Movement Disorders

Deep Brain Stimulation

Motor Scores Before and After Deep Brain Stimulation for Parkinson Disease (N = 61)

2019

DBS = deep brain stimulation

The Movement Disorders Society – Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS-III) is a clinician rating scale of motor symptoms of Parkinson disease (PD) including tremor, bradykinesia, rigidity, gait, posture, speech, and facial expression. Higher numbers reflect worse symptoms. Sixty-one patients who underwent deep brain stimulation (DBS) were assessed using the UPDRS-III both before and after surgery while off and on medications. Median time to follow-up was 175 days; range, 62-387). The graph shows mean clinician-rated motor impairment severity ± 2 standard errors of the mean. There was a significant improvement in motor scores after surgery in both medication states (paired-samples t > 5.0, P < 0.001). Cleveland Clinic has been designated a Parkinson's Disease Foundation Center of Excellence.

Change in Motor Aspects of Activities of Daily Living Following Deep Brain Stimulation for Parkinson Disease (N = 39)

2019

DBS = deep brain stimulation, MDS-UPDRS-II = Movement Disorders Society – Unified Parkinson’s Disease Rating Scale Part II

The Movement Disorders Society – Unified Parkinson’s Disease Rating Scale Part II (MDS-UPDRS-II) is a self-administered scale with items covering the motor aspects of activities of daily living including speech, feeding, hygiene, handwriting, tremor, hobbies, mobility, and freezing. Higher numbers reflect worse symptoms. Thirty-nine Parkinson disease (PD) patients who underwent deep brain stimulation (DBS) completed the UPDRS-II both before and after surgery (mean time to follow-up was 182 days; range, 54-361). The graph shows mean self-reported symptoms ± 2 standard errors of the mean and compares surgical outcome to the expected group change in symptoms during a 1-year period with medical therapy alone.¹ There was a significant improvement in motor-related activity of daily living skills during the treatment period (paired-samples t = 4.1, P < 0.001). Cleveland Clinic has been designated a Parkinson's Disease Foundation Center of Excellence.

Improvement Following Deep Brain Stimulation Treatment for Parkinson Disease (N = 45)

2019

PGI-I = Patient Global Impression of Improvement

In 2019, 45 PD patients completed the Patient Global Impression of Improvement (PGI-I) questionnaire after DBS. Median time to follow-up was 76 days (range, 26-284). At follow-up, 78% rated their condition as improved, compared with their condition before surgery.

Improvement Following Deep Brain Stimulation for Essential Tremor (N = 24)

2019

PGI-I = Patient Global Impression of Improvement

In 2019, 24 essential tremor patients completed the PGI-I questionnaire after DBS. Median duration of follow-up was 67 days (range, 10-356). At follow-up, 63% percent of patients rated their condition as improved, compared with their condition before surgery.

References
  1. Holden SK, Finseth T, Sillau SH, Berman BD. Progression of MDS-UPDRS scores over five years in de novo Parkinson disease from the Parkinson’s Progression Markers Initiative Cohort. Mov Disord Clin Pract. Jan-Feb 2018;5(1):47-53.