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Journal of Neurology

, Volume 256, Issue 10, pp 1736–1741 | Cite as

Reduced levodopa-induced complications after 5 years of subthalamic stimulation in Parkinson’s disease: a second honeymoon

  • Clemence Simonin
  • M. Tir
  • D. Devos
  • A. Kreisler
  • K. Dujardin
  • J. Salleron
  • A. Delval
  • S. Blond
  • L. Defebvre
  • A. Destée
  • P. Krystkowiak
Original Communication

Abstract

The purpose of this paper is to describe the effect of 5 years of subthalamic nucleus deep brain stimulation (STN DBS) on levodopa-induced complications, both in everyday life and during an acute challenge with levodopa. Thirty three patients were evaluated during an acute levodopa challenge before surgery and then 1 and 5 years afterwards (both off stim and on stim), using the UPDRS III scale and the CAPSIT-PD scales for dystonia and peak-dose dyskinesia. The UPDRS IV scale was used to assess motor complications in everyday life. The levodopa daily dose and DBS parameters were also recorded. Levodopa-induced complications in everyday life (UPDRS IV) and during an acute levodopa challenge had improved markedly after 1 year (both on and off stim) and still further at 5 years. Peak-dose dyskinesia decreased between the 1- and 5-year measurements. STN DBS decreases levodopa-induced motor complications over the long term. This phenomenon may be explained by (a) overall stabilization of the basal ganglia network and (b) striatal synaptic changes. Our results suggest that DBS leads to both qualitative and quantitative modulations in the corticostriatal loops.

Keywords

Parkinson’s disease (including surgical treatment) Dyskinesia Fluctuations Long-term outcome 

Notes

Conflict of interest statement

The authors have no conflicts of interest to report.

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Clemence Simonin
    • 1
    • 5
  • M. Tir
    • 1
    • 6
  • D. Devos
    • 1
  • A. Kreisler
    • 1
  • K. Dujardin
    • 1
  • J. Salleron
    • 4
  • A. Delval
    • 1
    • 2
  • S. Blond
    • 3
  • L. Defebvre
    • 1
  • A. Destée
    • 1
  • P. Krystkowiak
    • 1
    • 7
  1. 1.Department of Neurology and Movement Disorders, Salengro Hospital, EA 2683Lille University Medical CenterLilleFrance
  2. 2.Department of Neurophysiology, Salengro Hospital, EA 2683Lille University Medical CenterLilleFrance
  3. 3.Department of Neurosurgery, Salengro Hospital, EA 2683Lille University Medical CenterLilleFrance
  4. 4.Department of Biostatistics, Faculty of MedicineLille UniversityLilleFrance
  5. 5.Service de Neurologie AHôpital Roger SalengroLille CedexFrance
  6. 6.Department of NeurologyMignot Versailles HospitalVersaillesFrance
  7. 7.Department of NeurologyCNRS UMR 8160, Amiens University HospitalAmiensFrance

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