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

Aged Case-Control Studies Deep Brain Stimulation / statistics & numerical data Female Hospitalization / statistics & numerical data Humans Male Middle Aged Parkinson Disease / diagnosis Pilot Projects Retrospective Studies

Deep brain stimulation Dementia Falls Non-motor symptoms Parkinson's disease Urinary symptoms

Journal

Journal of the neurological sciences

ISSN: 1878-5883

Titre abrégé: J Neurol Sci

Pays: Netherlands

ID NLM: 0375403

Informations de publication

Date de publication:
15 Oct 2019

Historique:

received: 20 11 2018

revised: 14 04 2019

accepted: 23 07 2019

pubmed: 3 9 2019

medline: 15 9 2020

entrez: 3 9 2019

Statut: ppublish

Résumé

The impact of deep brain stimulation (DBS) on cognitive and urinary disorders, falls, and eventually hospitalizations and mortality in Parkinson's disease (PD) is still debated. We compared the rates of dementia, mild cognitive impairment (MCI), urinary incontinence, nocturia, falls, hospitalizations, and mortality in a cohort of PD patients undergoing DBS with a cohort of medically-treated patients chosen as controls. We conducted a retrospective pilot study in six Italian DBS centers. 91 PD patients receiving DBS and 91 age- and gender-matched controls receiving the best medical treatment alone with a minimum follow-up of one year were enrolled. Clinical data were collected from baseline to the last follow-up visit using an ad-hoc developed web-based system. The risk of dementia was similar in the two groups while patients in the surgical cohort had lower rates of MCI, urinary incontinence, nocturia, and falls. In contrast, the risk of hospital admissions related to PD was higher in the surgical cohort. However, when excluding hospitalizations related to DBS surgery, the difference between the two cohorts was not significant. The surgical cohort had a lower number of hospitalizations not related to PD. The risk of death was similar in the two groups. Despite a higher risk of hospitalization, patients receiving DBS had a lower rate of MCI, urinary incontinence, nocturia and falls, without evidence of an increased risk of dementia and mortality. Although these findings need to be confirmed in prospective studies, they seem to suggest that DBS may play a significant role in the management of non-motor symptoms and common complications of advanced PD.

Sections du résumé

BACKGROUND BACKGROUND

The impact of deep brain stimulation (DBS) on cognitive and urinary disorders, falls, and eventually hospitalizations and mortality in Parkinson's disease (PD) is still debated.

OBJECTIVE OBJECTIVE

We compared the rates of dementia, mild cognitive impairment (MCI), urinary incontinence, nocturia, falls, hospitalizations, and mortality in a cohort of PD patients undergoing DBS with a cohort of medically-treated patients chosen as controls.

METHODS METHODS

We conducted a retrospective pilot study in six Italian DBS centers. 91 PD patients receiving DBS and 91 age- and gender-matched controls receiving the best medical treatment alone with a minimum follow-up of one year were enrolled. Clinical data were collected from baseline to the last follow-up visit using an ad-hoc developed web-based system.

RESULTS RESULTS

The risk of dementia was similar in the two groups while patients in the surgical cohort had lower rates of MCI, urinary incontinence, nocturia, and falls. In contrast, the risk of hospital admissions related to PD was higher in the surgical cohort. However, when excluding hospitalizations related to DBS surgery, the difference between the two cohorts was not significant. The surgical cohort had a lower number of hospitalizations not related to PD. The risk of death was similar in the two groups.

CONCLUSION CONCLUSIONS

Despite a higher risk of hospitalization, patients receiving DBS had a lower rate of MCI, urinary incontinence, nocturia and falls, without evidence of an increased risk of dementia and mortality. Although these findings need to be confirmed in prospective studies, they seem to suggest that DBS may play a significant role in the management of non-motor symptoms and common complications of advanced PD.

Identifiants

DOI: 10.1016/j.jns.2019.07.029 PMID: 31476620

pubmed: 31476620

pii: S0022-510X(19)30332-6

doi: 10.1016/j.jns.2019.07.029

pii:

doi:

Types de publication

Journal Article Multicenter Study Observational Study

Langues

eng

Sous-ensembles de citation

Pagination

116411