Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul, Korea.
Department of Applied Bioengineering, Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.
Neurosurgery. 2022 Nov 1;91(5):726-733. doi: 10.1227/neu.0000000000002117. Epub 2022 Sep 2.
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) represents an effective treatment for severe Parkinson's disease (PD), but little is known about the long-term benefit.
To investigate the survival rate and long-term outcome of DBS.
We investigated all 81 patients including 37 males and 44 females who underwent bilateral STN DBS from March 2005 to March 2008 at a single institution. The current survival status of the patients was investigated. Preoperative and postoperative follow-up assessments were analyzed.
The mean age at the time of surgery was 62 (range 27-82) years, and the median clinical follow-up duration was 145 months. Thirty-five patients (43%) died during the follow-up period. The mean duration from DBS surgery to death was 110.46 ± 40.8 (range 0-155) months. The cumulative survival rate is as follows: 98.8 ± 1.2% (1 year), 95.1 ± 2.4% (5 years), and 79.0 ± 4.5% (10 years). Of the 81 patients, 33 (40%) were ambulatory up to more than 11 years. The Unified Parkinson's Disease Rating Scale (UPDRS) score was significantly improved until 5 years after surgery although it showed a tendency to increase again after 10 years. The patient group with both electrodes located within the STN showed a higher rate of survival and maintained ambulation.
STN DBS is a safe and effective treatment for patients with advanced PD. This study based on the long-term follow-up of large patient populations can be used to elucidate the long-term fate of patients who underwent bilateral STN DBS for PD.
丘脑底核（STN）深部脑刺激（DBS）是治疗严重帕金森病（PD）的有效方法，但对其长期获益知之甚少。
研究 DBS 的生存率和长期结果。
我们调查了 2005 年 3 月至 2008 年 3 月在一家单中心接受双侧 STN-DBS 的 81 例患者，包括 37 例男性和 44 例女性。调查了患者的当前生存状况。分析了术前和术后的随访评估。
手术时的平均年龄为 62 岁（范围 27-82 岁），中位临床随访时间为 145 个月。35 例（43%）患者在随访期间死亡。从 DBS 手术到死亡的平均时间为 110.46±40.8 个月（范围 0-155 个月）。累积生存率如下：98.8±1.2%（1 年）、95.1±2.4%（5 年）和 79.0±4.5%（10 年）。81 例患者中，33 例（40%）在 11 年以上的时间内可以走动。虽然在 10 年后，UPDRS 评分再次呈上升趋势，但在手术后 5 年内评分显著改善。双侧电极均位于 STN 内的患者组生存率更高，且能维持活动能力。
STN-DBS 是治疗晚期 PD 患者的安全有效方法。本研究基于对大量患者的长期随访，可以阐明接受双侧 STN-DBS 治疗 PD 的患者的长期结局。
