Journal article
Initial Results of Bilateral Subthalamic Nucleus Stimulation for Parkinson Disease in a Newly Established Center in a Developing Country: Shiraz, Southern Iran
World neurosurgery, Vol.121, pp.e129-e135
01/2019
DOI: 10.1016/j.wneu.2018.09.035
PMID: 30236810
Abstract
To report the establishment of a new center for deep brain stimulation (DBS) as a surgical treatment for Parkinson disease and the surgical outcomes, from 2014 to 2017 in Shiraz, Southern Iran.
A new treatment program was established in Shiraz through a multidisciplinary team in 2014. Thirty-four patients underwent implantation of subthalamic nucleus (STN) electrodes during the last 3 years. Twenty-five patients fulfilled the minimum 6-month follow-up criteria. The baseline Unified Parkinson Disease Rating Scale (UPDRS) was assessed 1 month before surgery in both off-medication and on-medication states by a movement disorder neurologist. To evaluate the outcomes, subscores of the UPDRS were assessed in all patients before surgery and at least 6 months after the operation.
All 25 patients had advanced Parkinson disease categorized as stage 3 or 4 using the Hoehn and Yahr scale. STN DBS resulted in a dramatic improvement in motor function of most patients. A reduction in dopaminergic medication dosage (average 60% reduction) was observed. The mean improvement was 40% in UPDRS II and 67% in UPDRS III. No surgical or hardware complications were observed. Stimulation-related adverse effects, including increased falling and worsening of speech, occurred in a few patients after surgery. Most of the patients experienced weight gain after surgery.
Bilateral STN DBS is a satisfactory and safe treatment for carefully selected patients with advanced Parkinson disease. According to the results, the procedure can be performed safely and with comparable results in developing countries around the world.
Details
- Title: Subtitle
- Initial Results of Bilateral Subthalamic Nucleus Stimulation for Parkinson Disease in a Newly Established Center in a Developing Country: Shiraz, Southern Iran
- Creators
- Ali Razmkon - Kowsar HospitalOmid Yousefi - Kowsar HospitalRaziyeh Rezaei - Kowsar HospitalSina Salehi - Shiraz University of Medical SciencesPeyman Petramfar - Shiraz University of Medical SciencesArash Mani - Shiraz University of Medical SciencesHashem Rahmati - Shiraz University of Medical SciencesJanardan Vaidyanathan - MedtronicGhazal Ilami - Kowsar HospitalYalda Amirmoezzi - Kowsar Hospital
- Resource Type
- Journal article
- Publication Details
- World neurosurgery, Vol.121, pp.e129-e135
- DOI
- 10.1016/j.wneu.2018.09.035
- PMID
- 30236810
- NLM abbreviation
- World Neurosurg
- ISSN
- 1878-8750
- eISSN
- 1878-8769
- Publisher
- Elsevier Inc
- Language
- English
- Date published
- 01/2019
- Academic Unit
- Neurology
- Record Identifier
- 9985014709002771
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