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

Raquel Pinheiro Barbosa¹, Caroline Moreau^{2

3}, Anne Sophie Rolland^{2

3}, Olivier Rascol¹, Christine Brefel-Courbon¹, Fabienne Ory-Magne¹, Paulo Bastos¹, Amaury de Barros¹, Elodie Hainque⁴, Tiphaine Rouaud⁵, Ana Marques⁶, Alexandre Eusebio⁷, Isabelle Benatru⁸, Sophie Drapier⁹, Dominique Guehl¹⁰, David Maltete^{11

12}, Christine Tranchant^{13

14

15}, Thomas Wirth^{13

14

15}, Caroline Giordana¹⁶, Melissa Tir^{17

18}, Stephane Thobois^{19

20}, Lucie Hopes²¹, Cecile Hubsch²², Bechir Jarraya^{23

24}, Jean Christophe Corvol⁴, Matthieu Bereau^{25

26}, David Devos^#^{2

3}, Margherita Fabbri^#²⁷; PREDISTIM Group

Affiliations

¹ Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Centre d'Investigation Clinique CIC1436, NeuroToul COEN Center, Toulouse, NS-PARK/FCRIN Network, University Hospital of Toulouse, Toulouse, France.
² Department of Medical Pharmacology, Neurology, Referent Center of Parkinson's Disease, CHU of Lille, Univ. Lille Neuroscience & Cognition, Inserm, UMR-S1172, Licend, NS-PARK/FCRIN Network, 59000, Lille, France.
³ Movement Disorders Department, Referent Center of Parkinson's Disease, CHU of Lille, Univ. Lille Neuroscience & Cognition, Inserm, UMR-S1172, Licend, NS-PARK/FCRIN Network, 59000, Lille, France.
⁴ Department of Neurology, NS-PARK/FCRIN Network, France, Sorbonne Université, Paris Brain Institute-ICM, Inserm, CNRS, Assistance Publique Hôpitaux de Paris, Paris, France.
⁵ Department of Neurology, NS-PARK/FCRIN Network, Nantes University Hospital, 44093, Nantes Cedex, France.
⁶ Neurology Department, NS-PARK/FCRIN Network, Université Clermont Auvergne, EA7280, Clermont-Ferrand University Hospital, 63000, Clermont-Ferrand, France.
⁷ Aix Marseille Université, AP-HM, Hôpital de La Timone, Service de Neurologie et Pathologie du Mouvement, and UMR CNRS, Marseille et Versailles, France.
⁸ Service de Neurologie, Centre Expert Parkinson, NS-PARK/FCRIN Network, CIC-INSERM 1402, CHU Poitiers, 86000, Poitiers, France.
⁹ Department of Neurology, NS-PARK/FCRIN Network, Rennes University Hospital, CIC-INSERM 1414, 35033, Rennes Cedex, France.
¹⁰ CHU de Bordeaux, Centre Expert Parkinson, Institut des Maladies Neuro-Dégénératives, 33000, Bordeaux, France.
¹¹ Department of Neurology, Rouen University Hospital and University of Rouen, Rouen, France.
¹² Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, NS-PARK/FCRIN Network, INSERM U1239, Mont-Saint-Aignan, France.
¹³ Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
¹⁴ Institut de Génétique Et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France.
¹⁵ NS-PARK/FCRIN Network, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.
¹⁶ Neurology Department, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France.
¹⁷ Department of Neurology, Expert Centre for Parkinson's Disease, NS-PARK/FCRIN Network, Amiens University Hospital, EA 4559 Laboratoire de Neurosciences Fonctionnelles et Pathologie (LNFP) Université de Picardie Jules Verne, University of Picardy Jules Verne (UPJV), Amiens, France.
¹⁸ Department of Neurosurgery, Expert Centre for Parkinson's Disease, NS-PARK/FCRIN Network, Amiens University Hospital, EA 4559 Laboratoire de Neurosciences Fonctionnelles Et Pathologie (LNFP) Université de Picardie Jules Verne, University of Picardy Jules Verne (UPJV), Versailles, France.
¹⁹ Univ Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; CNRS, Institut Des Sciences Cognitives, UMR 5229, Bron, France.
²⁰ NS-PARK/FCRIN Network, Centre Expert Parkinson, Hôpital Neurologique "Pierre Wertheimer", Hospices Civils de Lyon, Lyon, France.
²¹ Neurology Department, Nancy University Hospital, 54000, Nancy, France.
²² NS-PARK/FCRIN Network, Hôpital Fondation Ophtalmologique A de Rothschild, Unité James Parkinson, 75019, Paris, France.
²³ Pôle Neurosciences, Foch Hospital, Suresnes, France.
²⁴ Université de Versailles Paris-Saclay, INSERM U992, CEA Neurospin, Marseille et Versailles, France.
²⁵ Department of Neurology, NS-PARK/F-CRIN network, University Hospital of Besançon, 25030, Besançon Cedex, France.
²⁶ Université de Franche-Comté, UR LINC 481, F-2500, Besançon, France.
²⁷ Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Centre d'Investigation Clinique CIC1436, NeuroToul COEN Center, Toulouse, NS-PARK/FCRIN Network, University Hospital of Toulouse, Toulouse, France. margheritafabbrimd@gmail.com.

^# Contributed equally.

PMID: 38334813
DOI: 10.1007/s00415-023-12162-7

Multicenter Study

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

Raquel Pinheiro Barbosa et al. J Neurol. 2024 May.

. 2024 May;271(5):2582-2595.

doi: 10.1007/s00415-023-12162-7. Epub 2024 Feb 9.

Authors

Affiliations

¹ Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Centre d'Investigation Clinique CIC1436, NeuroToul COEN Center, Toulouse, NS-PARK/FCRIN Network, University Hospital of Toulouse, Toulouse, France.
² Department of Medical Pharmacology, Neurology, Referent Center of Parkinson's Disease, CHU of Lille, Univ. Lille Neuroscience & Cognition, Inserm, UMR-S1172, Licend, NS-PARK/FCRIN Network, 59000, Lille, France.
³ Movement Disorders Department, Referent Center of Parkinson's Disease, CHU of Lille, Univ. Lille Neuroscience & Cognition, Inserm, UMR-S1172, Licend, NS-PARK/FCRIN Network, 59000, Lille, France.
⁴ Department of Neurology, NS-PARK/FCRIN Network, France, Sorbonne Université, Paris Brain Institute-ICM, Inserm, CNRS, Assistance Publique Hôpitaux de Paris, Paris, France.
⁵ Department of Neurology, NS-PARK/FCRIN Network, Nantes University Hospital, 44093, Nantes Cedex, France.
⁶ Neurology Department, NS-PARK/FCRIN Network, Université Clermont Auvergne, EA7280, Clermont-Ferrand University Hospital, 63000, Clermont-Ferrand, France.
⁷ Aix Marseille Université, AP-HM, Hôpital de La Timone, Service de Neurologie et Pathologie du Mouvement, and UMR CNRS, Marseille et Versailles, France.
⁸ Service de Neurologie, Centre Expert Parkinson, NS-PARK/FCRIN Network, CIC-INSERM 1402, CHU Poitiers, 86000, Poitiers, France.
⁹ Department of Neurology, NS-PARK/FCRIN Network, Rennes University Hospital, CIC-INSERM 1414, 35033, Rennes Cedex, France.
¹⁰ CHU de Bordeaux, Centre Expert Parkinson, Institut des Maladies Neuro-Dégénératives, 33000, Bordeaux, France.
¹¹ Department of Neurology, Rouen University Hospital and University of Rouen, Rouen, France.
¹² Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, NS-PARK/FCRIN Network, INSERM U1239, Mont-Saint-Aignan, France.
¹³ Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
¹⁴ Institut de Génétique Et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France.
¹⁵ NS-PARK/FCRIN Network, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.
¹⁶ Neurology Department, Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France.
¹⁷ Department of Neurology, Expert Centre for Parkinson's Disease, NS-PARK/FCRIN Network, Amiens University Hospital, EA 4559 Laboratoire de Neurosciences Fonctionnelles et Pathologie (LNFP) Université de Picardie Jules Verne, University of Picardy Jules Verne (UPJV), Amiens, France.
¹⁸ Department of Neurosurgery, Expert Centre for Parkinson's Disease, NS-PARK/FCRIN Network, Amiens University Hospital, EA 4559 Laboratoire de Neurosciences Fonctionnelles Et Pathologie (LNFP) Université de Picardie Jules Verne, University of Picardy Jules Verne (UPJV), Versailles, France.
¹⁹ Univ Lyon, Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Sud Charles Mérieux; CNRS, Institut Des Sciences Cognitives, UMR 5229, Bron, France.
²⁰ NS-PARK/FCRIN Network, Centre Expert Parkinson, Hôpital Neurologique "Pierre Wertheimer", Hospices Civils de Lyon, Lyon, France.
²¹ Neurology Department, Nancy University Hospital, 54000, Nancy, France.
²² NS-PARK/FCRIN Network, Hôpital Fondation Ophtalmologique A de Rothschild, Unité James Parkinson, 75019, Paris, France.
²³ Pôle Neurosciences, Foch Hospital, Suresnes, France.
²⁴ Université de Versailles Paris-Saclay, INSERM U992, CEA Neurospin, Marseille et Versailles, France.
²⁵ Department of Neurology, NS-PARK/F-CRIN network, University Hospital of Besançon, 25030, Besançon Cedex, France.
²⁶ Université de Franche-Comté, UR LINC 481, F-2500, Besançon, France.
²⁷ Department of Clinical Pharmacology and Neurosciences, Parkinson Expert Center, Centre d'Investigation Clinique CIC1436, NeuroToul COEN Center, Toulouse, NS-PARK/FCRIN Network, University Hospital of Toulouse, Toulouse, France. margheritafabbrimd@gmail.com.

^# Contributed equally.

PMID: 38334813
DOI: 10.1007/s00415-023-12162-7

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.

Keywords: Deep brain stimulation; Motor symmetry; Parkinson’s disease; Quality of life.

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References

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

Affiliations

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

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Research Materials

Miscellaneous