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Determinants of Functional Independence or Its Loss following Subthalamic Nucleus Stimulation in Parkinson's Disease
- Title
- Determinants of Functional Independence or Its Loss following Subthalamic Nucleus Stimulation in Parkinson's Disease
- Authors
- Kim, Ryul; Yoo, Dallah; Jung, Yu Jin; Lee, Woong-Woo; Ehm, Gwanhee; Yun, Ji Young; Kim, Hee Jin; Lee, Jee-Young; Kim, Ji-Young; Kim, Han-Joon; Paek, Sun Ha; Jeon, Beomseok
- Ewha Authors
- 윤지영
- SCOPUS Author ID
- 윤지영
- Issue Date
- 2019
- Journal Title
- STEREOTACTIC AND FUNCTIONAL NEUROSURGERY
- ISSN
- 1011-6125
1423-0372
- Citation
- STEREOTACTIC AND FUNCTIONAL NEUROSURGERY vol. 97, no. 2, pp. 106 - 112
- Keywords
- Parkinson's disease; Deep brain stimulation; Activities of daily living; Dependence; Independence
- Publisher
- KARGER
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Objective: This study aimed to describe the change in functional status following bilateral subthalamic nucleus stimulation (STN-DBS) in Parkinson's disease (PD) and to identify predictors of postoperative functional dependence. Methods: We included PD patients with bilateral STN-DBS who had complete Schwab & England Activities of Daily Living (S&E ADL) Scale data at baseline and 6 months after surgery from our prospective registry. Functional dependence was defined as an S&E ADL score of less than 80%. All data were collected from the on-medication state and on-stimulation state (after surgery). Logistic regression analyses were performed to determine the factors predictive of functional dependence after surgery. Results: A total of 196 patients were included. At baseline, 41 patients were functionally dependent and the other 155 were functionally independent. Among the patients with preoperative dependence, 32 (78%) became functionally independent after surgery, and this conversion was associated with a lower baseline axial score (p = 0.012). Among the patients with preoperative independence, 21 (14%) developed postoperative dependence, and this conversion was associated with a higher baseline axial score (p = 0.013) and its smaller improvement (p < 0.001). Female sex (odds ratio [OR] 3.214; 95% confidence interval [CI] 1.210-8.542; p = 0.019) and a higher baseline axial score (OR 1.184; 95% CI 1.056-1.327; p = 0.004) significantly predicted the risk of postoperative functional dependence. Conclusions: We found that functional status following bilateral STN-DBS is closely related to preoperative axial symptoms. When loss of independence is a potential target for STN-DBS, clinicians should take into consideration the severity of axial impairment before surgery. (C) 2019 S. Karger AG, Basel
- DOI
- 10.1159/000500277
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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