Effect of subthalamic nucleus stimulation for pain related to Parkinson's disease
- Conditions
- Parkinson disease
- Registration Number
- JPRN-UMIN000005360
- Lead Sponsor
- ihon University School of Medicine
- Brief Summary
Several types of pain related to PD, the categories of which were based on a modification of two previous classifications (Ford and Honey), can occur in such patients: 1) musculoskeletal pain, 2) dystonic pain, 3) somatic pain exacerbated by PD, 4) radiculo-peripheral neuropathic pain, and 5) central pain. The overall mean VAS score was significantly decreased by 75% and 69% at 2 weeks and 6 months postoperatively (p 0.001). The mean VAS score at 12 months was also decreased by 80%; however, 6 instances of pain (3 of somatic back pain and 3 of radiculo-peripheral neuropathic pain) required additional spinal surgery to alleviate their severity. The results were analyzed using Wilcoxon's signed-ranks test, and demonstrated a significant reduction in VAS scores at all follow-up assessment times (p<0.001). Musculoskeletal pain and dystonic pain were well alleviated by STN stimulation. In contrast, somatic pain exacerbated by PD and peripheral neuropathic pain originating from lumbar spinal diseases, such as spondylosis deformans and/or canal stenosis, often deteriorated postoperatively despite their motor disability being attenuated. Patients with central pain were poor responders.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Complete: follow-up complete
- Sex
- All
- Target Recruitment
- 70
Not provided
Patients with major depression or cognitive dysfunction (Mini-Mental Status Examination score < 23) are excluded as candidates for surgery.
Study & Design
- Study Type
- Observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Data are collected from this cohort prospectively. All patients describe the severity of their pain according to a visual analogue scale (VAS; 0-10.0 points) preoperatively and at 2 weeks, 6 and 12 months postoperatively.
- Secondary Outcome Measures
Name Time Method nified Parkinson's Disease Rating Scale (UPDRS) is scored during the on-period and off-period with sustaining anti-parkinsonian agents. The levodopa-induced dyskinesias (LID) are categorized into three groups; off-period, diphasic, and on-period dyskinesia. The dyskinesia severity rating scale is employed to evaluate the severity of each of LID, scoring the dyskinesia in 6 body parts (neck, trunk, and each of the 4 extremities) on a 5-point scale (ranging from 0 to 4; e.g. 0=absent, 4=severe). All patients are also assessed for their mood using the Hamilton depression scale and their cognitive function by using Mini-Mental Status Examinations.