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Deep brain stimulation: 12 years’ experience and 150 patients treated with a follow-up of over a year

R. Figueiras-Méndez, C. Magariños-Ascone, I. Regidor, M. del Álamo-De Pedro, L. Cabañes-Martínez, M. Gómez-Galán [REV NEUROL 2009;49:511-516] PMID: 19859873 DOI: https://doi.org/10.33588/rn.4910.2009055

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Volumen 49 | Number 10 | Nº of views of the article 6.045 | Nº of PDF downloads 1.313 | Article publication date 15/11/2009

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ABSTRACT

INTRODUCTION Deep brain stimulation (DBS) is a widely accepted clinical technique. The main motor symptoms are significantly reduced. The success of the technique depends on the experience of the neurosurgeon, neurologist and neurophysiologist who carry it out. The presentation of extensive series is needed to confirm and further currently held knowledge.

AIM To demonstrate the clinical benefits of a long series of patients treated by a single group with a minimum follow-up of one year and to report new neurophysiological data.

PATIENTS AND METHODS The study examined a total of 250 patients with different diagnoses: most of them with Parkinson’s disease, tremor and dystonia. The nuclei that were chosen were located by magnetic resonance imaging, computerised axial tomography and neurophysiological registers. Neurophysiological exclusion criteria, such as reflex control of heart rate, sympathetic skin response and auditory startle reflex, are employed in order to exclude patients with Parkinson-plus.

RESULTS The motor sub-scale (part III) of the Unified Parkinson’s Disease Rating Scale improves by 64% in the off-medication status with sub-thalamic stimulation at one year after surgery. One year after DBS, patients with dystonia show a significant decrease on the Burke-Fahn-Marsden dystonia scale. The improvement on the scales continues, with a mean descent of 65% in the second year after surgery.

CONCLUSIONS DBS is a suitable technique for the treatment of movement disorders. The neuronal activity of the sub-thalamus and the internal globus pallidus presents its own characteristics that reflect the motor symptoms of the patients. Surface electromyography proves to be useful for quantifying the patients’ improvement. KeywordsDeep brain stimulation Dystonia Electromyography Neuronal activity Parkinson Tremor CategoriesNeurodegeneración Técnicas exploratorias Trastornos del movimiento

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Deep brain stimulation: 12 years’ experience and 150 patients treated with a follow-up of over a year

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