Early-term results of deep brain stimulation in Parkinson's disease: a case report

Year 2019, Volume: 44 Issue: 4, 1499 - 1505, 29.12.2019

Özlem İbrahimoğlu , Eda Akyol

Abstract

Subthalamic nucleus deep brain stimulation (STN-DBS) is a alternative treatment in Parkinson's disease. The iam of this case report is to present a case with a positive  effect of  STN-DBS on early-term results in Parkinson's disease. A 45-year-old man who underwent STN-DBS surgery as a treatment method for Parkinson's Disease was presented. He was  assessed in preoperative and postoperative period. STN-DBS surgery reduced the clinical severity of Parkinson's disease, the patient walked a certain distance in a shorter period, increased number of motion repetitions at a certain time interval, and decreased anxiety and depression level.  In conclusion STN DBS surgery has a positive effect on physical functions in Parkinson's disease and it may be useful to perform follow-up study in order to evaluate changes in cognitive functions. 

Keywords

Parkinson's Disease, Subthalamic Nucleus, Physical Function, Cognitive Function, Emotional Status

Parkinson hastalığında derin beyin stimülasyonunun erken dönem sonuçları: olgu sunumu

Abstract

Subtalamik çekirdek derin beyin stimülasyonu (STN-DBS) Parkinson hastalığında alternatif bir tedavi yöntemidir. Bu çalışmanın amacı Parkinson hastalığında STN-DBS'nin erken dönem sonuçları üzerine etkisini bir olgu bağlamında incelemektir. Parkinson hastalığında bir tedavi yöntemi olarak STN-DBS cerrahisi geçiren 45 yaşında erkek hasta sunuldu. Olgu ameliyat öncesi ve sonrası olmak üzere iki kez değerlendirildi. STN-DBS cerrahisinin Parkinson hastasında Parkinson Hastalığının klinik şiddetini azalttığı, hastanın belirli mesafe arasını daha kısa sürede yürüdüğü, belirli zaman aralığında hareket tekrar sayısının arttığı, anksiyete ve depresyon düzeyinin azaldığı belirlendi. Sonuç olarak STN-DBS'in Parkinson hastalığında fiziksel fonksiyonlar üzerine olumlu etkisi belirlenmiş olup, kognitif fonksiyonlardaki değişikliklerin değerlendirilebilmesi için işlem sonrası izlem çalışmasının yapılması yararlı olabilir.

Keywords

Parkinson Hastalığı, Subtalamik Çekirdek, Fiziksel Fonksiyon, Duygusal Durum, Bilişsel Fonksiyonlar

References

• Referans1 De Rosa A, Tessitore A, Bilo L, Pelusu S, De Michele G. Infusion treatments and deep brain stimulation in Parkinson's Disease: The role of nursing. Geriatric Nursing. 2016;37:434-9.
• Referans2 Luoma J, Pekkonen E, Airaksinen K, Helle L, Nurminen J, Taulu S, et al. Spontaneous sensorimotor cortical activity is suppressed by deep brain stimulation in patients with advanced Parkinson's disease. Neuroscience Letters. 2018;683:48-53.
• Referans3 Ulusoy EK, Ayar E, Bayındırlı D. Facial emotion recognition and discrimination deficit in idiopatic Parkinson Patients. Turkish Journal of Neurology. 2015;21(1):16-21.
• Referans4 Koçyiğit M, Akpek E, Güllü AÜ, Şenay Ş, Alhan C. Anesthesia experiences and coronary artery bypass surgery in a patient with deep brain stimulation. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2015;6(1):43-5.
• Referans5 Combs HL, Garcia-Willingham NE, Berry DTR, van Horne CG, Segerstrom S. Psychological functioning in Parkinson's disease post-deep brain stimulation: Self-regulation and executive functioning. Journal of Psychosomatic Research. 2018;111:42-9.
• Referans6 Altuğ F, Acar F, Acar G, Cavlak U. The influence of subthalamic nucleus deep brain stimulation on physical, emotional, cognitive functions and daily living activities in patients with Parkinson’s Disease. Turkish Neurosurgery. 2011;21(2):140-6.
• Referans7 Diez-Cirarda M, Ibarretxe-Bilbao N, Peria J, Ojeda N. Efficacy of cognitive rehabilitation in Parkinson's Disease. Neural Regeneration Research. 2018;13(2):226-7.
• Referans8 Giorgio Rizzone M, Martone T, Balestrino R, Lopiano L. Genetic background and outcome of deep brain stimulation in Parkinson's disease. Parkinsonism and Related Disorders. 2018; https://doi.org/10.1016/j.parkreldis.2018.08.006 (in press)
• Referans9 Brahimaj B, Kochanski RB, Sani S. Microelectrode accuracy in deep brain stimulation surgery. Journal of Clinical Neuroscience. 2018;50:58-61.
• Referans10 Halpern C, Hurtig H, Jaggi J, Grossman M, Won M, Baltuch G. Deep brain stimulation in neurologic disorders. Parkinsonism and Related Disorders. 2007;13:1-16.
• Referans11 Savaş A, Akbostancı C. Surgical technique and management of Parkinson's Disease. Turkiye Klinikleri J Neurol-Special Topics. 2008;1(4):103-8.
• Referans12 Benabid AL, Pollak P, Louveau A, Henry S, de Rougemont J. Combined (thalamotomy and stimulation) stereotactic surgery of the VIM thalamic nucleus for bilateral Parkinson disease. Appl Neurophysiol. 1987;50:344-6.
• Referans13 Timmermann L, Jain R, Chen L, Maarouf M, Barbe MT, Allert N, et al. Multiple-source current steering in subthalamic nucleus deep brain stimulation for Parkinson’s disease (the VANTAGE study): A non-randomised, prospective, multicentre, open-label study. Lancet Neurol. 2015;14:693-701.
• Referans14 Goetz CG, Tilley BC, Shaftman SR, Stebbins GT, Fahn S, Martinez-Martin P, et al. Movement disorder society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): Scale presentation and clinimetric testing results. Movement Disorders. 2008;23(15):2129-70.
• Referans15 National Parkinson Foundation. Available from: https://parkinson.org/Understanding-Parkinsons/What-is-Parkinsons/Stages-of-Parkinsons (Accessed 1 April 2018).
• Referans16 Aydemir Ö, Güvenir T, Küey L, Kültür S. Validity and reliability of Turkish Version of Hospital Anxiety and Depression Scale. Türk Psikiyatri Dergisi. 1997;8(4):280-7.
• Referans17 Öner N, Le Compte A. Durumluluk-Sürekli Kaygı Envanteri El Kitabı. 2. Baskı, İstanbul: Boğaziçi Yayınevi, 1998.
• Referans18 Hodkinson Abbreviated Mental Test. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2560932/ (Accessed 1 April 2018).
• Referans19 Parkinson's Disease Biomakers Program. Available from: https://pdbp-demo.cit.nih.gov/sites/default/files/assets/crfs/Modified%20Schwab%20and%20England%20Activities%20of%20Daily%20Living%20Scale.pdf (Accessed 01 April 2018).
• Referans20 Kalenka A, Schwarz A. Anaesthesia and Parkinson’s disease: how to manage with new therapies? Current Opinion in Anaesthesiology. 2009;22:419-24.
• Referans21 Holslag JAH, Neef N, Beudel M, Drost G, Oterdoom DLM, Kremer NI, et al. Deep brain stimulation for essential tremor: A comparison of Targets. World Neurosurgery. 2018;110:580-4.
• Referans22 Savaş A, Akbostancı C, Kanpolat Y. Surgical Treatment of Parkinson's Disease. Turkiye Klinikleri J Neurosurg-Special Topics. 2008;1(2):5-12.
• Referans23 Tabbal SD, Ushe M, Mink CW, Revilla F, Wernle AR, Hong M, et al. Unilateral subthalamic nucleus stimulation has a measurable ipsilateral effect on rigidity and bradykinesia in Parkinson Disease. Experimental Neurolog. 2008;211(1):234-42.
• Referans24 Slowınskı JL, Putzke JD, Uıttı RJ, Lucas JA, Turk MF, Kall BA, et al. Unilateral deep brain stimulation of the subthalamic nucleus for Parkinson Disease. Journal of Neurosurgery. 2007;106(4):626-32.
• Referans25 Llumiguano C, Kosztolany P, Kovacs N, Doczi T, Balas I. Bilateral STN DBS improves manual performance time in Parkinson's Disease. Movement Disorders. 2008;23(1):114-14.
• Referans26 Moro E, Lozano AM, Pollak P, Agid Y, Rehncrona S, Volkmann J, et al. Long-term results of a multicenter study on subthalamic and pallidal stimulation in Parkinson’s Disease. Movement Disorders. 2010;25(5):578-86.
• Referans27 Zhang JG, Zhang K, Ma Y, Hu H, Yang AC, Chu JS, et al. Follow-up of bilateral subthalamic deep brain stimulation for Parkinson's Disease. Acta Neurochir Supp. 2006;99:43-7.
• Referans28 Nilsson MH, Fransson PA, Jarnlo GB, Magnusson M, Rehncrona S. Research the effects of high frequency subthalamic stimulation on balance performance and fear of falling in patients with Parkinson's Disease. Journal of Neuroengineering and Rehabilitation. 2009;6(13):1-10.
• Referans29 Lubik S, Fogel W, Tronnier V, Krause M, König J, Jost WH. Gait analysis in patients with advanced Parkinson Disease: Different or additive effects on gait induced by levodopa and chronic STN stimulation. Journal of Neural Transmission. 2006;113(2):163-73.
• Referans30 Follett KA, Weaver FM, Stern M, Hur K, Harris CL, Luo P, et al. Pallidal versus subthalamic deep-brain stimulation for Parkinson's disease. New England Journal of Medicine. 2010;362:2077-91.
• Referans31 Kelly VE, Israel SM, Samii A, Slimp JC, Goodkin R, Shumway-Cook A. Assessing the effects of subthalamic nucleus stimulation on gait and mobility in people with Parkinson Disease. Disability and Rehabilitation. 2010;32(11):929-36.
• Referans32 Apaydın H, Emre M. Parkinson Hastalığında Demans ve Tedavisi. Türkiye Klinikleri Journal of Neurology. 2003;1(3):206-12.
• Referans33 Fraix V, Houeto JL, Lagrange C, Le Pen C, Krystkowiak P, Guehl D, et al. Clinical and economic results of bilateral subthalamic nucleus stimulation in Parkinson's Disease. Journal of Neurology, Neurosurgery and Psychiatry. 2006;77(4):443-9.
• Referans34 Witt K, Daniels C, Reiff J, Krack P, Volkmann J, Pinsker MO, et al. Neuropsychological and psychiatric changes after deep brain stimulation for Parkinson’s Disease: A randomized, multicentre study. The Lancet Neurology. 2008;7(7):605-14.
• Referans35 Zangaglia R, Pacchetti C, Pasotti C, Mancini F, Servello D, Sinforiani E, et al. Deep brain stimulation and cognitive functions in Parkinson's Disease: A three-year controlled study. Movement Disorders. 2009;24(11):1621-8.
• Referans36 Funkiewiez A, Ardouin C, Caputo E, Krack P, Fraix V, Klinger H, et al. Long term effects of bilateral subthalamic nucleus stimulation on cognitive function, mood, and behaviour in Parkinson’s Disease. Journal of Neurology, Neurosurgery and Psychiatry. 2004;75:834-9.
• Referans37 Appleby B, Duggan P, Regenberg A, Rabins PV. Psychiatric and neuropsychiatric adverse events associated with deep brain stimulation: A meta-analysis of ten years experience. Movement Disorders. 2007;22:1722-8.
• Referans38 Reijnders JS, Ehrt U, Weber WE, Aarsland D, Leentjens AF. A systematic review of prevalence studies of depression in Parkinson's disease. Movement Disorders. 2008;23(2):183-9.
• Referans39 Bhattacharjee S, Vadiei N, Goldstone L, Alrabiah Z, Sherman SJ. Patterns and predictors of depression treatment among older adults with Parkinson's Disease and depression in ambulatory care settings in the United States. Parkinson's Disease. 2018; https://doi.org/10.1155/2018/3402983 (in press).
• Referans40 Martínez-Martín P, Valldeoriola F, Tolosa E, Pilleri M, Molinuevo JL, Rumia J, et al. Bilateral subthalamic nucleus stimulation and quality of life in advanced Parkinson's Disease. Movement Disorders. 2002;17(2):372-7.
• Referans41 Wang X, Chang C, Geng N, Li N, Wang J, Ma J, et al. Long-term effects of bilateral deep brain stimulation of the subthalamic nucleus on depression in patients with Parkinsons Disease. Parkinsonism and Related Disorders. 2009;15(8):587-91.
• Referans42 Onur E, Yemez B, Cengizçetin N, Mertol S, Yaka E, Gürzyalçın N, et al. Factors affecting on depression and quality of life patients with Parkinson's disease. Archives of Neuropsychiatry. 2007;44(2):49-53.
• Referans43 Brozova H, Barnaure I, Alterman RL, Tagliati M. STN-DBS frequency effects on freezing of gait in advanced Parkinson Disease. Neurology. 2009;72(8):770-1.
• Referans44 Yamada K, Hamasaki T, Kuratsu Jİ. Subthalamic nucleus stimulation applied in the earlier vs. advanced stage of Parkinson’s Disease-retrospective evaluation of postoperative independence in pursuing daily activities. Parkinsonism and Related Disorders. 2009;15(10):746-51.
• Referans45 Powell DW, Blackmore SE, Puppa M, Lester D, Murray NG, Reed-Jones RJ, et al. Deep brain stimulation enhances movement complexity during gait in individuals with Parkinson's disease. Neuroscience Letters. 2018; https://doi.org/10.1016/j.neulet.2018.05.010 (in press).