Parkin mutation and deep brain stimulation outcome

Abstract

Patients with parkin mutations are expected to be good candidates for deep brain stimulation (DBS) because of an excellent levodopa response and frequent occurrence of levodopa-induced dyskinesia. However, there are insufficient data on surgical outcome in patients with parkin mutations. This study aimed to compare the outcome of subthalamic nucleus DBS in patients with early-onset Parkinson's disease with and without parkin mutations. Fourteen patients with early-onset Parkinson's disease who underwent bilateral subthalamic nucleus DBS surgery were screened for parkin mutations and assessed for surgical outcomes at baseline and 2-5years after surgery. Three patients had homozygote/compound heterozygote mutations; two had single heterozygote mutations; and nine had no mutations. Patients with homozygote/compound heterozygote mutations were younger at disease onset and had longer disease duration than patients without a parkin mutation. Postoperatively, there were no significant differences in improvement on the Unified Parkinson's Disease Rating Scale part II, III, and IV, or the reduction of levodopa equivalent daily doses between patients with and without parkin mutations. The therapeutic effect of DBS did not differ between patients with and without parkin mutations.

Keywords: Deep brain stimulation; Neurophysiology; Parkin; Parkinson’s disease; Subthalamic nucleus.