Long‐term results of bilateral pallidal stimulation in Parkinson's disease

TLDR

We followed up 11 patients for up to 5 years after bilateral pallidal deep brain stimulation for advanced Parkinson’s disease, and in four patients replacement of pallidal electrodes into the subthalamic nucleus restored initial benefit and allowed significant reduction of dopaminergic therapy. Dyskinesias remained significantly reduced, but the initial improvement in off‑period motor symptoms, fluctuations, and activities of daily living declined over time and was lost after the first year; however, in four patients replacement of pallidal electrodes into the subthalamic nucleus restored the initial benefit and reduced dopaminergic therapy.

Abstract

Abstract We followed up 11 patients for up to 5 years after bilateral pallidal deep brain stimulation for advanced Parkinson's disease. Dyskinesias remained significantly reduced until the last assessment. The initial improvement of off‐period motor symptoms and fluctuations, however, was not sustained and gradually declined. Beneficial effects of pallidal deep brain stimulation on activities of daily living in the on‐ and off‐period were lost after the first year. Replacement of pallidal electrodes into the subthalamic nucleus in four patients could restore the initial benefit of deep brain stimulation and allowed a significant reduction of dopaminergic drug therapy.