دورية أكاديمية
أعرض في EDS

Clinical profiles and outcomes of deep brain stimulation in G2019S LRRK2 Parkinson disease.

التفاصيل البيبلوغرافية
العنوان: Clinical profiles and outcomes of deep brain stimulation in G2019S LRRK2 Parkinson disease.
المؤلفون: Leaver K; 1Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York., Viser A; 2Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, California; and., Kopell BH; 1Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York., Ortega RA; 1Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York., Miravite J; 1Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York., Okun MS; 3Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, Florida., Elango S; 1Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York., Raymond D; 1Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York., Bressman SB; 1Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York., Saunders-Pullman R; 1Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York., Luciano MS; 2Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, California; and.
المصدر: Journal of neurosurgery [J Neurosurg] 2021 Nov 19; Vol. 137 (1), pp. 184-191. Date of Electronic Publication: 2021 Nov 19 (Print Publication: 2022).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: American Association of Neurological Surgeons Country of Publication: United States NLM ID: 0253357 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 1933-0693 (Electronic) Linking ISSN: 00223085 NLM ISO Abbreviation: J Neurosurg Subsets: PubMed not MEDLINE; MEDLINE
أسماء مطبوعة: Publication: Charlottesville, VA : American Association of Neurological Surgeons
Original Publication: Chicago [etc.]
مستخلص: Objective: The objective of this study was to evaluate clinical features and response to deep brain stimulation (DBS) in G2019S LRRK2-Parkinson disease (LRRK2-PD) and idiopathic PD (IPD).
Methods: The authors conducted a clinic-based cohort study of PD patients recruited from the Mount Sinai Beth Israel Genetics database of PD studies. The cohort included 87 participants with LRRK2-PD (13 who underwent DBS) and 14 DBS participants with IPD enrolled between 2009 and 2017. The baseline clinical features, including motor ratings and levodopa-equivalent daily dose (LEDD), were compared among LRRK2-PD patients with and without DBS, between LRRK2-PD with DBS and IPD with DBS, and between LRRK2-PD with subthalamic nucleus (STN) and internal segment of the globus pallidus (GPi) DBS. Longitudinal motor scores (Unified Parkinson's Disease Rating Scale-part III) and medication usage were also assessed pre- and postoperatively.
Results: Compared to LRRK2-PD without DBS (n = 74), the LRRK2-PD with DBS cohort (n = 13) had a significantly younger age of onset, longer disease duration, were more likely to have dyskinesia, and were less likely to experience hand tremor at disease onset. LRRK2-PD participants were also more likely to be referred for surgery because of severe dyskinesia (11/13 [85%] vs 6/14 [43%], p = 0.04) and were less likely to be referred for medically refractory tremor (0/13 [0%] vs 6/14 [43%], p = 0.02) than were IPD patients. Among LRRK2-PD patients, both STN-DBS and GPi-DBS targets were effective, although the sample size was small for both groups. There were no revisions or adverse effects reported in the GPi-DBS group, while 2 of the LRRK2-PD participants who underwent STN-DBS required revisions and a third reported depression as a stimulation-related side effect. Medication reduction favored the STN group.
Conclusions: The LRRK2-PD cohort referred for DBS had a slightly different profile, including earlier age of onset and dyskinesia. Both the STN and GPi DBS targets were effective in symptom suppression. Patients with G2019S LRRK2 PD were well-suited for DBS therapy and had favorable motor outcomes regardless of the DBS target. LRRK2-DBS patients had longer disease durations and tended to have more dyskinesia. Dyskinesia commonly served as the trigger for DBS surgical candidacy. Medication-refractory tremor was not a common indication for surgery in the LRRK2 cohort.
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معلومات مُعتمدة: R01 NS096008 United States NS NINDS NIH HHS; R25 NS108939 United States NS NINDS NIH HHS; R01 NR014852 United States NR NINR NIH HHS; K23 NS099441 United States NS NINDS NIH HHS; U01 NS094148 United States NS NINDS NIH HHS; U01 NS107016 United States NS NINDS NIH HHS
فهرسة مساهمة: Keywords: DBS; GPi; LRRK2; Parkinson’s disease; STN; deep brain stimulation; functional neurosurgery
تواريخ الأحداث: Date Created: 20211119 Latest Revision: 20240523
رمز التحديث: 20240523
مُعرف محوري في PubMed: PMC9117559
DOI: 10.3171/2021.7.JNS21190
PMID: 34798606
قاعدة البيانات: MEDLINE
الوصف
تدمد:1933-0693
DOI:10.3171/2021.7.JNS21190