Effectiveness of deep brain stimulation in Parkinson's disease treatment with Single-center experience in Pakistan

Abstract

Objective: To assess the effectiveness and accuracy of deep brain stimulation in Parkinsonian Disease (PD).

Methods: This study was a descriptive prospective study, and patients were treated at Neurospinal and Cancer Care Institute Karachi, from February 1, 2016, to June 30, 2020. We had 21 cases of parkinsonian disease. Inclusion criteria was Idiopathic Parkinson's disease, marked motor fluctuations against the response to dopaminergic therapy, UPDRS-III scores, which is 30 or higher, with a duration of disease of five years or longer, developing dyskinesia while the exclusion criteria was patient with known comorbid or active psychiatric disease.

Results: Mean age of patient was 64 years. The standard deviation was 1.11697. The male patients' mean, median and mode had a standard deviation of 0.3. For the duration of disease, the mean was 1.4, the median 1 (5-6 years) and mode one. The standard deviation was 0.51177. The primary symptoms' mean was 2.2857, the median was 2.0, and the mode was two (tremor). The mean on medication (age) was 2 (45-49), and the median and mode were the same.

Conclusion: Deep brain stimulation (DBS) is an effective treatment option for a carefully selected patient. DBS improves tremors, dyskinesias, rigidity, motor fluctuations and bradykinesia. DBS is unlikely to benefit Autonomic dysfunction, cognitive disorders, hypophonia, and postural instability. Although it is an expensive treatment compared to lesioning or gamma knife, it is reversible.

Keywords: Deep brain stimulation; Levodopa; Motor fluctuation; Parkinsonian disease; Tremor.

Fig.1

Showing post DBS x-ray. We can appreciate leads and Internal pulse generator (with patient’s permission).