AUTHOR=Rahmani Mounia , Benabdeljlil Maria , Bellakhdar Fouad , Faris Mustapha El Alaoui , Jiddane Mohamed , Bayad Khalil El , Boutbib Fatima , Razine Rachid , Gana Rachid , Hassani Moulay R. El , Fatemi Nizar El , Fikri Meryem , Sanhaji Siham , Tassine Hennou , Balrhiti Imane El Alaoui , Hadri Souad El , Kettani Najwa Ech-Cherif , Abbadi Najia El , Amor Mourad , Moussaoui Abdelmjid , Semlali Afifa , Aidi Saadia , Benhaddou El Hachmia Ait , Benomar Ali , Bouhouche Ahmed , Yahyaoui Mohamed , Khamlichi Abdeslam El , Ouahabi Abdessamad El , Maaqili Rachid El , Tibar Houyam , Arkha Yasser , Melhaoui Adyl , Benazzouz Abdelhamid , Regragui Wafa
TITLE=Deep Brain Stimulation in Moroccan Patients With Parkinson's Disease: The Experience of Neurology Department of Rabat
JOURNAL=Frontiers in Neurology
VOLUME=9
YEAR=2018
URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2018.00532
DOI=10.3389/fneur.2018.00532
ISSN=1664-2295
ABSTRACT=Introduction: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is known as a therapy of choice of advanced Parkinson's disease. The present study aimed to assess the beneficial and side effects of STN DBS in Moroccan Parkinsonian patients.
Material and Methods: Thirty five patients underwent bilateral STN DBS from 2008 to 2016 in the Rabat University Hospital. Patients were assessed preoperatively and followed up for 6 to 12 months using the Unified Parkinson's Disease Rating Scale in four conditions (stimulation OFF and ON and medication OFF and ON), the levodopa-equivalent daily dose (LEDD), dyskinesia and fluctuation scores and PDQ39 scale for quality of life (QOL). Postoperative side effects were also recorded.
Results: The mean age at disease onset was 42.31 ± 7.29 years [28–58] and the mean age at surgery was 54.66 ± 8.51 years [34–70]. The median disease duration was 11.95 ± 4.28 years [5–22]. Sixty-three percentage of patients were male. 11.4% of patients were tremor dominant while 45.71 showed akinetic-rigid form and 42.90 were classified as mixed phenotype. The LEDD before surgery was 1200 mg/day [800-1500]. All patients had motor fluctuations whereas non-motor fluctuations were present in 61.80% of cases. STN DBS decreased the LEDD by 51.72%, as the mean LEDD post-surgery was 450 [188-800]. The UPDRS-III was improved by 52.27%, dyskinesia score by 66.70% and motor fluctuations by 50%, whereas QOL improved by 27.12%. Post-operative side effects were hypophonia (2 cases), infection (3 cases), and pneumocephalus (2 cases).
Conclusion: Our results showed that STN DBS is an effective treatment in Moroccan Parkinsonian patients leading to a major improvement of the most disabling symptoms (dyskinesia, motor fluctuation) and a better QOL.