Table A3.
Characteristics of patients firstly treated with DBS, CLI as second treatment—reported in literature.
| Klostermann et al., 2011 | Aldred et al., 2016 | Regidor et al., 2017 | Faust-Socher et al., 2018 | Kumar et al., 2018 | Liang et al., 2018 | Elkouzi et al., 2019 | |||
| Case | Case 1 | Case 2 | Case 1 | Combined data (n = 19) | Combined data (n = 7) | Combined data (n = 7) | Case 1 | Case 2 | Combined data (n = 6) |
| Sex M:F | M | M | UA | 11:8 | 5:2 | 4:3 | M | F | 6:0 |
| Age at PD diagnosis in years; range (mean) | 50 | 50 | UA | (44 *, SD 5.2 *) | UA | 31–60 (48) | 43 | 53 | 30–70 (53) |
| Age at initiation first treatment in years; range (mean) | 61 | 63 | UA | UA | UA, range disease duration 6–12 years |
55–72 (63) | 65 | 71 | 40–77 (61) |
| Interval between initiation treatments in years; range (mean) | 9 | 9 | 5 | 2–12 (7.8) | 3–10 | 2–12 (5) | 7 | 4 | 6–18 (13) |
| Initial effect of first treatment | Good | Good | Responsive | UA | Significant benefit | Good (n = 3) Little (n = 1) None (n = 3) |
Good | Little | Successful, in all |
| DBS target | UA | R/L STN | R/L STN | R/L STN | R/L STN (n = 5), Unil STN (n = 2) |
R/L STN (n = 3) Unil STN (n = 1) L GPi (n = 1) Unil PPN (n = 2) |
STN | STN | R/L STN (n = 3) R/L GPi (n = 1) Unil GPi (n = 2) |
| Initial therapy continued | Yes | Yes | UA | Yes (14/19) CLI discontinued (n = 5) |
UA | UA | Yes | Yes | Yes |
| Indication for second treatment | MF, increased off time | Increased off time, chin tremor | Disabling FOG in ON phase | Invalidating symptoms In off state (n = 16) Axial dystonia (n = 2) Severe pain (n = 1) |
UA | MFD (n = 7) FOG (n = 1) Pain (n = 1) Fatigue (n = 1) Cognitive impairment (n = 1) |
Mood elevation, speech impairment | Dyskinesia | MF (n = 6) Cognitive decline (n = 2) Subdural hematoma (n = 1) |
| LEDD pre-CLI; range (mean) | 2600 | 2183 | UA | UA | UA | 800–2695 (1456) | 1082 | 2278 | 1100–3150 (2241) |
| LEDD post-CLI; range (mean) | UA | UA | UA | UA | UA | 608–3188 (1310) | 848 | Unchanged | 1600–3216 (2317) |
| UPDRS-III med off pre-DBS; range (mean) | UA | UA | UA | 52 | UA | 15–50 (41, n = 6) | UA | UA | 25–36 (30) |
| UPDRS-III med on pre-DBS; range (mean) | UA | UA | UA | 25 | UA | 9–33, (17, n = 6) | UA | UA | UA |
| Improvement according to authors | Yes, decrease in off time | Yes, decrease in off time | Yes | Yes, on group level | Yes, in all | Yes, improvement of motor fluctuations | Yes | Yes, improvement of dyskinesia | Yes, in all |
| Kimber et al., 2019 | Sanchez-Rodriguez et al., 2019 | Bautista et al., 2020 | Gonzalez-Herrero et al., 2020 | Spanaki et al., 2020 | |||||
| Case | Case 1 | Case 2 | Case 3 | Case 1 | Case 1 | Case 2 | Case 3 | Combined data (n = 5) | Combined data (n = 5) †† |
| Sex M:F | UA | UA | UA | M | F | F | F | 0:5 | UA |
| Age at PD diagnosis in years; range (mean) | 51 | 46 | 46 | 44 | 56 | 46 | 59 | 54–63 (56) | UA |
| Age at initiation first treatment in years; range (mean) | 58 | 53 | 58 | 51 | 63 | 58 | 70 | 57–69 (65) | UA |
| Interval between initiation treatments in years; range (mean) | 9 | 8 | 8 | 4 | 8 | 6 | 2 | 0–6 (2.6) | UA |
| Initial effect of first treatment | Substantial in all | Good | Good | Good | Good | UA | UA | ||
| DBS target | STN | STN | STN | STN, later GPi | R/L STN | R/L STN | R/L GPi | STN | STN |
| Initial therapy continued | UA | UA | UA | UA | Yes | Yes | Yes, CLI (2nd therapy) discontinued after 1 month | Yes, in 3/5 | Yes |
| Indication for second treatment | FOG, GI, dystonia | FOG, GI, dystonia | FOG, GI, dystonia | MFD, dystonia | MFD | MFD | MF | FOG | MF |
| LEDD pre-CLI; range (mean) | 800 | 612 | 801 | UA | 653 | 1327 | 1430 | 855–2400 (1653) | UA |
| LEDD post-CLI; range (mean) | CLI 40 mg/h | CLI 52 mg/h | CLI 70 mg/h | UA | 960 | 1246 | 1689 | 1098–2310 (1820) | UA |
| UPDRS-III med off pre-DBS; range (mean) | UA | UA | UA | UA | UA | UA | UA | UA | UA |
| UPDRS-III med on pre-DBS; range (mean) | UA | UA | UA | UA | UA | UA | UA | UA | UA |
| Improvement according to authors | Long lasting in all | None † | Yes | Yes | Yes | Yes, in 4/5 | UA | ||
CLI: continuous levodopa/carbidopa infusion; DBS: deep brain stimulation; GI: gait impairment; F: female; FOG: freezing of gait; GPi: globus pallidus interna; LEDD: levodopa equivalent daily dose; M: male; med: medication; MF: unpredictable motor fluctuations; MFD: unpredictable motor fluctuations and dyskinesias; PD: Parkinson’s disease; PPN: pedunculopontine nucleus; R/L: right/left; STN: subthalamic nucleus; Unil: unilateral; UA: unavailable; UPDRS: Unified Parkinson’s Disease Rating Scale, part III; *: derived from available data; †: a trial with continuous apomorphine infusion after CLI showed slight improvement; ††: one additional patient had been treated with continuous apomorphine infusion instead of CLI after DBS, separate results were unavailable.