Deep brain stimulation in Parkinson's disease

A multicentric, long-term, observational pilot study

Emma Scelzo, Ettore Beghi, Manuela Rosa, Serena Angrisano, Angelo Antonini, Caterina Bagella, Elisa Bianchi, Elena Caputo, Francesco Lena, Leonardo Lopiano, Andrea Marcante, Sara Marceglia, Francesco Massaro, Nicola Modugno, Claudio Pacchetti, Manuela Pilleri, Nicolo Gabriele Pozzi, Luigi Michele Romito, Marco Santilli, Filippo Tamma & 3 others Luca Weis, Maurizio Zibetti, Alberto Priori

Research output: Contribution to journalArticle

Abstract

Background: The impact of deep brain stimulation (DBS) on cognitive and urinary disorders, falls, and eventually hospitalizations and mortality in Parkinson's disease (PD) is still debated. Objective: We compared the rates of dementia, mild cognitive impairment (MCI), urinary incontinence, nocturia, falls, hospitalizations, and mortality in a cohort of PD patients undergoing DBS with a cohort of medically-treated patients chosen as controls. Methods: We conducted a retrospective pilot study in six Italian DBS centers. 91 PD patients receiving DBS and 91 age- and gender-matched controls receiving the best medical treatment alone with a minimum follow-up of one year were enrolled. Clinical data were collected from baseline to the last follow-up visit using an ad-hoc developed web-based system. Results: The risk of dementia was similar in the two groups while patients in the surgical cohort had lower rates of MCI, urinary incontinence, nocturia, and falls. In contrast, the risk of hospital admissions related to PD was higher in the surgical cohort. However, when excluding hospitalizations related to DBS surgery, the difference between the two cohorts was not significant. The surgical cohort had a lower number of hospitalizations not related to PD. The risk of death was similar in the two groups. Conclusion: Despite a higher risk of hospitalization, patients receiving DBS had a lower rate of MCI, urinary incontinence, nocturia and falls, without evidence of an increased risk of dementia and mortality. Although these findings need to be confirmed in prospective studies, they seem to suggest that DBS may play a significant role in the management of non-motor symptoms and common complications of advanced PD.

Original languageEnglish
Article number116411
JournalJournal of the Neurological Sciences
Volume405
DOIs
Publication statusPublished - Oct 15 2019

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Deep Brain Stimulation
Observational Studies
Parkinson Disease
Nocturia
Hospitalization
Urinary Incontinence
Dementia
Mortality
Retrospective Studies
Prospective Studies
Cognitive Dysfunction

Keywords

  • Deep brain stimulation
  • Dementia
  • Falls
  • Non-motor symptoms
  • Parkinson's disease
  • Urinary symptoms

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Deep brain stimulation in Parkinson's disease : A multicentric, long-term, observational pilot study. / Scelzo, Emma; Beghi, Ettore; Rosa, Manuela; Angrisano, Serena; Antonini, Angelo; Bagella, Caterina; Bianchi, Elisa; Caputo, Elena; Lena, Francesco; Lopiano, Leonardo; Marcante, Andrea; Marceglia, Sara; Massaro, Francesco; Modugno, Nicola; Pacchetti, Claudio; Pilleri, Manuela; Pozzi, Nicolo Gabriele; Romito, Luigi Michele; Santilli, Marco; Tamma, Filippo; Weis, Luca; Zibetti, Maurizio; Priori, Alberto.

In: Journal of the Neurological Sciences, Vol. 405, 116411, 15.10.2019.

Research output: Contribution to journalArticle

Scelzo, E, Beghi, E, Rosa, M, Angrisano, S, Antonini, A, Bagella, C, Bianchi, E, Caputo, E, Lena, F, Lopiano, L, Marcante, A, Marceglia, S, Massaro, F, Modugno, N, Pacchetti, C, Pilleri, M, Pozzi, NG, Romito, LM, Santilli, M, Tamma, F, Weis, L, Zibetti, M & Priori, A 2019, 'Deep brain stimulation in Parkinson's disease: A multicentric, long-term, observational pilot study', Journal of the Neurological Sciences, vol. 405, 116411. https://doi.org/10.1016/j.jns.2019.07.029
Scelzo, Emma ; Beghi, Ettore ; Rosa, Manuela ; Angrisano, Serena ; Antonini, Angelo ; Bagella, Caterina ; Bianchi, Elisa ; Caputo, Elena ; Lena, Francesco ; Lopiano, Leonardo ; Marcante, Andrea ; Marceglia, Sara ; Massaro, Francesco ; Modugno, Nicola ; Pacchetti, Claudio ; Pilleri, Manuela ; Pozzi, Nicolo Gabriele ; Romito, Luigi Michele ; Santilli, Marco ; Tamma, Filippo ; Weis, Luca ; Zibetti, Maurizio ; Priori, Alberto. / Deep brain stimulation in Parkinson's disease : A multicentric, long-term, observational pilot study. In: Journal of the Neurological Sciences. 2019 ; Vol. 405.
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abstract = "Background: The impact of deep brain stimulation (DBS) on cognitive and urinary disorders, falls, and eventually hospitalizations and mortality in Parkinson's disease (PD) is still debated. Objective: We compared the rates of dementia, mild cognitive impairment (MCI), urinary incontinence, nocturia, falls, hospitalizations, and mortality in a cohort of PD patients undergoing DBS with a cohort of medically-treated patients chosen as controls. Methods: We conducted a retrospective pilot study in six Italian DBS centers. 91 PD patients receiving DBS and 91 age- and gender-matched controls receiving the best medical treatment alone with a minimum follow-up of one year were enrolled. Clinical data were collected from baseline to the last follow-up visit using an ad-hoc developed web-based system. Results: The risk of dementia was similar in the two groups while patients in the surgical cohort had lower rates of MCI, urinary incontinence, nocturia, and falls. In contrast, the risk of hospital admissions related to PD was higher in the surgical cohort. However, when excluding hospitalizations related to DBS surgery, the difference between the two cohorts was not significant. The surgical cohort had a lower number of hospitalizations not related to PD. The risk of death was similar in the two groups. Conclusion: Despite a higher risk of hospitalization, patients receiving DBS had a lower rate of MCI, urinary incontinence, nocturia and falls, without evidence of an increased risk of dementia and mortality. Although these findings need to be confirmed in prospective studies, they seem to suggest that DBS may play a significant role in the management of non-motor symptoms and common complications of advanced PD.",
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AU - Scelzo, Emma

AU - Beghi, Ettore

AU - Rosa, Manuela

AU - Angrisano, Serena

AU - Antonini, Angelo

AU - Bagella, Caterina

AU - Bianchi, Elisa

AU - Caputo, Elena

AU - Lena, Francesco

AU - Lopiano, Leonardo

AU - Marcante, Andrea

AU - Marceglia, Sara

AU - Massaro, Francesco

AU - Modugno, Nicola

AU - Pacchetti, Claudio

AU - Pilleri, Manuela

AU - Pozzi, Nicolo Gabriele

AU - Romito, Luigi Michele

AU - Santilli, Marco

AU - Tamma, Filippo

AU - Weis, Luca

AU - Zibetti, Maurizio

AU - Priori, Alberto

PY - 2019/10/15

Y1 - 2019/10/15

N2 - Background: The impact of deep brain stimulation (DBS) on cognitive and urinary disorders, falls, and eventually hospitalizations and mortality in Parkinson's disease (PD) is still debated. Objective: We compared the rates of dementia, mild cognitive impairment (MCI), urinary incontinence, nocturia, falls, hospitalizations, and mortality in a cohort of PD patients undergoing DBS with a cohort of medically-treated patients chosen as controls. Methods: We conducted a retrospective pilot study in six Italian DBS centers. 91 PD patients receiving DBS and 91 age- and gender-matched controls receiving the best medical treatment alone with a minimum follow-up of one year were enrolled. Clinical data were collected from baseline to the last follow-up visit using an ad-hoc developed web-based system. Results: The risk of dementia was similar in the two groups while patients in the surgical cohort had lower rates of MCI, urinary incontinence, nocturia, and falls. In contrast, the risk of hospital admissions related to PD was higher in the surgical cohort. However, when excluding hospitalizations related to DBS surgery, the difference between the two cohorts was not significant. The surgical cohort had a lower number of hospitalizations not related to PD. The risk of death was similar in the two groups. Conclusion: Despite a higher risk of hospitalization, patients receiving DBS had a lower rate of MCI, urinary incontinence, nocturia and falls, without evidence of an increased risk of dementia and mortality. Although these findings need to be confirmed in prospective studies, they seem to suggest that DBS may play a significant role in the management of non-motor symptoms and common complications of advanced PD.

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KW - Falls

KW - Non-motor symptoms

KW - Parkinson's disease

KW - Urinary symptoms

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