Author(s)

Atsushi Umemura^1,2, Miwako Miyata³, Yuichi Oka⁴, Kenji Okita⁵, Genko Oyama⁶, Yasushi Shimo^1,6, Nobutaka Hattori⁶

¹Department of Research and Therapeutics for Movement Disorders, Juntendo University Graduate School of Medicine, Tokyo, Japan.
²Department of Neurosurgery, Juntendo University Graduate School of Medicine, Tokyo, Japan.
³Health Assistant Information Technology Course, Department of Human Care Engineering, Faculty of Health Science, Nihon Fukushi University, Aichi, Japan.
⁴Department of Neurosurgery, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
⁵Department of Neurology, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
⁶Department of Neurology, Juntendo University Graduate School of Medicine, Tokyo, Japan.

Background: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is widely performed for medically refractory Parkinson’s disease (PD). Several western studies have examined the long-term outcomes of STN DBS. However, the long-term outcomes in Japanese patients have not been reported. Methods: We studied the long-term outcomes of STN DBS in Japanese patients with PD. Fifty-five consecutive patients treated with bilateral STN DBS were followed for 5 years after surgery. Each patient underwent Unified Parkinson’s Disease Rating Scale assessments preoperatively and 1 and 5 years after surgery. Results: Twelve patients (22%) were lost to follow up within 5 years. Among them, 7 died and 5 became bed ridden because of PD deterioration. In the 43 patients followed for 5 years, STN DBS significantly improved motor function. The cardinal motor symptoms of tremor, rigidity, and bradykinesia in medication-on periods were significantly better than baseline 5 years after DBS. However, axial motor symptoms of speech, gait and postural stability gradually deteriorated and significantly worsened 5 years after DBS. Motor complications, including dyskinesia and motor fluctuations, significantly improved after DBS with a marked reduction in dopaminergic medication. These effects were maintained 5 years after DBS. Frequently, persisting adverse effects included apraxia of eyelid opening and dysarthria. Conclusions: STN DBS significantly improved motor symptoms in patients with advanced PD. These effects were maintained over 5 years in most patients. However, some showed rapid PD progression even after STN DBS. Other treatments for the axial symptoms and disease progression are needed in long-term PD treatment.

Deep Brain Stimulation, Subthalamic Nucleus, Parkinson’s Disease, Long-Term Outcome, Adverse Effect

Umemura, A. , Miyata, M. , Oka, Y. , Okita, K. , Oyama, G. , Shimo, Y. and Hattori, N. (2015) Five-Year Outcomes of Bilateral Subthalamic Nucleus Stimulation in Japanese Patients with Parkinson’s Disease. Advances in Parkinson's Disease, 4, 21-27. doi: 10.4236/apd.2015.42004.