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Bilateral STN DBS improved the mean total Unified Parkinson's Disease Rating Scale motor score by 54%, whereas unilateral stimulation improved motor scores only 23%. Unilateral STN DBS improved postural stability and gait 14%, other axial motor features 19%, and overall parkinsonism in limbs contralateral to stimulation by 46%, including an 86% improvement in contralateral tremor. However, bilateral STN DBS resulted in greater improvement in each of these domains, including limb function, i.e., the reduction in scores from the limbs on one side was greater with bilateral than with unilateral stimulation of the contralateral STN. Bilateral STN DBS improves parkinsonism considerably more than unilateral STN DBS; bilateral simultaneous elec trode implantation may be the most appropriate surgical option for patients with significant bilateral disability. Unilateral STN DBS results in moderate improvement in all aspects of off-period parkinsonism and improves tremor as much as is typically re ported with DBS of the ventral intermedius nucleus of the thalamus (Vim). For this reason, STN DBS may be a more appropriate choice than Vim DBS or thalamotomy for parkinsonian tremor. Some patients with highly asymmetric tremor-dominant PD might be app ropriately treated with unilateral instead of bilateral STN DBS. |
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disability rating scale,neurological
Parkinson disease
Parkinson disease,surgical treatment of
Parkinson disease,treatment of
stimulation,deep brain
subthalamic nucleus
subthalamic nucleus deep brain stimulation
treatment of neurologic disorder
tremor
tremor,surgical treatment of
tremor,thalamic stimulation for suppression of
tremor,treatment of
Unified Parkinson Rating Scale
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