Levodopa and subthalamic deep brain stimulation responses are not congruent

Adam Zaidel*, Hagai Bergman, Ya'acov Ritov, Zvi Israel Md

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

31 Scopus citations

Abstract

There is a consensus that in Parkinson's disease, the extent of preoperative levodopa responsiveness predicts the efficacy of subthalamic nucleus deep brain stimulation (STN DBS). However, this may be the result of statistical methods and primary assumptions. We were able to reproduce previously published correlation results on our data (N = 49 patients). Yet, these same results were demonstrated even after random shuffling of our data. Notably, we did not observe a correlation between STN DBS efficacy and preoperative levodopa responsiveness when using their respective baselines and fractional scores of motor improvement. Furthermore, postoperative responses were not limited by preoperative scores, with tremor demonstrating the greatest discrepancy. We conclude that preoperative levodopa responsiveness does not predict or limit the outcome of STN DBS. These results imply different therapeutic mechanisms for levodopa and STN DBS and therefore question the validity of using substantial preoperative levodopa responsiveness as a selection criterion for STN DBS.

Original languageAmerican English
Pages (from-to)2379-2386
Number of pages8
JournalMovement Disorders
Volume25
Issue number14
DOIs
StatePublished - Oct 2010

Keywords

  • Basal ganglia
  • Deep brain stimulation
  • Levodopa
  • Parkinson's disease
  • Predictive factor
  • Subthalamic nucleus

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