The impact of subthalamic deep-brain stimulation in restoring motor symmetry in Parkinson's disease patients: a prospective study - Archive ouverte HAL Access content directly
Journal Articles Journal of Neurology Year : 2024

The impact of subthalamic deep-brain stimulation in restoring motor symmetry in Parkinson's disease patients: a prospective study

Olivier Rascol
Amaury de Barros
Elodie Hainque
  • Function : Author
  • PersonId : 1020281
Ana Marques-Raquel
Alexandre Eusebio
  • Function : Author
  • PersonId : 899214
Isabelle Benatru
  • Function : Author
Dominique Guehl
  • Function : Author
Cécile Hubsch
  • Function : Author
  • PersonId : 1293142

Abstract

Background and objectives: The impact of subthalamic deep-brain stimulation (STN-DBS) on motor asymmetry and its influence on both motor and non-motor outcomes remain unclear. The present study aims at assessing the role of STN-DBS on motor asymmetry and how its modulation translates into benefits in motor function, activities of daily living (ADLs) and quality of life (QoL). Methods: Postoperative motor asymmetry has been assessed on the multicentric, prospective Predictive Factors and Subthalamic Stimulation in Parkinson's Disease cohort. Asymmetry was evaluated at both baseline (pre-DBS) and 1 year after STN-DBS. A patient was considered asymmetric when the right-to-left MDS-UPDRS part III difference was ≥ 5. In parallel, analyses have been carried out using the absolute right-to-left difference. The proportion of asymmetric patients at baseline was compared to that in the post-surgery evaluation across different medication/stimulation conditions. Results: 537 PD patients have been included. The proportion of asymmetric patients was significantly reduced after both STN-DBS and medication administration (asymmetric patients: 50% in pre-DBS MedOFF, 35% in MedOFF/StimON, 26% in MedON/StimOFF, and 12% in MedON/StimON state). Older patients at surgery and with higher baseline UPDRS II scores were significantly less likely to benefit from STN-DBS at the level of motor asymmetry. No significant correlation between motor asymmetry and ADLs (UPDRS II) or overall QoL (PDQ-39) score was observed. Asymmetric patients had significantly higher mobility, communication, and daily living PDQ-39 sub-scores. Conclusions: Both STN-DBS and levodopa lead to a reduction in motor asymmetry. Motor symmetry is associated with improvements in certain QoL sub-scores.
No file

Dates and versions

hal-04480277 , version 1 (27-02-2024)

Identifiers

Cite

Raquel Pinheiro Barbosa, Caroline Moreau, Anne Sophie Rolland, Olivier Rascol, Christine Brefel-Courbon, et al.. The impact of subthalamic deep-brain stimulation in restoring motor symmetry in Parkinson's disease patients: a prospective study. Journal of Neurology, 2024, Journal of Neurology, ⟨10.1007/s00415-023-12162-7⟩. ⟨hal-04480277⟩
33 View
0 Download

Altmetric

Share

Gmail Mastodon Facebook X LinkedIn More