Annals of Neurology: a predictive factor for postoperative motor performance in people with Parkinson's disease, deep brain stimulation

Subcultic deep brain stimulation (STN-DBS) is an effective treatment for short-term and long-term follow-up in patients with advanced Parkinson's disease (PD).
success of STN-DBS surgery depends on accurate patient selection, precise brain targeting, optimized DBS programming, and postoperative drug management.
predictive factors for postoperative outcomes are critical at the selection stage of the surgical procedure.
response to L-doba has always been the key to determining a patient's suitability for surgery and is considered the best predictive factor for short-term postoperative exercise response.
other short-term positive preoperative predictor factors were younger age during surgery, higher exercise scores on the Unified Parkinson's Disease Score Sheet (UPDRS) under non-drug treatment conditions, longer courses of illness, and tremor dominant (TD) PD esomor.
online use: The Unified Parkinson's Disease Assessment Scale (UPDRS 3.0) found a long-term negative correlation between high gait scores in preoperative non-drug conditions and postoperative exercise outcomes.
, patients with advanced PD had a higher UPDRS III score under de-drug status, had rapid eye movement sleep disorder before surgery, and had a higher risk of developing disability 10 years after surgery.
, however, since all of these factors are studied in very small populations, these results may not be reliable if long-term results on STN-DBS are explored.
, some predictive short-term benefits have not been confirmed in long-term follow-up, such as L-doba reactive.
as the number and life expectancy of PD patients worldwide increase, it is important to understand the long-term effects of DBS surgery for patients, caregivers, and therapies.
university hospital in Grenoble, France, performed the world's first PD STN-DBS operation in 1993.
, they systematically followed large PD patient queues on both sides of STN-DBS.
Francesco Cavallieri and others at the university hospital, based on their follow-up queues, focused on long-term exercise results after receiving deep core stimulation (STN-DBS) in patients with Parkinson's disease (PD) and analyzed their preoperative predictive factors.
all continuous PD patients who received double-sided STN-DBS at Grenoble University Hospital between 1993 and 2015 were evaluated for long periods of time before, for one year (short term) and after surgery.
collected all available demographic variables, neuroimaging data, and clinical characteristics.
analysis, the preoperative predictive factors of long-term exercise results were studied.
long-term exercise gain loss for stimulation is defined as a reduction of less than 25% in the MDS-UPDRS Part III score compared to the baseline non-drug treatment score.
also assessed potential predictive factors for short-term movement outcomes after STN-DBS.
results showed that 138 patients were included in the long-term analysis (average follow-up time was 8.4±6.26 years).
preoperative higher prefrontal function score and non-drug-treated MDS-UPDRS Part III score predicted a better response of long-term exercise to stimulation, while the presence of vascular changes in neuroimaging predicted poor exercise outcomes.
of 357 patients who received one-year follow-up, preoperative L-Doba reaction, tremor-led, baseline frontal leaf function score, and non-drug treatment MDS-UPDRS Part III scores predicted short-term exercise outcomes.
the significance of this study is found that preletete dysfunction, severity of disease in non-drug states, and vascular changes in neuroimaging are the main predictive factors for long-term motor performance after STN-DBS in PD patients.
origins: Cavallieri, F., Fraix, V., Bove, F., Mulas, D., Tondelli, M., Castrioto, A., ... & Moro, E. (2020). Predictors of long‐term outcome of subthalamic stimulation in Parkinson disease. _Annals of Neurology_. Freeman Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that indicate "Source: Mets Medicine" or "Source: MedSci Originals" are owned by Mets Medical and are not reproduced by any media, website or individual without authorization, and are authorized to be reproduced with the words "Source: Mets Medicine".
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