Management of antiparkinsonian therapy during chronic subthalamic stimulation in Parkinson's disease

Parkinsonism & Related Disorders
Maurizio ZibettiLeonardo Lopiano

Abstract

This article reports the detailed analysis of antiparkinsonian drug therapy in 78 consecutive Parkinson's disease (PD) patients undergoing deep brain stimulation (DBS) of the subthalamic nucleus (STN). The amount and type of antiparkinsonian drugs--including L-dopa, dopamine receptor agonists, associated drugs such as catechol-O-methyl transferase and monoamine oxidase inhibitors, amantadine and anticholinergics--were quantified before surgery and at two control visits 1 and 3 years following chronic STN stimulation. The L-dopa mean daily dose was reduced by approximately 60% after 1 year and remained stable after 3 years. Apomorphine, bromocriptine, tolcapone and selegiline were withdrawn after STN-DBS. Three years postoperatively, 9 patients (11.5%) no longer required L-dopa and 6 patients (7.7%) completely stopped all dopaminergic medications. More patients were on monotherapy with either L-dopa or dopamine receptor agonist, and fewer patients required combined treatment of dopamine receptor agonist and L-dopa compared with the pre-surgical condition. Dopaminergic drug treatment is persistently reduced and simplified following chronic STN-DBS for up to 3 years.

References

Nov 16, 2004·Parkinsonism & Related Disorders·P David CharlesThomas L Davis
Mar 18, 2006·Journal of Neurology, Neurosurgery, and Psychiatry·V FraixUNKNOWN SPARK Study Group
Apr 20, 2006·Parkinsonism & Related Disorders·Yasin TemelVeerle Visser-Vandewalle

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Citations

Sep 10, 2014·Expert Opinion on Drug Metabolism & Toxicology·Thomas Müller
Sep 15, 2012·Movement Disorders : Official Journal of the Movement Disorder Society·Frances M WeaverDolores Ippolito
Jan 1, 2015·Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova·E V BrilV A Shabalov

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