• World Neurosurg · Sep 2016

    Multicenter Study Clinical Trial

    Subthalamic nucleus deep brain stimulation for Parkinson's disease in Hong Kong: A prospective territory-wide 2 year follow-up study.

    • Danny T M Chan, Cannon X L Zhu, Claire K Y Lau, Tak L Poon, Fung C Cheung, Michael Lee, Benedict Taw, Kwan N Hung, Priscilla Choi, Mandy AuYeung, Germaine Chan, Yuk F Cheung, Anne Y Y Chan, Jonas H M Yeung, Vincent C T Mok, Wai S Poon, and Hong Kong Movement Disorder Society.
    • Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, Hong Kong. Electronic address: tmdanny@surgery.cuhk.edu.hk.
    • World Neurosurg. 2016 Sep 1; 93: 229-36.

    ObjectiveWe assessed the effects of bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) in patients with Parkinson disease at the 1-year and 2-year follow-up evaluations. Unified Parkinson's Disease Rating Scale (UPDRS) motor score at "off" medication ("on" DBS) and quality-of-life assessments (39-item Parkinson's Disease Questionnaire [PDQ-39]) were conducted. The percentage of awake "on" time and awake "off" time and levodopa requirement were also assessed.MethodsA 2-year prospective study was conducted of 25 consecutive patients from 3 DBS referral centers in Hong Kong. The patients were treated with bilateral stimulation of the STN. Assessments were performed at 1 year and 2 years after DBS and were compared with the baseline.ResultsThe 2-year outcome assessments were completed by 18 patients. The mean UPDRS motor score improvement was 57% in the first year and 45% in the second year. PDQ-39 showed significant improvement in quality of life for 2 consecutive years. The levodopa requirement decreased 63% in the first year and 55.9% in the second year. The awake "on" time was doubled in the first year and sustained in the second year. Awake "off" time was reduced from 28.1% to 5.9% in the first year and returned to 10.6% in the second year. Improvement of UPDRS motor score, reduction in awake "off" time, and decrease of daily levodopa dosage all were main factors correlated with the improvement in PDQ-39 summary index.ConclusionsThe effects of STN DBS in patients with Parkinson disease in Hong Kong were satisfactory. The results showed that reduction in UPDRS motor score, awake "off"-time, and daily levodopa dosage were the major drivers of overall improvement in PDQ-39.Copyright © 2016 Elsevier Inc. All rights reserved.

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