Maurizio Zibetti MD et al in article first published online: 25 AUG 2011, Deep brain stimulation of the subthalamic nucleus is an effective treatment for advanced Parkinson’s disease. The benefits of bilateral subthalamic stimulation are well documented, and some studies reported outcomes with a follow-up of 5 to 6 years; nevertheless, few data are available beyond 5 years. We report a long-term prospective evaluation of 14 consecutive parkinsonian patients, treated by bilateral subthalamic stimulation for at least 9 years. Motor symptoms, activity of daily living, and motor complications were evaluated by means of the Unified Parkinson’s Disease Rating Scale, while cognition and mood were assessed with a specific neuropsychological test battery; medication intake, stimulation parameters, comorbidity, and adverse events were also recorded. Patients were evaluated before surgery and at 1, 5, and ≥9 years after surgery. At last follow-up, deep brain stimulation significantly improved the motor score by 42% compared to baseline, whereas activities of daily living were no longer improved; there was a 39% reduction in the dosage of dopaminergic drugs and a 59% improvement of l-dopa–related motor complications. The neuropsychological assessment showed that 4 patients (29%) developed a significant cognitive decline over the follow-up period. These results indicate a persistent effect of deep brain stimulation of the subthalamic nucleus on the cardinal motor symptoms in advanced Parkinson’s disease patients in the long-term; however, a worsening of patients’ disability, mainly due to disease progression, was observed. © 2011 Movement Disorder Society. Although there is no known cure for Parkinson’s disease there is help to alleviate some of the symptoms. Research the HandTutor, ArmTutor, LegTutor and 3DTutor. The devices are being used successfully in a num ber of U.S. and foreign hospitals as well as physical therapy clinics and in the patient’s own home using tele rehabilitation.
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