Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Neurosurgery and Radiosurgery Gamma Knife Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
J Neurol. 2021 Aug;268(8):2821-2830. doi: 10.1007/s00415-021-10430-y. Epub 2021 Feb 17.
Parkinson's disease (PD) is the second most common neurodegenerative disorder, affecting both motor and non-motor systems. Deep brain stimulation of the subthalamic nucleus (STN-DBS) has been an approved treatment for PD for more than 30 years, but few data are available regarding its long-term effectiveness.
The aim of this study is to evaluate patients' outcome, both from a motor and non-motor perspective, 9 to 14 years after DBS implantation. We have investigated patients with advanced PD and treated with STN-DBS, in relation to key clinical features of PD.
18 patients were assessed both retrospectively and prospectively. They underwent motor examination, neuropsychological evaluation and questionnaires on the quality of life, preoperatively, as well as 1, 9 and 14 years after DBS surgery. All patients were implanted with STN-DBS at San Raffaele Hospital between 2004 and 2010.
13 males and five females underwent DBS implantation with a mean PD duration of 11 years. Stimulation significantly improved med-off/stim-on condition up to 9 years, compared to the preoperative off state, and med-on/stim-on condition at 14 years, compared to med-on/stim-off state. Long term improvement specifically involved tremor and rigidity, as well as dopaminergic daily dose. At the same time, STN-DBS had no long-lasting effect on axial symptoms and cognitive functions.
STN-DBS remains an effective therapy for advanced PD, also over the years. Despite the underlying progression of the disease, this treatment extends the period in which the overall quality of life is still acceptable.
帕金森病（PD）是第二常见的神经退行性疾病，影响运动和非运动系统。丘脑底核（STN）深部脑刺激（DBS）已被批准用于治疗 PD 超过 30 年，但关于其长期疗效的数据很少。
本研究旨在评估 DBS 植入后 9 至 14 年患者的预后，从运动和非运动两个方面。我们调查了接受 STN-DBS 治疗的晚期 PD 患者，并与 PD 的关键临床特征相关。
18 名患者进行了回顾性和前瞻性评估。他们在术前、术后 1、9 和 14 年接受了运动检查、神经心理学评估和生活质量问卷。所有患者均于 2004 年至 2010 年在圣拉斐尔医院植入 STN-DBS。
13 名男性和 5 名女性接受了 DBS 植入，PD 持续时间平均为 11 年。与术前关闭状态相比，刺激在 9 年内显著改善了关闭/刺激开启状态，与 14 年内的开启/刺激开启状态相比，改善了开启/刺激开启状态。长期改善特别涉及震颤和僵硬，以及多巴胺每日剂量。与此同时，STN-DBS 对轴性症状和认知功能没有持久影响。
STN-DBS 仍然是晚期 PD 的有效治疗方法，多年来也是如此。尽管疾病仍在进展，但这种治疗方法延长了整体生活质量仍然可以接受的时期。
