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- Development of Clinical Milestones in Parkinson’s Disease After Bilateral Subthalamic Deep Brain Stimulation
- Jed Noel A. Ong, Jung Hwan Shin, Seungho Jeon, Chan Young Lee, Han-Joon Kim, Sun Ha Paek, Beomseok Jeon
- J Mov Disord. 2022;15(2):124-131. Published online May 26, 2022
- DOI: https://doi.org/10.14802/jmd.21106
- 2,486 View
- 137 Download
- 1 Web of Science
- 1 Crossref
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Abstract
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Supplementary Material - Objective
Deep brain stimulation of the subthalamic nucleus (STN-DBS) in Parkinson’s disease (PD) patients does not halt disease progression, as these patients will progress and develop disabling non-levodopa responsive symptoms. These features may act as milestones that represent the overall functionality of patients after DBS. The objective of this study was to investigate the development of clinical milestones in advanced PD patients who underwent bilateral STN-DBS.
Methods
The study evaluated PD patients who underwent STN-DBS at baseline up to their last follow-up using the Unified Parkinson’s Disease Rating Scale and Hoehn and Yahr scale. The symptoms of hallucinations, dysarthria, dysphagia, frequent falls, difficulty walking, cognitive impairment and the loss of autonomy were chosen as the clinical milestones.
Results
A total of 106 patients with a mean age of 47.21 ± 10.52 years at disease onset, a mean age of 58.72 ± 8.74 years at surgery and a mean disease duration of 11.51 ± 4.4 years before surgery were included. Initial improvement of motor symptoms was seen after the surgery with the appearance of clinical milestones over time. Using the moderately disabling criteria, 81 patients (76.41%) developed at least one clinical milestone, while 48 patients (45.28%) developed a milestone when using the severely disabling criteria.
Conclusion
STN-DBS has a limited effect on axial and nonmotor symptoms of the PD patients, in contrast to the effect on motor symptoms. These symptoms may serve as clinical milestones that can convey the status of PD patients and its impact on the patients and their caregivers. Therefore, advanced PD patients, even those treated with bilateral STN-DBS, will still require assistance and cannot live independently in the long run. -
Citations
Citations to this article as recorded by
- Unveiling the Impact of Outpatient Physiotherapy on Specific Motor Symptoms in Parkinson’s Disease: A Prospective Cohort Study
Yuta Terasawa, Koki Ikuno, Shintaro Fujii, Yuki Nishi, Emi Tanizawa, Sachio Nabeshima, Yohei Okada
Brain & Neurorehabilitation.2023;[Epub] CrossRef
- Unveiling the Impact of Outpatient Physiotherapy on Specific Motor Symptoms in Parkinson’s Disease: A Prospective Cohort Study
- Clinical Features and Disability Milestones in Multiple System Atrophy and Progressive Supranuclear Palsy
- Sang-Wook Lee, Seong-Beom Koh
- J Mov Disord. 2012;5(2):42-47.
- DOI: https://doi.org/10.14802/jmd.12010
- 23,669 View
- 135 Download
- 12 Crossref
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Abstract
PDF
Multiple system atrophy (MSA) and progressive supranuclear palsy (PSP) are an adult-onset progressive neurodegenerative disorder that are known to display diverse clinical features and disease progression. We aim to characterize the clinical features and disease progression in patients with MSA and PSP by using a number of relevant disability milestones in Koreans. Forty-one patients with MSA and 14 patients with PSP had been enrolled. The mean age at onset of MSA-C, MSA-P and PSP was 56.7 ± 7.8, 62.5 ± 8.0, 68.9 ± 6.1 years respectively. The most commonly reported symptom at disease onset is disequilibrium/dizziness in MSA-C, tremor in MSA-P and frequent falling in PSP. The mean duration of reaching milestones after disease onset in MSA-C were as followings: 20.8 (urinary incontinence), 22.9 (frequent falling), 27.8 (wheelchair bound), 31.8 (dysarthria) and 35.8 months (diagnosis). The mean duration of reaching milestones after disease onset were 22.0 (urinary incontinence), 32.6 (frequent falling and diagnosis), 41.2 (dysarthria), 61.4 months (wheelchair bound) in MSA-P and 16.8 (dysarthria), 21.6 (diagnosis), 21.7 (frequent falling), 24.0 months (wheel chair bound) in PSP. In the case of MSA, dizziness may occur for the first time. Thus, when the patient complains of non-specific dizziness, a follow-up examination to distinguish it from MSA can be helpful. There was a trend for patients with MSA-C to reach more disability milestones than in MSA-P and PSP before diagnosis. It may explain why patients with MSA-C are required more detail history taking and neurologic examination at an earlier stage.
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Citations
Citations to this article as recorded by- Disease course and treatment patterns in progressive supranuclear palsy: A real-world study
John C. Morgan, Xiaolan Ye, Jennifer A. Mellor, Keisha J. Golden, Jorge Zamudio, Louis A. Chiodo, Yanjun Bao, Tao Xie
Journal of the Neurological Sciences.2021; 421: 117293. CrossRef - Progression of Oropharyngeal Dysphagia in Patients with Multiple System Atrophy
Hui Jae Do, Han Gil Seo, Hyun Haeng Lee, Byung-Mo Oh, Yoon Kim, Aryun Kim, Han-Joon Kim, Beomseok Jeon, Tai Ryoon Han
Dysphagia.2020; 35(1): 24. CrossRef - Is There a Difference in Autonomic Dysfunction Between Multiple System Atrophy Subtypes?
Divyani Garg, Achal Kumar Srivastava, Ashok Kumar Jaryal, Roopa Rajan, Akanksha Singh, Awadh Kishor Pandit, Deepti Vibha, Garima Shukla, Ajay Garg, Ravindra Mohan Pandey, Kameshwar Prasad
Movement Disorders Clinical Practice.2020; 7(4): 405. CrossRef - Models of multiple system atrophy
He-Jin Lee, Diadem Ricarte, Darlene Ortiz, Seung-Jae Lee
Experimental & Molecular Medicine.2019; 51(11): 1. CrossRef - Multiple System Atrophy: An Oligodendroglioneural Synucleinopathy1
Kurt A. Jellinger, George Perry, Jesus Avila, Massimo Tabaton, Xiongwei Zhu
Journal of Alzheimer's Disease.2018; 62(3): 1141. CrossRef - Present and future of disease-modifying therapies in multiple system atrophy
Miguel Lopez-Cuina, Alexandra Foubert-Samier, François Tison, Wassilios G. Meissner
Autonomic Neuroscience.2018; 211: 31. CrossRef - Different subregional metabolism patterns in patients with cerebellar ataxia by 18F-fluorodeoxyglucose positron emission tomography
Minyoung Oh, Jae Seung Kim, Jungsu S. Oh, Chong Sik Lee, Sun Ju Chung, Byeong-Cheol Ahn
PLOS ONE.2017; 12(3): e0173275. CrossRef - Vestibular Deficits in Neurodegenerative Disorders: Balance, Dizziness, and Spatial Disorientation
Thomas Cronin, Qadeer Arshad, Barry M. Seemungal
Frontiers in Neurology.2017;[Epub] CrossRef - Progressive supranuclear palsy: progression and survival
Julieta E. Arena, Stephen D. Weigand, Jennifer L. Whitwell, Anhar Hassan, Scott D. Eggers, Günter U. Höglinger, Irene Litvan, Keith A. Josephs
Journal of Neurology.2016; 263(2): 380. CrossRef - Multiple system atrophy: pathogenic mechanisms and biomarkers
Kurt A. Jellinger, Gregor K. Wenning
Journal of Neural Transmission.2016; 123(6): 555. CrossRef - Urinary Dysfunction in Progressive Supranuclear Palsy Compared with Other Parkinsonian Disorders
Tatsuya Yamamoto, Fuyuki Tateno, Ryuji Sakakibara, Shogo Furukawa, Masato Asahina, Tomoyuki Uchiyama, Shigeki Hirano, Yoshitaka Yamanaka, Miki Fuse, Yasuko Koga, Mitsuru Yanagisawa, Satoshi Kuwabara, Jong-Ling Fuh
PLOS ONE.2016; 11(2): e0149278. CrossRef - Movement and Other Neurodegenerative Syndromes in Patients with Systemic Rheumatic Diseases
Rikitha Menezes, Alexander Pantelyat, Izlem Izbudak, Julius Birnbaum
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- Disease course and treatment patterns in progressive supranuclear palsy: A real-world study
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