Target selection and response to deep brain stimulation according to target and genetic subgroup
| UPDRS-III score: Mean ± SD | UPDRS-IV | ||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Post-op | Dyskinesia score: Mean ± SD | ||||||||||||||||||||||||||
| Genetic test results | No. of patients | DBS target | Disease duration at DBS: Mean ± SD, y | Pre-op: Off meds | Off meds/off stim | Off meds/on stim | Percentage improvement in UPDRS-III score off meds/on stim vs pre-op off meds | Post-op: On meds/on stim | Mean ± SD reduction in LED, mg | Pre-op | Post-op | Percentage improvement in post-op vs pre-op UPDRS-IV score | |||||||||||||||
| Parkin (compound Hets/Homozy's) | 3 | GPi | 21.1 ± 16.2 | 53.3 ± 13.9 | 43.3 ± 16.4 | 42.0 ± 19.0 | 21% | 27.3 ± 17.6 | −237 ± 315 | 8.0 ± 1.4 | 1.67 ± 2.0 | 70% | |||||||||||||||
| 2 | STN | 31.3 ± 0.6 | 62.5 ± 3.5 | 84.0 ± 22.6 | 43.0 ± 0.0 | 31% | 23.5 ± 6.4 | 20 ± 594 | 2.5 ± 3.5 | 2.0 ± 1.4 | 20% | ||||||||||||||||
| GBA (confirmed PD mutation) | 2 | GPi | 15.5 ± 5.3 | 64.5 ± 21.9 | 66.5 ± 19.1 | 50.0 ± 19.8 | 22% | 41.0 ± 15.6 | 1005 ± 77 | 8.5 ± 0.7 | 0.5 ± 0.7 | 94% | |||||||||||||||
| 13 | STN | 10.9 ± 4.9 | 50.5 ± 12.4 | 56.1 ± 18.8 | 28 ± 11.4 | 40% | 15.9 ± 10.4 | 146 ± 510 | 2.4 ± 1.7 | 1.5 ± 1.6 | 37% | ||||||||||||||||
| 1 | VIM (unilateral) | 3.9 | 35 | 35 | 20 | 43% | 8 | 445 | 0 | 0 | — | ||||||||||||||||
| LRRK2 | 5 | STN | 12.1 ± 1.8 | 65.4 ± 14.9 | 69.2 ± 12.4 | 30.6 ± 16.1 | 53% | 14.0 ± 8.1 | 586 ± 495 | 4.2 ± 3.1 | 1.4 ± 2.6 | 50% | |||||||||||||||
| No mutation found | 2 | GPi | 21.7 ± 0.5 | 40.5 ± 13.4 | 78 ± 7.1 | 51.0 ± 7.1 | −28% | 25.5 ± 4.9 | 227 ± 89 | 6.0 ± 1.4 | 3.5 ± 0.7 | 42% | |||||||||||||||
| 65 | STN | 14.8 ± 5.4 | 47.6 ± 14.8 | 50.0 ± 15.4 | 24.6 ± 11.3 | 48% | 15.0 ± 9.0 | 468 ± 494 | 3.1 ± 2.2 | 3.0 ± 2.2 | 26% | ||||||||||||||||
SD, standard deviation; UPDRS-III, Unified Parkinson's Disease Rating Scale, part 3 (motor examination); meds, medication; stim, stimulation; LED, l-dopa equivalent dose; UPDRS-IV, Unified Parkinson's Disease Rating Scale, part 4 (motor complications); DBS, deep brain stimulation; GPi, globus pallidus internus; STN, subthalamic nucleus; GBA, glucosidase beta acid; VIM, ventral intermediate nucleus; LRRK2, leucine-rich repeat kinase 2.