Highlights
- •STN-DBS has potential neuromodulatory impact on Parkinson’s disease progression.
- •The neuromodulatory impact of STN-DBS on PD progression is the most observable in first postoperative months.
- •STN-DBS influences on both motor and non-motor symptoms in Parkinson’s disease patients.
Abstract
Introduction
STN-DBS has been claimed to change progression symptoms in animal models of PD, but information is lacking about the possible neuromodulatory
role of STN-DBS in humans. The aim of this prospective controlled study was to evaluate
the long-term impact of STN-DBS on motor disabilities and cognitive impairment in
PD patients in comparison to Best-Medical-Therapy (BMT) and Long-term-Post-Operative
(POP) groups.
Material and methods
Patients were divided into 3 groups: the BMT-group consisted of 20 patients treated
only with pharmacotherapy, the DBS-group consisted of 20 PD patients who underwent
bilateral STN-DBS (examined pre- and postoperatively) and the POP-group consisted
of 14 long-term postoperative patients in median 30 month-time after DBS. UPDRS III
scale was measured during 3 visits in 9 ± 2 months periods (V1, V2, V3) in total-OFF
phase. Cognitive assessment was performed during each visit in total-ON phase.
Results
The comparable UPDRS III OFF gain was observed in both BMT-group and POP-group evaluations
(p < 0.05). UPDRS III OFF results in DBS-group revealed significant UPDRS III OFF
increase in ΔV2-V1 assessment (p < 0.05) with no significant UPDRS III OFF alteration
in ΔV3-V2 DBS-group evaluation (p > 0.05). Cognitive assessment revealed significant
alterations between DBS-group and BMT-group in working memory, executive functions
and learning abilities (p < 0.05).
Conclusions
The impact of STN-DBS on UPDRS III OFF score and cognitive alterations suggest its
neuromodulatory role, mainly during the first 9–18 months after surgery.
Keywords
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Article info
Publication history
Published online: January 27, 2020
Accepted:
December 30,
2019
Received:
September 26,
2019
Identification
Copyright
© 2019 Published by Elsevier Ltd.
