Balance response to levodopa predicts balance improvement after bilateral subthalamic nucleus deep brain stimulation in Parkinson’s disease

Abstract The effect of subthalamic nucleus deep brain stimulation (STN-DBS) on balance function in patients with Parkinson’s disease (PD) and the potential outcome predictive factors remains unclear. We retrospectively included 261 PD patients who underwent STN-DBS and finished the 1-month follow-up...

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Autores principales:	Zixiao Yin, Yutong Bai, Liangying Zou, Xin Zhang, Huimin Wang, Dongmei Gao, Guofan Qin, Ruoyu Ma, Kai Zhang, Fangang Meng, Yin Jiang, Anchao Yang, Jianguo Zhang
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/969d84a8f3384c6790f5aef9e8c564f8
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spelling	oai:doaj.org-article:969d84a8f3384c6790f5aef9e8c564f82021-12-02T14:47:32ZBalance response to levodopa predicts balance improvement after bilateral subthalamic nucleus deep brain stimulation in Parkinson’s disease10.1038/s41531-021-00192-92373-8057https://doaj.org/article/969d84a8f3384c6790f5aef9e8c564f82021-05-01T00:00:00Zhttps://doi.org/10.1038/s41531-021-00192-9https://doaj.org/toc/2373-8057Abstract The effect of subthalamic nucleus deep brain stimulation (STN-DBS) on balance function in patients with Parkinson’s disease (PD) and the potential outcome predictive factors remains unclear. We retrospectively included 261 PD patients who underwent STN-DBS and finished the 1-month follow-up (M1) assessment in the explorative set for identifying postoperative balance change predictors, and 111 patients who finished both the M1 and 12-month follow-up (M12) assessment in the validation set for verifying the identified factors. Motor and balance improvement were evaluated through the UPDRS-III and the Berg balance scale (BBS) and pull test (PT), respectively. Candidate predictors of balance improvement included age, disease duration, motor subtypes, baseline severity of PD, cognitive status, motor and balance response to levodopa, and stimulation parameters. In the off-medication condition, STN-DBS significantly improved BBS and PT performance in both the M1 and M12, in both datasets. While in the on-medication condition, no significant balance improvement was observed. Higher preoperative BBS response to levodopa was significantly associated with larger postoperative off-medication, but not on-medication, BBS (p < 0.001) and PT (p < 0.001) improvement in both the M1 and M12. BBS subitems 8, 9, 11, 13, and 14 were the major contributors to the prediction of balance improvement after STN-DBS. STN-DBS improves short-term off-medication, but not on-medication, balance function assessed through BBS and PT. Preoperative BBS response to levodopa best predicts postoperative off-medication balance improvement. For patients who manifested severe balance problems, a levodopa challenge test on BBS or the short version of BBS is recommended.Zixiao YinYutong BaiLiangying ZouXin ZhangHuimin WangDongmei GaoGuofan QinRuoyu MaKai ZhangFangang MengYin JiangAnchao YangJianguo ZhangNature PortfolioarticleNeurology. Diseases of the nervous systemRC346-429ENnpj Parkinson's Disease, Vol 7, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Zixiao Yin Yutong Bai Liangying Zou Xin Zhang Huimin Wang Dongmei Gao Guofan Qin Ruoyu Ma Kai Zhang Fangang Meng Yin Jiang Anchao Yang Jianguo Zhang Balance response to levodopa predicts balance improvement after bilateral subthalamic nucleus deep brain stimulation in Parkinson’s disease
description	Abstract The effect of subthalamic nucleus deep brain stimulation (STN-DBS) on balance function in patients with Parkinson’s disease (PD) and the potential outcome predictive factors remains unclear. We retrospectively included 261 PD patients who underwent STN-DBS and finished the 1-month follow-up (M1) assessment in the explorative set for identifying postoperative balance change predictors, and 111 patients who finished both the M1 and 12-month follow-up (M12) assessment in the validation set for verifying the identified factors. Motor and balance improvement were evaluated through the UPDRS-III and the Berg balance scale (BBS) and pull test (PT), respectively. Candidate predictors of balance improvement included age, disease duration, motor subtypes, baseline severity of PD, cognitive status, motor and balance response to levodopa, and stimulation parameters. In the off-medication condition, STN-DBS significantly improved BBS and PT performance in both the M1 and M12, in both datasets. While in the on-medication condition, no significant balance improvement was observed. Higher preoperative BBS response to levodopa was significantly associated with larger postoperative off-medication, but not on-medication, BBS (p < 0.001) and PT (p < 0.001) improvement in both the M1 and M12. BBS subitems 8, 9, 11, 13, and 14 were the major contributors to the prediction of balance improvement after STN-DBS. STN-DBS improves short-term off-medication, but not on-medication, balance function assessed through BBS and PT. Preoperative BBS response to levodopa best predicts postoperative off-medication balance improvement. For patients who manifested severe balance problems, a levodopa challenge test on BBS or the short version of BBS is recommended.
format	article
author	Zixiao Yin Yutong Bai Liangying Zou Xin Zhang Huimin Wang Dongmei Gao Guofan Qin Ruoyu Ma Kai Zhang Fangang Meng Yin Jiang Anchao Yang Jianguo Zhang
author_facet	Zixiao Yin Yutong Bai Liangying Zou Xin Zhang Huimin Wang Dongmei Gao Guofan Qin Ruoyu Ma Kai Zhang Fangang Meng Yin Jiang Anchao Yang Jianguo Zhang
author_sort	Zixiao Yin
title	Balance response to levodopa predicts balance improvement after bilateral subthalamic nucleus deep brain stimulation in Parkinson’s disease
title_short	Balance response to levodopa predicts balance improvement after bilateral subthalamic nucleus deep brain stimulation in Parkinson’s disease
title_full	Balance response to levodopa predicts balance improvement after bilateral subthalamic nucleus deep brain stimulation in Parkinson’s disease
title_fullStr	Balance response to levodopa predicts balance improvement after bilateral subthalamic nucleus deep brain stimulation in Parkinson’s disease
title_full_unstemmed	Balance response to levodopa predicts balance improvement after bilateral subthalamic nucleus deep brain stimulation in Parkinson’s disease
title_sort	balance response to levodopa predicts balance improvement after bilateral subthalamic nucleus deep brain stimulation in parkinson’s disease
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/969d84a8f3384c6790f5aef9e8c564f8
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Balance response to levodopa predicts balance improvement after bilateral subthalamic nucleus deep brain stimulation in Parkinson’s disease

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