Deep Brain Stimulation for Early-Stage Parkinson's Disease: An Illustrative Case

作者：Gill Chandler E; Allen Laura A; Konrad Peter E; Davis Thomas L; Bliton Mark J; Finder Stuart G; Tramontana Michael G; Kao C Chris; Remple Michael S; Bradenham Courtney H; Charles P David^*

来源：Neuromodulation, 2011, 14(6): 515-521.

DOI：10.1111/j.1525-1403.2011.00391.x

• Deep brain stimulation (DBS)
• early stage
• Parkinson's Disease (PD)
• Unified Parkinson's Disease Rating Scale Motor Subscale (UPDRS-III)

Objectives: Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective intervention in advanced Parkinson's disease (PD), but its efficacy and safety in early PD are unknown. We are conducting a randomized pilot trial investigating DBS in early PD. This report describes one participant who received bilateral STN-DBS.
Materials and Methods: Thirty subjects have been randomized to either optimal drug therapy (ODT) or DBS + ODT. Microelectrode recordings from the STN and substantia nigra are collected at implantation. The Unified Parkinson's Disease Rating Scale Motor Subscale (UPDRS-III) is administered in the ON and OFF states semi-annually and neuropsychological function and quality of life are assessed annually. We describe a 54-year-old man with a two-year history of PD who was randomized to DBS + ODT and followed for two years.
Results: The subject showed a lower STN to substantia nigra ratio of neuronal activity than advanced PD patients, and higher firing rate than non-PD patients. The subject's total UPDRS and UPDRS-III scores improved during the two-year follow-up, while his OFF UPDRS-III score and levodopa equivalent daily dose increased. Quality of life, verbal fluency, and verbal learning improved. He did not experience any serious adverse events.
Conclusions: This report details the first successful application of bilateral STN-DBS for early-stage PD during a clinical trial.

• 出版日期2011-12