Clinical Analysis Of Levodopa-induced Dyskinesia Treated By Subthalamic Deep Brain Stimulation

Objective: To evaluate the effect of bilateral subthalamic nucleus(STN)deep brain stimulation(DBS)on levodopa-induced dyskinesia(LID)in patients with Parkinson’s disease(PD),and to explore the possible underlying mechanism.Methods: A retrospective review was conducted on twelve patients who underwent STN DBS for PD from March 2016 to December 2019 in our department.The outcome measures included the Unified Parkinson’s Disease Rating Scale(UPDRS)part Ⅲ and part IV,the dyskinesia subscore(items 32 to 34 of UPDRS part IV)and the levodopa equivalent daily dose(LEDD),which were used to evaluate the improvement of the symptoms before and in 6 months after operation.Results: Six months after STN-DBS,the LID symptoms of the 12 patients were significantly improved,and the improvement of LID were(45.91±13.01)% and(61.96±22.03)%,respectively for UPDRS IV score and the dyskinesia subscore.Six months after surgery,the LEDD was maintained in 2 patients,while the dose was reduced in the other 10 patients.The improvement rate on average of all patients was 43.58%,while the highest rate was 72.00%.Meanwhile,the motor symptoms of all patients were also significantly improved,and the improvement rate of UPDRS Ⅲ score was(68.14 ±9.51)%.Conclusion: STN-DBS could significantly improve dyskinesia symptom of PD patients,and the anti-dyskinesia effect may be not only related to drug reduction,but also related to directly inhibit LID.