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Prendes Fernández P, Blázquez Estrada M, Sol Álvarez J, Álvarez Martínez V, Suárez San Martín E, García Fernández C, Álvarez Carriles JC, Lozano Aragoneses B, Saiz Ayala A, Santamarta Liébana E, González Álvarez L. Analysis of deep brain stimulation of the subthalamic nucleus (STN-DBS) in patients with monogenic PRKN and LRRK2 forms of Parkinson's disease. Parkinsonism Relat Disord 2023; 107:105282. [PMID: 36657280 DOI: 10.1016/j.parkreldis.2023.105282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/24/2022] [Accepted: 01/07/2023] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Deep brain stimulation of the subthalamic nucleus (STN-DBS) is the most common surgical treatment for Parkinson's disease (PD). Patient selection and genetic background can modify the response to this treatment. The objective of this study was to compare both clinical and pharmacologic response of STN-DBS between patients with monogenic forms of PD and non-mutation carriers with idiopathic PD. METHODS A retrospective analysis among 23 carriers of genetic mutations (8 PRKN and 15 LRRK2) and 74 patients with idiopathic PD was performed. The study included comparisons of Unified Parkinson's Disease Rating Scale (UPDRS) II and III scores, Schwab and England (S&E) scale values, Hoehn & Yahr (H&Y) stage scores, and equivalent doses of levodopa before and after the surgery (at 6 and 12 months) between both groups. RESULTS The mean age at the time in which STN-DBS was performed was 59.5 ± 8.6. Linear mixed models showed the absence of statistically significant differences between mutation and non-mutation carriers regarding levodopa doses (p = 0.576), UPDRS II (p = 0.956) and III (p = 0.512) scores, and S&E scale scores (0.758). The only difference between the two groups was observed with respect to H&Y stage in OFF medication/ON stimulation status being lower in genetic PD at 6 months after surgery (p = 0.030). CONCLUSION Clinical and pharmacological benefit of bilateral STN-DBS is similar in PRKN and LRRK2 mutation carriers and patients with idiopathic PD.
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Affiliation(s)
- P Prendes Fernández
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 3011, Oviedo, Spain
| | - M Blázquez Estrada
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 3011, Oviedo, Spain; Servicio de Neurología. Hospital Universitario Central de Asturias (HUCA), 3011, Oviedo, Spain.
| | - J Sol Álvarez
- Servicio de Neurocirugía. Hospital Universitario Central de Asturias (HUCA), 3011, Oviedo, Spain
| | - V Álvarez Martínez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 3011, Oviedo, Spain; Laboratorio de Genética. Hospital Universitario Central de Asturias (HUCA), 3011, Oviedo, Spain
| | - E Suárez San Martín
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 3011, Oviedo, Spain; Servicio de Neurología. Hospital Universitario Central de Asturias (HUCA), 3011, Oviedo, Spain
| | - C García Fernández
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 3011, Oviedo, Spain; Servicio de Neurología. Hospital Universitario Central de Asturias (HUCA), 3011, Oviedo, Spain
| | - J C Álvarez Carriles
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 3011, Oviedo, Spain; Neuropsicología. Área de Gestión Clínica de Salud Mental. Hospital Universitario Central de Asturias (HUCA), 3011, Oviedo, Spain
| | - B Lozano Aragoneses
- Servicio de Neurofisiología. Hospital Universitario Central de Asturias (HUCA), 3011, Oviedo, Spain
| | - A Saiz Ayala
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 3011, Oviedo, Spain; Neurorradiología. Servicio de Radiodiagnóstico. Hospital Universitario Central de Asturias (HUCA), 3011, Oviedo, Spain
| | - E Santamarta Liébana
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 3011, Oviedo, Spain; Neurorradiología. Servicio de Radiodiagnóstico. Hospital Universitario Central de Asturias (HUCA), 3011, Oviedo, Spain
| | - L González Álvarez
- Servicio de Neurología. Hospital Universitario Central de Asturias (HUCA), 3011, Oviedo, Spain
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