The MDS-UPDRS tracks motor and non-motor improvement due to subthalamic nucleus deep brain stimulation in Parkinson disease

Parkinsonism Relat Disord. 2013 Nov;19(11):966-9. doi: 10.1016/j.parkreldis.2013.06.010. Epub 2013 Jul 10.

Abstract

Background: The Movement Disorders Society revision of the Unified Parkinson Disease Rating Scale (MDS-UPDRS) improves upon the original UPDRS by adding more non-motor items, making it a more robust tool to evaluate the severity of motor and non-motor symptoms of Parkinson disease. Previous studies on deep brain stimulation have not used the MDS-UPDRS.

Objective: To determine if the MDS-UPDRS could detect improvement in both motor and non-motor symptoms after bilateral subthalamic nucleus deep brain stimulation for Parkinson disease.

Methods: We compared scores on the entire MDS-UPDRS prior to surgery (baseline) and approximately six months following the initial programming visit in twenty subjects (12M/8F) with Parkinson disease undergoing bilateral subthalamic nucleus deep brain stimulation.

Results: STN DBS significantly improved the scores for every section of the MDS-UPDRS at the 6 month follow-up. Part I improved by 3.1 points (22%), Part II by 5.3 points (29%), Part III by 13.1 points (29%) with stimulation alone, and Part IV by 7.1 points (74%). Individual non-motor items in Part I that improved significantly were constipation, light-headedness, and fatigue.

Conclusions: Both motor and non-motor symptoms, as assessed by the MDS-UPDRS, improve with bilateral subthalamic nucleus stimulation six months after the stimulator is turned on. We recommend that the MDS-UPDRS be utilized in future deep brain stimulation studies because of the advantage of detecting change in non-motor symptoms.

Keywords: Deep brain stimulation; Motor symptoms; Non-motor symptoms; Parkinson disease; Subthalamic nucleus.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Deep Brain Stimulation / methods
  • Deep Brain Stimulation / trends*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Motor Skills / physiology*
  • Parkinson Disease / diagnosis
  • Parkinson Disease / physiopathology*
  • Parkinson Disease / therapy*
  • Prospective Studies
  • Subthalamic Nucleus / physiology*
  • Treatment Outcome