The aim of this study is to investigate the impact of DBS not only no motor outcomes, but also on neuropsychological and psychiatric aspects and on quality of life in young patients with a short history of disease.
Bilateral STN DBS is a powerful treatment for advanced Parkinson disease with Levodopa induced motor complications. The beneficial effects of STN stimulation on motor disability and quality of life have been proved. However, the mean delay before neurosurgery is currently 14 years after diagnosis, when medical treatment no longer controls PD symptoms and quality of life is already severely impaired. Aim of this study is to prospectively assess the effects of bilateral STN stimulation on motor signs, psychological and psychiatric aspects and quality of life in a group of 20 patients with PD who underwent surgery after 5 years from the onset of the disease. These results will be compared with those of a group of 20 patients with a PD history from more than 10 years. The two groups of patients will be evaluated at baseline and after 3 and 12 months from DBS implant; at each visit neurological and motor examinations were assessed and dedicated neuropsychological and psychiatric tests will be performed. Neurosurgery may be considered superior to medical treatment alone even in mild to moderate PD of 10 years duration, rather than a last resort in very advanced stages of the disease. Thanks to this study we could compare motor outcomes and cognitive aspects between DBS patients with a short and with long history of disease
Study Type
OBSERVATIONAL
Enrollment
40
Deep Brain Stimulation of STN in Parkinsonian patients
Azienda Ospedaliera Ospedali Riuniti di Bergamo
Bergamo, Lombardy, Italy
percentage of improvement in motor aspects
The primary objective of the study is calculates as: (UPDRS III 12 months - UPDRS III baseline)/UPDRS III baseline where UPDRS III 12 months means the score of this test in "medication off , stimulation on" condition at 12 months after implant, while UPDRS III baseline means the score of this test in "medication off " condition.
Time frame: after 12 months of stimulation
Neuropsychological aspects
Evaluation of changes in the * global cognitive efficiency * short tem memory * attention * logical/executive functions * abstract reasoning * verbal fluency tasks * visuospatial and visuoconstructional abilities
Time frame: after 3 and12 months of stimulation
Psychiatrical aspects
Evaluation of changes in depression assessed by the Beck Depression Inventory
Time frame: after 3 and12 months of stimulation
Quality of Life
Evaluation of changes in quality of life assessed by PDQ39
Time frame: after 3 and12 months of stimulation
Medication intake
Time frame: after 3 and12 months of stimulation
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