Effects of Bilateral Subthalamic Nucleus Deep Brain Stimulation on Motor and nonmotor Symptoms in Patients with Moderate and Advanced Parkinson's Disease-A Two-Year Follow-up Study
Bibliographic record
Abstract
Objective To study the effects of the bilateral subthalamic nucleus(STN) deep brain stimulation(DBS) on motor and nonmotor symptoms in moderate or advanced Parkinsonian patients 2 years after surgery.Methods From August 2006 to October 2011,33 consecutive patients with refractory motor fluctuations or dyskinesia had underwent the surgery in our hospital,and 16 of them were followed up two years after operation.All Patients were evaluated by Unified Parkinson's Disease Rating Scale(UPDRS),HoehnYahr stage(HY),Parkinson's Disease Questionnaire(PDQ-39) as well as Mini Mental State Examination(MMSE),Montreal Cognitive Assessment(MOCA),Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA),Parkinson's Disease Sleep Scale-Chinese version(PDSS-CV),Pittsburgh sleep quality index(PSQI),and recorded the dosage of anti-parkinsonian drugs a week before surgery and 24 months post-operation respectively.Results Sixteen patients had significant improvements in motor sympotoms.Compared with that in medication state pre-operation,the scores of UPDRSⅢ,tremor,rigidity,bradykinesia and axial symptoms reduced significantly by 35.4%,34.8%,55.1%,28.8%,28.1% respectively in on stimulation medication condition and by 66.4%,81.8%,75.7%,64.4%,57.8% respectively at on stimulation on medication status.Compared with that in on medication condition pre-operation,UPDRSⅢ score and subscores had no statistic difference in on stimulation medication and on stimulation on medication conditions.The off duration decreased significantly from(6.3±0.8)h/d to(2.8±0.6)h/d(P=0.008).The HY stage(off condition) decreased significantly and PDQ-39 declined significantly from 56.3±16.4 pre-operation to 28.5±14.3 at 2 year follow-up.There was no significant difference in the scores of nonmotor symptom scales(including MMSE,MOCA,HAMD,HAMA,PDSS and PSQI).The daily levodopa equivalent dosage(LEDD) of antiparkinsonian medication was significantly reduced by 44.4% two years after operation(P0.001).While the DBS parameter of voltage increased from(1.6±0.2)V to(2.3±0.3)V(P=0.001),pulse width increased from(61.9±5.1) μs to(71.3±14.0) μs(P=0.007)and frequency increased from(131.7±5.6) Hz to(146.0±18.5) Hz(P=0.006).Conclusions Bilateral STN DBS can significantly ameliorate motor symptoms without worsening nonmotor symptoms in the patients with moderate or advanced Parkinson's disease.STN DBS improves the quality of life and reduces LEDD.This procedure has the advantages of an excellent safety,minor side effects and easy control.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".