DBS-STN appropriate to treat severe Parkinson disease in an elderly population?
Derost PP, Ouchchane L, Morand D, Ulla M, Llorca PM, Barget M, Debilly B, Lemaire JJ, Durif F. DBS-STN appropriate to treat severe Parkinson disease in an elderly population? , Neurology, 68(17):1345-55Is
This study looked at the age of patient’s undergoing DBS STN and if there is a difference (short and long term) in efficacy, adverse events, or PD symptoms between an older (65+) and younger (<65) group of people with Parkinson’s disease. Patients were tested 1 month prior to surgery and 3, 6, 12, and 24 months post surgery with various measures. The authors found that acutely both groups experienced significant motor improvement from DBS STN. Younger patients had more improvement in quality of life related to mobility, activities of daily living, stigma, cognition, and communication as compared to the older group. These areas generally stayed the same or slightly worsened for the older group. Both groups had a reduction in their levodopa dose and stimulation parameters were not different between the groups. The most common adverse events for both groups was worsened dysarthria, weight gain, and transient mood elevation (hypomania improved within weeks after surgery). There were no significant differences between the groups in regard to adverse events. All adverse events are listed in the article. It is notable that both groups did not experience significant cognitive change after DBS STN. Overall the authors concluded that DBS STN is effective in the short and long term for motor symptoms of both young and older patients but that younger patients may experience more benefit in regard to quality of life than their older counter parts