KMID : 1001920080440010026
|
|
Journal of Korean Neurosurgical Society 2008 Volume.44 No. 1 p.26 ~ p.35
|
|
STN DBS of Advanced Parkinson¡¯s Disease Experienced in a Specialized Monitoring Unit with a Prospective Protocol
|
|
Lee Ji-Yeoun
Han Jung-Ho Kim Han-Joon Jeon Beom-Seok Kim Dong-Gyu Paek Sun-Ha
|
|
Abstract
|
|
|
Objective : In the evaluation of patients with Parkinson¡¯s disease (PD), most neurologists only see their patients during a limited period of their fluctuating 24-hour-a-day lives. This study aimed to assess the short-term outcome of STN stimulation for patients with advanced PD evaluated in a 24-hour monitoring unit for movement disorder (MUMD) using a prospective protocol.
Methods : Forty-two patients with advanced PD consecutively treated with bilateral STN stimulation using multi-channel microelectrode recording were included in this study. All patients were evaluated using a 24-hour MUMD with a video recording/editing system and were evaluated with a prospective protocol of the Unified Parkinson¡¯s Disease Rating Scale, Hoehn and Yahr Staging, Schwab and England Activities of Daily Living, levodopa equivalent daily dose (LEDD), Short Form-36 Health Survey, and neuropsychological tests. Magnetic resonance (MR) images of the brain were performed prior to and six months after surgery.
Results : All patients were evaluated at three and six months after surgery. There was a rapid and significant improvement of the motor symptoms, especially in tremor and rigidity, after STN stimulation with low morbidity. Dyskinesia was markedly decreased with much lowered LEDD values by 50% after STN stimulation. 1.5T MR images were safely taken according to the manufacturer¡¯s guidelines at six months after surgery without any adverse effects in 41 patients treated with STN stimulations.
Conclusion : Evaluations in a 24-hour monitoring unit could reduce the dose of medication efficiently to an optimal level with patients¡¯ comfort and improve the clinical symptoms in harmony with STN stimulation.
|
|
KEYWORD
|
|
Parkinson¡¯s disease, 24-hour monitoring unit for movement disorder (MUMD), Subthalamic nucleus, Deep brain stimulation, Multi-channel parallel microelectrode recording (MER), MR images
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|