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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
The impact of age and disease duration on the long term outcome of neurostimulation of the subthalamic nucleus
Parkinsonism and Related Disorders, Volume 20, No. 1, Year 2014
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Description
Background: Selection of patients with Parkinson's disease for neurostimulation of subthalamic nucleus (STN-DBS) is still poorly studied. Aim: To identify the impact of age and disease duration on the outcome of bilateral STN-DBS. Methods: 110 operated patients in a single center covering a large range of age and disease duration were retrospectively included and followed for up-to 5 years. Standardized UPDRS assessments were obtained at 0.5-1 and 3-5 years. Patients were stratified into three age groups (≤55, 56-64 and ≥65 years) and the middle age group was further stratified into 2 disease duration subgroups (<15years, ≥15 years). Results: The age groups had comparable baseline data except for the predefined differences. Compared to baseline early and late intra-group "Med Off-Stim On" motor scores were significantly improved for all groups (p<0.001). Mood/cognition were significantly improved in younger two groups (p=0.008, 0.019) at 0.5-1 year. Inter-group comparisons showed significantly worse early and late axial scores for older patients (p<0.05). All groups had comparable postoperative improvement except for the older group which had significantly less improvement of early UPDRS-II, late UPDRS-I, and early and late PIGD/axial scores. Different disease durations had no effect on the outcome except for worse Schwab and England Off-score in longer duration group (p=0.02). Side effects of surgery and long-term management were similar. Conclusion: STN-DBS is an efficient treatment of advanced PD for all treated age-groups. Provided strict inclusion criteria are respected, older age and longer disease duration are associated with slightly worse effects mainly on L-dopa-resistant symptoms. © 2013 Elsevier Ltd.
Authors & Co-Authors
Shalash, Ali Soliman
Germany, Kiel
Christian-albrechts-universität zu Kiel
Egypt, Cairo
Ain Shams University
Alexoudi, Athanasia
Germany, Kiel
Christian-albrechts-universität zu Kiel
Knudsen, Karina
Germany, Kiel
Christian-albrechts-universität zu Kiel
Volkmann, Jens
Germany, Kiel
Christian-albrechts-universität zu Kiel
Germany, Wurzburg
Universitätsklinikum Würzburg
Mehdorn, H. M.
Germany, Kiel
Christian-albrechts-universität zu Kiel
Deuschl, Günther D.
Germany, Kiel
Christian-albrechts-universität zu Kiel
Statistics
Citations: 36
Authors: 6
Affiliations: 3
Identifiers
Doi:
10.1016/j.parkreldis.2013.09.014
e-ISSN:
18735126
Research Areas
Health System And Policy