Deep brain stimulation in Parkinson's disease: A multicentric, long-term, observational pilot study

Scelzo, Emma; Beghi, Ettore; Rosa, Manuela; Angrisano, Serena; Antonini, Angelo; Bagella, C.; Bianchi, Elisa; Caputo, E.; Lena, Francesco; Lopiano, Leonardo; Marcante, Andrea; Marceglia, Sara; Massaro, Francesco Mirko; Modugno, Nicola; Pacchetti, Claudio; Pilleri, Manuela; Pozzi, Nicoló Gabriele; Romito, Luigi; Santilli, Marco; Tamma, Filippo; Weis, Luca; Zibetti, Maurizio; Priori, Alberto

doi:10.1016/j.jns.2019.07.029

Cited by 8 publications

(15 citation statements)

References 42 publications

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“…30 The most recent study in this area is an Italian mulitcenter study of long-term outcomes among DBS recipients (n = 91) who were age-and gender-matched to non-DBS controls (n = 91), in which a minimum of 1-year follow-up for all patients was required. 13 Mortality rates were similar between groups, which may reflect the minimal total follow-up time for each group (367.5 and 230.7 person-years for the DBS group and non-DBS group, respectively). Our study is the first community-based study to examine differences in survival between PD patients treated with DBS and patients who were medically managed.…”

Section: Discussionmentioning

confidence: 78%

“…A number of studies have examined survival after DBS surgery for PD; [11][12][13][14][24][25][26][27][28][29] however, few studies have compared the survival of DBS recipients to that of non-DBS controls with PD. [11][12][13][14] Of reports comparing DBS recipients to patients that were medically managed, average survival effects are difficult to approximate due to design and analysis variability across studies. The first study on this topic was a single center study in the United Kingdom that examined survival between patients with severe PD who were eligible for and offered DBS between 2002 and 2012.…”

Section: Discussionmentioning

confidence: 99%

“…36 Most recently, a small pilot observational study found that patients treated with DBS (n = 91) had a non-significantly reduced risk of injurious falls compared to non-DBS controls (n = 91) (adjusted relative risk: 0.61, 95% CI: 0.25-1.46). 13 Our study of the long-term risk of falling between DBS and non-DBS groups includes the largest number of individuals with PD and greatest total number of person-years follow-up. We show that DBS recipients were more likely to require medical intervention for a fall than medically managed patients.…”

Section: Discussionmentioning

confidence: 99%

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Survival and Health Care Use After Deep Brain Stimulation for Parkinson’s Disease

Crispo

Lam²,

Le³

et al. 2020

Can. J. Neurol. Sci.

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Objectives: To compare long-term survival of Parkinson's disease (PD) patients with deep brain stimulation (DBS) to matched controls, and examine whether DBS was associated with differences in injurious falls, long-term care, and home care. Methods: Using administrative health data (Ontario, Canada), we examined DBS outcomes within a cohort of individuals diagnosed with PD between 1997 and 2012. Patients receiving DBS were matched with non-DBS controls by age, sex, PD diagnosis date, time with PD, and a propensity score. Survival between groups was compared using the log-rank test and marginal Cox proportional hazards regression. Cumulative incidence function curves and marginal subdistribution hazard models were used to assess effects of DBS on falls, long-term care admission, and home care use, with death as a competing risk. Results: There were 260 DBS recipients matched with 551 controls. Patients undergoing DBS did not experience a significant survival advantage compared to controls (log-rank test p = 0.50; HR: 0.89, 95% CI: 0.65-1.22). Among patients <65 years of age, DBS recipients had a significantly reduced risk of death (HR: 0.49, 95% CI: 0.28-0.84). Patients receiving DBS were more likely than controls to receive care for falls (HR: 1.56, 95% CI: 1.19-2.05) and home care (HR: 1.59, 95% CI: 1.32-1.90), while long-term care admission was similar between groups. Conclusions: Receiving DBS may increase survival for younger PD patients who undergo DBS. Future studies should examine whether survival benefits may be attributed to effects on PD or the absence of comorbidities that influence mortality. RÉSUMÉ : Taux de survie et utilisation des soins de santé dans le cas de patients atteints de la maladie de Parkinson ayant bénéficié de la stimulation cérébrale profonde. Objectifs : Comparer le taux de survie à long terme de patients atteints de la maladie de Parkinson (MP) qui ont bénéficié de la stimulation cérébrale profonde (SCP) à celui de témoins appariés ; analyser dans quelle mesure la SCP a été associée à des variations en ce qui concerne le nombre de chutes avec blessures et la nécessité de soins de longue durée et de soins à domicile. Méthodes : C'est au moyen de données administratives ontariennes du domaine de la santé, plus précisément une cohorte d'individus chez qui l'on a diagnostiqué la MP entre 1997 et 2012, que nous nous sommes attardés aux effets de la SCP. Des patients ayant bénéficiée de ce traitement ont ainsi été appariés en fonction de l'âge, du sexe, de la date du diagnostic de MP, de la durée de cette maladie et des scores de propension (propensity score) à des témoins qui n'en ont pas bénéficié. Les taux de survie de ces deux groupes ont été comparés au moyen du test de Mantel-Haenszel et du modèle de régression de Cox (MRC). Des courbes estimant la fonction d'incidence cumulée (cumulative incidence function curves) et des modèles de risque basés sur une sous-distribution marginale (marginal subdistribution hazard models) ont également été utilisés pour évaluer les effets de la SCP ...

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Survival and Health Care Use After Deep Brain Stimulation for Parkinson’s Disease

Crispo

Lam²,

Le³

et al. 2020

Can. J. Neurol. Sci.

View full text Add to dashboard Cite

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“…For nocturia, extended release of levodopa administered at bed-time was also found to be effective for PD patients [ 78 ]. Additionally, based on altered brain-bladder relationship in PD patients, recent several independent studies found that deep brain stimulations significantly alleviated urinary dysfunctions including urinary frequency, urgency, incontinence, and nocturia [ 79 , 80 ]. Treatment of the obstructive urinary symptoms depends on the etiology.…”

Section: Treatment Options For Autonomic Dysfunctions In Pdmentioning

confidence: 99%

Autonomic Dysfunctions in Parkinson’s Disease: Prevalence, Clinical Characteristics, Potential Diagnostic Markers, and Treatment

Zhang

Chen

2020

Parkinson's Disease

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Parkinson’s disease (PD) is a common neurodegenerative disease in the middle-aged and the elderly. Symptoms of autonomic dysfunctions are frequently seen in PD patients, severely affecting the quality of life. This review summarizes the epidemiology, clinical manifestations, and treatment options of autonomic dysfunctions. The clinical significance of autonomic dysfunctions in PD early diagnosis and differential diagnosis is also discussed.

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“…W leczeniu zaburzeń ze strony układu moczowego stosuje się terapię behawioralną i leki przeciwcholinergiczne -zmniejszają one kurczliwość mięśnia wypieracza. Udowodniono również, iż u pacjentów leczonych głęboką stymulacją mózgu (DBS) jądra podwzgórzowego włączenie stymulatora powoduje normalizację odruchu oddawania moczu [41].…”

Section: Zaburzenia Oddawania Moczuunclassified

Diagnosis of Autonomic Disorders in Parkinson’s Disease

Dutkiewicz

Friedman

2020

Wiad Lek

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Deep brain stimulation in Parkinson's disease: A multicentric, long-term, observational pilot study

Cited by 8 publications

References 42 publications

Survival and Health Care Use After Deep Brain Stimulation for Parkinson’s Disease

Survival and Health Care Use After Deep Brain Stimulation for Parkinson’s Disease

Autonomic Dysfunctions in Parkinson’s Disease: Prevalence, Clinical Characteristics, Potential Diagnostic Markers, and Treatment

Diagnosis of Autonomic Disorders in Parkinson’s Disease

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