Side-effects of subthalamic stimulation in Parkinson’s disease: Clinical evolution and predictive factors

D. Guehl, E. Cuny, A. Benazzouz, A. Rougier, F. Tison, S. Machado, D. Grabot, C. Gross, B. Bioulac, P. Burbaud
Eur J Neurol. 2006-09-01; 13(9): 963-971
DOI: 10.1111/j.1468-1331.2006.01405.x

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1. Eur J Neurol. 2006 Sep;13(9):963-71. doi: 10.1111/j.1468-1331.2006.01405.x.

Side-effects of subthalamic stimulation in Parkinson’s disease: clinical
evolution and predictive factors.

Guehl D(1), Cuny E, Benazzouz A, Rougier A, Tison F, Machado S, Grabot D, Gross
C, Bioulac B, Burbaud P.

Author information:
(1)Service de Neurophysiologie Clinique, Hôpital Pellegrin, Place Amélie-Rabat
Léon, Bordeaux, France.

Chronic bilateral high-frequency stimulation of the subthalamic nucleus (STN) is
an alternative treatment for disabling forms of Parkinson’s disease when on-off
fluctuations and levodopa-induced dyskinesias compromise patients’ quality of
life. The aim of this study was to assess the evolution of side-effects during
the first year of follow-up and search for clinical predictive factors
accounting for their occurrence. We compared the frequency of side-effects at 3
and 12 months after surgery in a cohort of 44 patients. The off-medication
scores of Unified Parkinson’s Disease Rating Scale (UPDRS) II, III, axial
symptoms, disease duration and age at surgery were retained for correlation
analysis. Dysarthria/hypophonia, weight gain and postural instability were the
most frequent chronic side-effects. Whereas dysarthria/hypophonia remained
stable over time, weight gain and postural instability increased during the
first year post-op. High axial and UPDRS II scores at surgery were predictive of
dysarthria/hypophonia. Age and axial score at surgery were positively correlated
with postural instability. Despite the occurrence of side-effects, the
benefit/side-effects ratio of STN stimulation was largely positive during the
first year of follow-up. Age, intensity of axial symptoms and UDPRS II
off-medication score before surgery are predictive factors of
dysarthria/hypophonia and postural instability after surgery.

DOI: 10.1111/j.1468-1331.2006.01405.x
PMID: 16930362 [Indexed for MEDLINE]

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