Abstract

RUEDA-ACEVEDO, Mauricio; BASTIDAS BENAVIDES, José Libardo  and  BARENO SILVA, José. Efectiveness of deep brain stimulation of the subthalamic nucleus in patients with Parkinson's disease: experience in Antioquia. Acta Neurol Colomb. [online]. 2014, vol.30, n.3, pp.143-148. ISSN 0120-8748.

Introduction: Deep brain stimulation of the subthalamic nucleus is an effective therapy in the treatment of Parkinson's disease's motor symptoms. However, the success of the therapy depends on whether the patient fulfills the program's protocol, on the accuracy in the implantation of the electrodes, and the programming of the electrodes. Objective. To describe the results of a functional Neurosurgery program in Colombia. Materials and Methods: This is a observational cross-sectional study, where the results of deep brain stimulation performed in a cohort of 38 patients using the UPDRS -III scale are described, as well as changes of levodopa equivalent doses and surgical complications after one year of follow up. Results: A 51% decrease in the severity of the UPDRS-III motor scale after surgery was obtained in the On stimulation Off medication status one year after the procedure compared to the preoperative Off medication status. There was also significant reduction in the subscales of tremor (-84%), stiffness (-70%), bradykinesia (-44%), gait (-49%) and balance (-73%). There was no significant speech worsening (8%). The levodopa equivalent daily dose was reduced by 64%. The main postoperative complication was a display of confusion that was present in two patients. Conclusion: The results obtained by applying a structured protocol in patient selection, surgery and programming are consistent with the results described in the medical literature. These determining factors are very important in the implementation of DBS therapy and its justification on the cost-effectiveness paradigm.

Keywords : Deep brain stimulation; subthalamic nucleus; Parkinson's Disease.

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