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Three-Year Gait and Axial Outcomes of Bilateral STN and GPi Parkinson's Disease Deep Brain Stimulation

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机构: [1]Univ Florida, Norman Fixel Inst Neurol Dis, Dept Neurol, Gainesville, FL 32611 USA [2]Univ Florida, Dept Neurosurg, Norman Fixel Inst Neurol Dis, Gainesville, FL 32611 USA [3]Capital Med Univ, Dept Neurol, Xuanwu Hosp, Beijing, Peoples R China [4]Univ Florida, Dept Biomed Engn, Gainesville, FL USA [5]Univ Florida, Coll Hlth & Human Performance, Gainesville, FL USA
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关键词: deep brain stimulation globus pallidus internus (GPi) subthalamic nucleus (STN) long-term effect gait disability axial symptoms Parkinson's diasese

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Objective: To examine the short- and long-term clinical outcomes of the bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) on gait and axial symptoms in Parkinson's disease (PD) patients. Available data have been inconsistent and mostly short-term regarding the effect of both brain targets on gait and axial symptoms. We aimed to identify potential target specific differences at 3-year follow-up from a large single-center experience. Methods: We retrospectively reviewed short-term (6-month follow-up) and long-term (36-month follow-up) changes in the Unified Parkinson's Disease Rating Scale (UPDRS) Part II and III total scores of 72 PD patients (53 with bilateral STN-DBS and 19 with bilateral GPi-DBS). An interdisciplinary team made target-specific decisions for each DBS patient. We analyzed changes in gait and axial subscores derived from UPDRS II and III. Results: In both the STN- and GPi-DBS cohorts, we observed no significant differences in gait and axial UPDRS derived subscores in the off-med/on stimulation state at long-term follow-up when compared to baseline. On-med axial scores remained similar in the short-term but worsened in both groups (STN, 2.23 +/- 3.43, p < 0.001; GPi, 2.53 +/- 2.37, p < 0.01) in the long-term possibly due to disease progression. At long-term follow-up, the UPDRS III off-med/on stimulation scores worsened but were persistently improved from baseline in both groups (-9.07 +/- 13.9, p < 0.001). Conclusions: The study showed that long-term both STN- and GPi-DBS had a similar effect on gait and axial symptoms in UPDRS derived subscores at 36-month follow-up despite potential baseline differences in criteria for selection of each target. More sophisticated measures of gait and balance beyond the categorical UPDRS score will be needed for future studies.

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出版当年[2019]版:
大类 | 3 区 医学
小类 | 2 区 心理学 3 区 神经科学
最新[2023]版:
大类 | 3 区 医学
小类 | 3 区 神经科学 3 区 心理学
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出版当年[2018]版:
Q2 PSYCHOLOGY Q3 NEUROSCIENCES
最新[2023]版:
Q2 PSYCHOLOGY Q3 NEUROSCIENCES

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第一作者机构: [1]Univ Florida, Norman Fixel Inst Neurol Dis, Dept Neurol, Gainesville, FL 32611 USA [2]Univ Florida, Dept Neurosurg, Norman Fixel Inst Neurol Dis, Gainesville, FL 32611 USA [3]Capital Med Univ, Dept Neurol, Xuanwu Hosp, Beijing, Peoples R China
通讯作者:
通讯机构: [1]Univ Florida, Norman Fixel Inst Neurol Dis, Dept Neurol, Gainesville, FL 32611 USA [2]Univ Florida, Dept Neurosurg, Norman Fixel Inst Neurol Dis, Gainesville, FL 32611 USA [3]Capital Med Univ, Dept Neurol, Xuanwu Hosp, Beijing, Peoples R China
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