Clinical Effectiveness of DBS for Parkinson's Disease

There are several globally recognized tools used to monitor the severity of Parkinson’s disease as well as track the quality of life. The Unified Parkinson's Disease Rating Scale (UPDRS) is a globally recognized tool used to assess the severity of Parkinson’s disease. The Parkinson’s disease Questionnaire (PDQ-39) is used to measure the health status of people living with Parkinson’s disease specifically focusing on 8 aspects related to quality of life.

Multiple studies have demonstrated a reduction in UPDRS III and PDQ-39 scores, which correlates with an improvement in motor function & quality of life.

Key findings from these studies concluded that:

Primary
Author

Study
Design
Sample
Size
Follow
Up
Change in Mean
UPDRS III Scores
% Improvement in UPDRS III &
 PDQ-39 Scores
Deuschl 2006¹ Randomized pairs trial  78 6 mos.

• Baseline: 48 ± 12.3

• Post DBS: 28.3 ± 14

• 41% improvement in UPDRS III

• 25% improvement in PDQ-39

Tir 2007² Prospective, single-center study  103 12 mos.

• Baseline: 50 ± 16

• Post DBS: 29 ± 11.5

• 42% improvement in UPDRS III
Fraix 2006³ Prospective, multi-center 95 12 mos.

• Baseline: 49.2 ± 16.4

• Post DBS: 19.4 ± 11.5

• 57% improvement in UPDRS III
Lefaucheur 2008⁴  Single-center study 54 12 mos.

• Baseline: 48.2 ± 16.1

• Post DBS: 21.4 ± 8.2

• 56% improvement in UPDRS III
Follett 2010⁵ Multi-center, randomized, blinded  299 24 mos.

STN

• Baseline: 43 ± 15

• Post DBS: 32.1 ± 15.6

GPi

• Baseline: 41.8 ± 13.1

• Post DBS: 30 ± 14.2

• 25.3% improvement in UPDRS III

• Improvement in 6 of 8 subscales

Rodriquez-Oroz 2005⁶ Multi-center study 69 3-4 yrs.

STN

• Baseline: 56.7 ± 15.7

• Post DBS: 28.6 ± 15.7

GPi

• Baseline: 51.7 ± 13.6

• Post DBS: 31.7 ± 12.8

• 50% improvement in UPDRS III

• with STN and 39% improvement

• with GPi at 3-4 yrs.

Gervais-Bernard 2009⁷ Prospective, single-center 23 5 yrs.

• Baseline: 43.11 ± 14.04

• Post DBS: 19.52 ± 7.17

• 55% improvement in UPDRS III
Moro 2010⁸

Nonrandomized, prospect,

blinded, multicenter

study

51 5-6 yrs.

STN

• Baseline: 56 ± 2.7

• Post DBS: 30.1 ± 2.5

GPi

• Baseline: 52.2 ± 3.5

• Post DBS: 32.6 ± 4.6

• 45.4 (STN) to 20% (GPi) improvement in UPDRS III

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References

1.     Deuschl G , Schade-Brittinger C et al. A Randomized Trial of Deep-Brain Stimulation for Parkinson’s Disease. N Engl J Med 2006;355:896-908.

2.     Tir M, Exhaustive, one-year follow-up of subthalamic nucleus deep brain stimulation in a large, single-center cohort of Parkinson’s patients, Neurosurgery 61:297–305, 2007.

3.     Fraix V, Houeto JL, Lagrange C et al. Clinical and economic results of bilateral subthalamic nucleus stimulation in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2006;77:443–449.

4.     Lafaucheur JP, Gurruchaga JM, Pollin B et al. Outcome of Bilateral Subthalamic Nucleus Stimulation in the Treatment of Parkinson’s Disease: Correlation with Intra-Operative Multi-Unit Recordings but Not with the Type of Anaesthesia. Eur Neurol 2008;60:186–199.

5.     Follett KA, Weaver FM, Stern M et al. Pallidal versus Subthalamic Deep-Brain Stimulation for Parkinson’s Disease. N Engl J Med 2010;362:2077-91.

6.     Rodriguez-Oroz MC, Bilateral deep brain stimulation in Parkinson’s disease: a multicentre study with 4 years follow-up, Brain (2005), 128, 2240–2249.

7.     Gervais-Bernard H, Xie-Brustolin J, Mertens P et al, Bilateral subthalamic nucleus stimulation in advanced Parkinson’s disease: Five year follow-up. J Neurol (2009) 256:225–233.

8.     Moro E, Lozano A, Pollak P et al. Long-Term Results of a Multicenter Study on Subthalamic and Pallidal Stimulation in Parkinson’s Disease. Movement Disorders

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