ABSTRACT
BACKGROUND AND STUDY AIMS: To determine the effect on psychiatric symptoms and quality of life in 30 patients with Parkinson's disease (PD) treated with deep brain stimulation (DBS) of both subthalamic nuclei (STN) after 1 year of follow-up. MATERIAL AND METHOD: We conducted a prospective 1-year follow-up study with a baseline assessment before and 6 and 12 months after surgery. The following were used as assessment instruments: the Bech-Rafaelsen Melancholia Scale (MES), the Bech-Rafaelsen Mania Scale (MAS), the Beck Scale for Suicidal Ideation (SSI), the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), the Oviedo Sleep Questionnaire (OSQ), the 36-Item Short Form Health Survey (SF-36), the Unified Parkinson's Disease Rating Scale (UPDRS), the dose of levodopa, and the active contact stereotactic coordinates. RESULTS: We recorded a clinical improvement between baseline with medication use (ON medication) and the results obtained at 6 and 12 months with medication use and stimulation (ON stimulation, ON medication) in MES and OSQ (p < 0.0001) and in SF-36 (p < 0.005). No changes were observed in MAS and SSI. There was a clinical improvement between baseline with ON medication and the results obtained at 12 months with ON stimulation, ON medication in Y-BOCS (p < 0.04). Also, there was a 53.3% reduction in levodopa at 6 months and a 54.7% reduction at 12 months after surgery (p < 0.0001). There was an improvement between baseline with OFF medication and the results obtained at 6 and 12 months OFF medication, ON stimulation (p < 0.0001) in UPDRS-III. There were no statistically significant differences between the initial and final active contact coordinates, or between stimulation parameters. CONCLUSIONS: DBS of the STN in patients with PD is associated with an improvement in psychiatric (affective and sleep-wake cycle) symptoms, clinical motor symptoms, and quality of life at 1 year after surgery.
Subject(s)
Deep Brain Stimulation , Parkinson Disease/psychology , Parkinson Disease/therapy , Quality of Life , Aged , Antiparkinson Agents/therapeutic use , Female , Follow-Up Studies , Humans , Levodopa/therapeutic use , Male , Middle Aged , Prospective Studies , Subthalamic Nucleus , Surveys and Questionnaires , Treatment OutcomeABSTRACT
We present the case of a 67-year-old patient, asymptomatic, with a prior diagnosis of amelanotic cutaneous melanoma with positive ganglions (2002), who was referred for thoracic-abdominal-pelvic computed tomography (CT) as part of routine follow-up (2007). The CT revealed a mass in the right atrium cardiac magnetic resonance imaging was practiced to characterize the mass.
