Evaluation of preoperative efficacy of levodopa in subthalamic deep brain stimulation

被引:0
作者
Liu, Wen [1 ,2 ]
Zhang, Xiumin [1 ,2 ]
Nie, Pan [1 ,2 ]
Chen, Lidao [1 ,2 ]
Fu, Kai [1 ,2 ]
Zhang, Jibo [1 ,2 ]
Chen, Jincao [1 ,2 ]
Zhang, Jie [1 ,2 ]
机构
[1] Wuhan Univ, Zhangnan Hosp, Dept Neurosurg, 169 Donghu Rd, Wuhan 430071, Hubei, Peoples R China
[2] Wuhan Univ, Zhangnan Hosp, Ctr Funt Neurosurg, 169 Donghu Rd, Wuhan 430071, Hubei, Peoples R China
来源
AMERICAN JOURNAL OF TRANSLATIONAL RESEARCH | 2022年 / 14卷 / 03期
关键词
Deep brain stimulation; microelectrode recording; levodopa; subthalamic nucleus; INTRAOPERATIVE MICROELECTRODE RECORDINGS; PARKINSONS-DISEASE; GENERAL-ANESTHESIA; BASAL GANGLIA; NUCLEUS; THERAPY;
D O I
暂无
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Objective: Withdrawal of levodopa (L-dopa) the night before subthalamic nucleus-deep brain stimulation (STN-DBS) procedures have been a standard practice, although some patients experienced severe withdrawal symptoms. In this cohort study, we investigated the effects of continuing preoperative L-dopa therapy on intraoperative microelectrode recording (MER), intraoperative cooperation and the clinical outcome for deep brain stimulation (DBS) which was performed under local anesthesia. Methods: The study included 99 patients with Parkinson's disease who were treated with bilateral STN-DBS between October 2014 and August 2018. The patients were followed for 12 months postoperatively and divided into "on-medication" and "off-medication" groups. The length of MER recordings, the number of microelectrode tracks, intraoperation cooperation, operation duration, and clinical outcomes were compared between the two groups. Results: The length of MER recording was longer in the "on-medication" group in both the left and right subthalamic nucleus (STN; P<0.001 and P=0.007, respectively). The unified Parkinson's disease rating scale (UPDRS) motor score indicated better improvement in the "on-medication" group at postoperative one month, six months and twelve months (P=0.045, P=0.034 and P=0.001 respectively). Patients in "on-medication" group could cooperate better with a shorter operation duration (177.9 vs. 195 min, P=0.038). Reduction in L-dopa equivalent dose (LED) and improvement of Hoehn-Yahr scale were comparable between the two groups during the follow-up period. Conclusion: The continuation of L-dopa therapy prior to DBS procedures had no impediment on MER and can contribute to reducing the duration of operation, and benefit the electrode insertion, as well as the clinical outcomes.
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页码:1909 / 1922
页数:14
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