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Reduced levodopa-induced complications after 5 years of subthalamic stimulation in Parkinson’s disease: a second honeymoon

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Abstract

The purpose of this paper is to describe the effect of 5 years of subthalamic nucleus deep brain stimulation (STN DBS) on levodopa-induced complications, both in everyday life and during an acute challenge with levodopa. Thirty three patients were evaluated during an acute levodopa challenge before surgery and then 1 and 5 years afterwards (both off stim and on stim), using the UPDRS III scale and the CAPSIT-PD scales for dystonia and peak-dose dyskinesia. The UPDRS IV scale was used to assess motor complications in everyday life. The levodopa daily dose and DBS parameters were also recorded. Levodopa-induced complications in everyday life (UPDRS IV) and during an acute levodopa challenge had improved markedly after 1 year (both on and off stim) and still further at 5 years. Peak-dose dyskinesia decreased between the 1- and 5-year measurements. STN DBS decreases levodopa-induced motor complications over the long term. This phenomenon may be explained by (a) overall stabilization of the basal ganglia network and (b) striatal synaptic changes. Our results suggest that DBS leads to both qualitative and quantitative modulations in the corticostriatal loops.

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Conflict of interest statement

The authors have no conflicts of interest to report.

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Authors and Affiliations

  1. Department of Neurology and Movement Disorders, Salengro Hospital, EA 2683, Lille University Medical Center, Lille, France

    Clemence Simonin, M. Tir, D. Devos, A. Kreisler, K. Dujardin, A. Delval, L. Defebvre, A. Destée & P. Krystkowiak

  2. Department of Neurophysiology, Salengro Hospital, EA 2683, Lille University Medical Center, Lille, France

    A. Delval

  3. Department of Neurosurgery, Salengro Hospital, EA 2683, Lille University Medical Center, Lille, France

    S. Blond

  4. Department of Biostatistics, Faculty of Medicine, Lille University, Lille, France

    J. Salleron

  5. Service de Neurologie A, Hôpital Roger Salengro, CHRU de Lille, 59037, Lille Cedex, France

    Clemence Simonin

  6. Department of Neurology, Mignot Versailles Hospital, Versailles, France

    M. Tir

  7. Department of Neurology, CNRS UMR 8160, Amiens University Hospital, 80054, Amiens, France

    P. Krystkowiak

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  1. Clemence Simonin
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  2. M. Tir
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  3. D. Devos
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  4. A. Kreisler
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  5. K. Dujardin
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  7. A. Delval
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  8. S. Blond
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  9. L. Defebvre
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  10. A. Destée
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  11. P. Krystkowiak
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Correspondence to Clemence Simonin.

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Simonin, C., Tir, M., Devos, D. et al. Reduced levodopa-induced complications after 5 years of subthalamic stimulation in Parkinson’s disease: a second honeymoon. J Neurol 256, 1736–1741 (2009). https://doi.org/10.1007/s00415-009-5195-2

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  • DOI: https://doi.org/10.1007/s00415-009-5195-2

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