Introduction: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is known as a therapy of choice of advanced Parkinson's disease. The present study aimed to assess the beneficial and side effects of STN DBS in Moroccan Parkinsonian patients.Material and Methods: Thirty five patients underwent bilateral STN DBS from 2008 to 2016 in the Rabat University Hospital. Patients were assessed preoperatively and followed up for 6 to 12 months using the Unified Parkinson's Disease Rating Scale in four conditions (stimulation OFF and ON and medication OFF and ON), the levodopa-equivalent daily dose (LEDD), dyskinesia and fluctuation scores and PDQ39 scale for quality of life (QOL). Postoperative side effects were also recorded.Results: The mean age at disease onset was 42.31 ± 7.29 years [28–58] and the mean age at surgery was 54.66 ± 8.51 years [34–70]. The median disease duration was 11.95 ± 4.28 years [5–22]. Sixty-three percentage of patients were male. 11.4% of patients were tremor dominant while 45.71 showed akinetic-rigid form and 42.90 were classified as mixed phenotype. The LEDD before surgery was 1200 mg/day [800-1500]. All patients had motor fluctuations whereas non-motor fluctuations were present in 61.80% of cases. STN DBS decreased the LEDD by 51.72%, as the mean LEDD post-surgery was 450 [188-800]. The UPDRS-III was improved by 52.27%, dyskinesia score by 66.70% and motor fluctuations by 50%, whereas QOL improved by 27.12%. Post-operative side effects were hypophonia (2 cases), infection (3 cases), and pneumocephalus (2 cases).Conclusion: Our results showed that STN DBS is an effective treatment in Moroccan Parkinsonian patients leading to a major improvement of the most disabling symptoms (dyskinesia, motor fluctuation) and a better QOL.
The present study aims to adapt and to standardize the MDRS in the Moroccan population. The Moroccan Dementia Rating Scale was adapted in Arabic and was administered to 192 younger and older individuals without cognitive deficits (96 men and 96 women) whose ages ranged from 18 to 85 years old. To investigate the impact of age and schooling, participants were classified into three levels of education, and three age categories. The results show that age and level of education strongly influenced the performance of an average of 124/144 of the MDRS subjects who were tested.
Parkinson's disease (PD) is associated with an increased incidence of cognitive impairment and dementia. Population-based cohort of 25 patients with incident PD underwent a large neuropsychological battery. Executive functions were the most affected cognitive domain including particularly initiation, mental flexibility and inhibition. Episodic memory and visuo-spatial functions were less affected. We found that 92% of patients were classified as having Mild Cognitive Impairment (MCI); most of them experienced PD-MCI Single-Domain (17 patients) with disturbances on executive functions. Less frequently, we identified a group of patients with multiple-domain PD-MCI demonstrating deficits on executive functions as well as on episodic memory and/or visuospatial capacities.
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