Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova · 2025
[Pathomorphosis of the Parkinson's disease against the background of DBS STN].
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Bril E V, Tomskiy A A, Gamaleya A A, Poddubskaia A A, Kesarev D G, Omarova S M, Fedorova N V, Levin O S
Аннотация
OBJECTIVES: To study the clinical pathomorphosis of Parkinson's disease (PD) against the background of stimulation of the subthalamic nucleus (DBS STN).
MATERIAL AND METHODS: : We present a 15-year analysis of 401 patients with PD in two groups: DBS STN (n=233) and drug therapy group (n=168). In order to study the clinical pathomorphism of the disease, an analysis of the dynamics of the main motor symptoms of PD was carried out using the UPDRS scale, as well as an analysis of the survival of patients in both groups.
RESULTS: DBS STN significantly improved motor symptoms in patients with PD during the off period by 57.3% by year 1, by 23.7% by year 15. According to this indicator, patients did not reach the preoperative level. During the inclusion period in this group, the improvement was 40%, the indicator remained stable for 3 years, however, due to the progression of the disease, by the 15th year the deterioration was 20.9%. In the group of patients receiving only drug therapy, there was a progressive worsening of motor symptoms in the off period by 67.5% by the 15th year of observation, in the on period 64.5% (p<0.05). Univariate survival analysis showed that patients receiving STN-DBS had significantly longer survival than those receiving medical treatment alone (p=0.008).
CONCLUSION: DBS STN changes the clinical pathomorphosis of Parkinson's disease, leading to less severity of parkinsonian symptoms and greater survival of this group of patients.
MATERIAL AND METHODS: : We present a 15-year analysis of 401 patients with PD in two groups: DBS STN (n=233) and drug therapy group (n=168). In order to study the clinical pathomorphism of the disease, an analysis of the dynamics of the main motor symptoms of PD was carried out using the UPDRS scale, as well as an analysis of the survival of patients in both groups.
RESULTS: DBS STN significantly improved motor symptoms in patients with PD during the off period by 57.3% by year 1, by 23.7% by year 15. According to this indicator, patients did not reach the preoperative level. During the inclusion period in this group, the improvement was 40%, the indicator remained stable for 3 years, however, due to the progression of the disease, by the 15th year the deterioration was 20.9%. In the group of patients receiving only drug therapy, there was a progressive worsening of motor symptoms in the off period by 67.5% by the 15th year of observation, in the on period 64.5% (p<0.05). Univariate survival analysis showed that patients receiving STN-DBS had significantly longer survival than those receiving medical treatment alone (p=0.008).
CONCLUSION: DBS STN changes the clinical pathomorphosis of Parkinson's disease, leading to less severity of parkinsonian symptoms and greater survival of this group of patients.