DOI: https://doi.org/10.22141/2224-0713.5.99.2018.142964

Experience of using deep brain stimulation in patients with Parkinson’s disease and psychoneurological comorbidities

K.R. Kostiuk, N.S. Vasyliv, V.L. Lomadze

Abstract


Background. Objective: to evaluate the efficacy of subthalamic nucleus deep brain stimulation in patients with Parkinson’s disease (PD) and psychoneurological comorbidities. Materials and methods. Thirteen patients with PD were enrolled in the study. Their age ranged from 37 to 70 years (mean 58.61 ± 5.43 years). Average duration of PD was 8.53 ± 1.82 years. Neuropsychological status was assessed before and after treatment by Unified Parkinson’s Disease Rating Scale (UPDRS) II, Hoehn and Yahr scale, Schwab and England scale, Mini­Mental State Exa­mination, Beck’s Depression Inventory, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale and the 39­Item Parkinson’s Disease Questionnaire (PDQ­39). Surgery was performed using CRW stereotactic system. Postoperative follow­up ranged from 1 to 7 years (mean 4.14 ± 0.42 years). Results. After surgery, tremor stopped and rigidity regressed in 12 (92.31 %) patients; regression of hypokinesia was observed in all 4 (100.00 %) persons who have had it before surgery. Six months after the surgery, UPDRS II score improved by 74.00 % in “On” period and by 62.90 % — in “Off” period. After treatment, the dose of levodopa decreased on average by 56.14 %. The majority of ope­rated patients noted a reduction of depression and anxiety, average improvement on the PDQ­39 was 30.00 %. There were no surgical complications. Conclusions. Psychoneurological disorders in patients with PD are directly dependent on the duration of the disease, the dose and duration of levodopa therapy. Deep brain stimulation is effective and safe method of surgical treatment for PD, which improves motor symptoms, reduces psychoemotional disorders and increases the quality of life.


Keywords


Parkinson’s disease; deep brain stimulation; subthalamic nucleus; psychoneurological disorders; quality of life

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