Long-term effects of bilateral subthalamic deep brain stimulation on postural instability and gait difficulty in patients with parkinson’s disease

Hae Won Shin, Mi Sun Kim, Sung Reul Kim, Sang Ryong Jeon, Sun Ju Chung

Research output: Contribution to journalArticlepeer-review

Abstract

ObjectiveaaThe long-term effects of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on postural instability and gait difficulty (PIGD) in patients with Parkinson’s disease (PD) remain unclear. In this study, we aimed to evaluate the long-term effects of STN-DBS surgery on PIGD symptoms in patients with advanced-stage PD. MethodsaaThis study included 49 consecutively included patients with PD who underwent bilateral STN-DBS. The Unified Parkinson’s Disease Rating Scale (UPDRS) scores and subscores for PIGD were assessed at baseline and at 1, 3, and 5 years post-operatively. The PIGD subscore was divided into PIGD-motor and PIGD-activities of daily living (ADL) scores according to parts III and II of the UPDRS, respectively. ResultsaaThe PIGD-motor and PIGD-ADL scores at the “medication-off” state improved at 3 and 5 years, respectively. Overall, the UPDRS III and II scores at “medication-off” improved at 5 years. The UPDRS IV score also significantly improved and the le-vodopa equivalent daily dosage decreased at all follow-ups. Finally, the PIGD-motor score at baseline was able to predict long-term improvement in the PIGD-motor score at the 5-year follow-up. ConclusionaaThe STN-DBS has both short-and long-term effects on PIGD, as well as overall motor function, in patients with advanced PD. The degree of PIGD at the preoperative evaluation can be used to predict long-term outcomes after STN-DBS surgery.

Original languageEnglish
Pages (from-to)127-132
Number of pages6
JournalJournal of Movement Disorders
Volume13
Issue number2
DOIs
Publication statusPublished - 2020 May

Keywords

  • Deep brain stimulation
  • Gait difficulty
  • Parkinson disease
  • Postural instability
  • Subthalamic nucleus

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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