Effect of subthalamotomy on daily life activities in idiopathic Parkinson’s disease

Matter, Mohamed Amgad; Galhom, Ayman Elsayed; Khedr, Ali Salah; Nada, Ahmed Sameh; Abu Elfadle, Amr Said

doi:10.21608/muj.2024.321209.1185

Effect of subthalamotomy on daily life activities in idiopathic Parkinson’s disease

Document Type : Original Article

Authors

¹ general health insurance

² Neurosurgery department, Faculty of medicine, Port Said University, Egypt

³ neurosurgery department, suez canal university

10.21608/muj.2024.321209.1185

Abstract

Background:
Subthalamotomy, a surgical procedure targeting the subthalamic nucleus, has been shown to improve motor symptoms in Parkinson's disease patients.The aim of the study was to determine if subthalamotomy is effective on daily life activities in Parkinson’s disease patients.
Methods:
Between 2021 to 2024 in Al-Salam hospital, the general authority of healthcare, Port Said, Suez Canal University Hospital, Ismailia, and affiliated hospitals, A descriptive study was performed on fourteen patients, lesioning stereotactic surgery on the subthalamic nucleus was done. Radiofrequency thermocoagulation was employed to induce lesions. Fourteen individuals who underwent unilateral subthalamotomy were assessed over a period of up to six months using PDQ-39 QUESTIONNAIRE, UPDRS and shwab and England ADL scale.
Results:
Six months into the “off” period after surgery, there were significant improvements in contralateral bradykinesia, rigidity and tremors, Schwab & England ADL scale was significantly increased six months after surgery than before from 46.0±9.21 to 84.00±7.58 during “Off” state and from 68.0±9.68 to 94.0±5.34 during “On” state. The levodopa requirement was reduced by 50.65% for the unilateral treated group. Two patients suffered hemiballismus, one was mild and resolved within two weeks through a reduction in levodopa dosage. The second patient had severe hemiballismus.
Conclusion:
The results suggest that subthalamotomy can effectively manage the key symptoms of Parkinson's disease, decrease the required levodopa dosage, and enhance patients' quality of life. While DBS of the STN has been the preferred treatment approach for PD, ablation of the subthalamic nucleus may provide a safe, technically viable, and more cost-effective alternative.

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