J Korean Neurol Assoc > Volume 20(3); 2002 > Article

Journal of the Korean Neurological Association 2002;20(3): 234-242.

"진행된 특발성 파킨슨병에서 시상하핵 자극의 효과"

김원찬 , 오승헌 김현숙 류철형찬 이진구 장진우 이명식

연세대학교 의과대학 영동세브란스병원 신경과,세브란스병원 신경외과학교실

"The Effect of Subthalamic Nucleus Stimulation in Patients with Advanced Idiopathic Parkinson■s Disease"

Won Chan Kim, M.D.

"Department of Neurology, Yongdong Severance Hospital Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine"

Abstract

"Background: To determine the efficacy and safety of subthalamic nucleus (STN) stimulation in patients with advanced Parkinson s disease (PD). Methods : In 5 patients with PD, we evaluated the effect of bilateral STN stimula-tion. Using the Unified PD Rating Scale (UPDRS), Clinical Dyskinesia Rating Scale, Activities of Daily Living(ADL) Score and patient s diary, we evaluated the patients before and at one, three and 12 months after surgery. We examined the patients while they were drug off and on . Results : While patients were off , stimulation induced a signifi-cant reduction in the UPDRS part III score by 46% at 12 months after the operation, compared to the baseline state. During drug on state, levodopa-induced dyskinesias were reduced by 88% at 12 months after the operation. Off-peri-od dystonia was reduced by 45% at 12 months after the operation. ADL scores also improved after the stimulation. Patients diaries showed significant reduction in the off period while awake (73% reduction at 12 months). The daily dose of levodopa was reduced by 56% at 12 months after the operation. There was no significant complication related to the surgical procedure or electrical stimulation. Conclusions : We conclude that STN stimulation is an effective and safe treatment strategy for the patients with advanced PD.Key Words : Idiopathic Parkinson s disease, Subthalamic nucleus, Stimulation"