.
Background: Caputo et al., (2017)[1] presented data from twenty Parkinson’s patients that had been implanted bilaterally in the STN from January of 2013 to March 2015 and were intradepartmental referrals managed and followed by us after DBS. Data consisted of pre-DBS management and UPDRS-III scores, and a fine grained temporal analysis of post-DBS values followed for three years. In Autumn of 2021, our program shifted to a different geographical location and of the original cohort 16/20 shifted their care with us. As such, we now add recent years of management, allowing a single center retrospective review post-DBS at the decade mark.
Method: We reviewed the charts of the 16 patients, who were part of the original cohort. Adding the recent data to the UPDRS-III scores prior to DBS and the logged UPDRS-III scores for the first three years post-DBS. Scores were aggregated for yearly scores of the 1st, 2nd, and 3rd years, and then again for the 8th, 9th, and 10th years. Statistical comparisons were made using paired t-tests.
Results: As before, no differences were found between the average UPDRS-III “On” scores in the year preceding DBS versus the Da Challenge “On” score (p=0.901). Consequently, these scores were aggregated to form a pre-DBS baseline. Subsequent post-DBS yearly scores exhibited mean differences that were statistically less for the 1st (mean diff: -5.16; p=0.007), 2nd (mean diff: -7.37; p=0.011 and 3rd (mean diff: -4.58; p=0.005) years. Baseline was not statistically different from the 8th (mean diff: 2.33; p=0.425), 9th (mean diff: 1.73; p=0.153) and 10th (mean diff: 4.33; p=0.069) yearly scores.
Conclusion: As before, our results indicate that DBS can improve assessment scores during the first three years in contrast to the initial year prior to DBS under medical management alone. Consequently, at the 10 year mark post-DBS, managed individuals are doing as well motorically, as they were a decade earlier under medical management alone. However, substantial non-motor complexities can appear at the 10 year mark. Ongoing analyses explore the changes in medical management across the same epoch, as well as document the non-motor complexities that arise.
References: [1] Caputo D.L., Mark, O., Schneider D.P., DiPaola, R.J., Danish S.F., Hargreaves E.L. (2017). Degree, Onset and longevity of benefit achieved with Deep Brain Stimulation (DBS) of the subthalamic nucleus (STN) as assessed by the UPDRS. The International Parkinson and Movement Disorder Society (MDS), (Presented by DLC, June, Vancouver, Canada).
To cite this abstract in AMA style:
D. Caputo, R. Dipaola, S. Danish, E. Hargreaves. Longevity of Motor Benefit Achieved with Deep Brain Stimulation (DBS) of the Subthalamic Nucleus (STN) in a Single Center Cohort at the Decade Mark Post-Implantation. [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/longevity-of-motor-benefit-achieved-with-deep-brain-stimulation-dbs-of-the-subthalamic-nucleus-stn-in-a-single-center-cohort-at-the-decade-mark-post-implantation/. Accessed October 4, 2024.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/longevity-of-motor-benefit-achieved-with-deep-brain-stimulation-dbs-of-the-subthalamic-nucleus-stn-in-a-single-center-cohort-at-the-decade-mark-post-implantation/