Deep Brain Stimulation in Moroccan Patients With Parkinson’s Disease: The Experience of Neurology Department of Rabat
Front. Neurol.. 2018-07-31; 9:
DOI: 10.3389/fneur.2018.00532
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Rahmani M(1), Benabdeljlil M(1), Bellakhdar F(2), Faris MEA(1), Jiddane M(3), Bayad KE(4), Boutbib F(1), Razine R(5), Gana R(2), Hassani MRE(3), Fatemi NE(2), Fikri M(3), Sanhaji S(1), Tassine H(4), Balrhiti IEA(1), Hadri SE(1), Kettani NE(3), Abbadi NE(2), Amor M(6), Moussaoui A(6), Semlali A(7), Aidi S(1),
Benhaddou EHA(4), Benomar A(4), Bouhouche A(4), Yahyaoui M(4), Khamlichi AE(8), Ouahabi AE(8), Maaqili RE(2), Tibar H(4), Arkha Y(8), Melhaoui A(8), Benazzouz A(9), Regragui W(4).
Author information:
(1)Research Team in Neurology and Neurogenetics, Department of Neurology A and
Neuropsychology, Faculty of Medicine and Pharmacy, Hôpital des Spécialités ONO,
University Mohammed V, Rabat, Morocco.
(2)Department of Neurosurgery, Faculty of Medicine and Pharmacy, Hôpital Ibn
Sina, University Mohammed V, Rabat, Morocco.
(3)Department of Neuroradiology, Faculty of Medicine and Pharmacy, Hôpital des
Spécialités ONO, University Mohammed V, Rabat, Morocco.
(4)Research Team in Neurology and Neurogenetics, Department of Neurology B and
Neurogenetics, Faculty of Medicine and Pharmacy, Hôpital des Spécialités ONO,
University Mohammed V, Rabat, Morocco.
(5)Laboratory of Biostatistics, Clinical Research and Epidemiology, Faculty of
Medicine and Pharmacy, University Mohammed V, Rabat, Morocco.
(6)Department of Anesthesia and Intensive Care, Faculty of Medicine and
Pharmacy, Hôpital des Spécialités ONO, University Mohammed V, Rabat, Morocco.
(7)Department of Surgical Intensive Care, Faculty of Medicine and Pharmacy,
Hôpital Ibn Sina, University Mohammed V, Rabat, Morocco.
(8)Department of Neurosurgery, Faculty of Medicine and Pharmacy, Centre de
Rehabilitation et de Neurosciences, Hôpital des Spécialités ONO, University
Mohammed V, Rabat, Morocco.
(9)Centre National de la Recherche Scientifique, Institut des Maladies
Neurodégénératives, Univ. de Bordeaux UMR 5293, Bordeaux, France.
Introduction: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is
known as a therapy of choice of advanced Parkinson’s disease. The present study
aimed to assess the beneficial and side effects of STN DBS in Moroccan
Parkinsonian patients. Material and Methods: Thirty five patients underwent
bilateral STN DBS from 2008 to 2016 in the Rabat University Hospital. Patients
were assessed preoperatively and followed up for 6 to 12 months using the
Unified Parkinson’s Disease Rating Scale in four conditions (stimulation OFF and
ON and medication OFF and ON), the levodopa-equivalent daily dose (LEDD),
dyskinesia and fluctuation scores and PDQ39 scale for quality of life (QOL).
Postoperative side effects were also recorded. Results: The mean age at disease
onset was 42.31 ± 7.29 years [28-58] and the mean age at surgery was 54.66 ±
8.51 years [34-70]. The median disease duration was 11.95 ± 4.28 years [5-22].
Sixty-three percentage of patients were male. 11.4% of patients were tremor
dominant while 45.71 showed akinetic-rigid form and 42.90 were classified as
mixed phenotype. The LEDD before surgery was 1200 mg/day [800-1500]. All
patients had motor fluctuations whereas non-motor fluctuations were present in
61.80% of cases. STN DBS decreased the LEDD by 51.72%, as the mean LEDD
post-surgery was 450 [188-800]. The UPDRS-III was improved by 52.27%, dyskinesia
score by 66.70% and motor fluctuations by 50%, whereas QOL improved by 27.12%.
Post-operative side effects were hypophonia (2 cases), infection (3 cases), and
pneumocephalus (2 cases). Conclusion: Our results showed that STN DBS is an
effective treatment in Moroccan Parkinsonian patients leading to a major
improvement of the most disabling symptoms (dyskinesia, motor fluctuation) and a
better QOL.
DOI: 10.3389/fneur.2018.00532
PMCID: PMC6080137
PMID: 30108543