The decade after subthalamic stimulation in advanced XXXX : A balancing act.

@entity1 @entity3034 @entity2003 @entity9221 @entity910 @entity191 @entity2845 @entity400
AIM: The duration of improvement in quality of life after subthalamic nucleus deep brain stimulation ( @entity9221 DBS) for @entity191 ( @entity191 ) and the presurgical identification of factors predicting sustained clinical benefits have implications in @entity1 selection and timing of surgery. These aspects were assessed in @entity1 who underwent yearly assessment for at least 7 years after surgery. MATERIALS AND METHODS: The quality of life, motor and cognitive outcomes of 25 @entity1 who completed the 7-year assessment, and 12 @entity1 who completed the 10-year assessment, were analyzed. RESULTS: The improvement in quality of life was sustained only for 5 years, while the severity of motor signs and motor fluctuations remained reduced at 7 and 10 years. @entity400 and @entity2003 showed more enduring reduction than @entity2845 and axial signs. The dose reduction in medications could be maintained until 7 years, by which time, the axial scores were worse than that seen at the pre-DBS levels. At 10 years, a higher @entity3034 requirement and recurrence of @entity910 were noted. @entity1 with greater pre-DBS @entity3034 -responsive motor signs had greater long-term motor improvement. CONCLUSIONS: @entity9221 DBS performed in @entity1 with advanced motor fluctuations and severe @entity910 provide only an average of 5 years of quality of life improvement. @entity9221 DBS in @entity1 with motor signs that are less responsive to @entity3034 results in shorter duration of clinical benefits. The improvements in the severity of motor fluctuations, @entity2003 , and @entity400 are the most enduring benefits of @entity9221 DBS that last a decade . However, these are offset by worsening axial and cognitive functions, @entity2845 , a higher @entity3034 requirement, and recurrence of @entity910 by the end of the decade.
