Deep Brain Stimulation in Moroccan Patients With Parkinson's Disease: The Experience of Neurology Department of Rabat

• Main Authors: Mounia Rahmani, Maria Benabdeljlil, Fouad Bellakhdar, Mustapha El Alaoui Faris, Mohamed Jiddane, Khalil El Bayad, Fatima Boutbib, Rachid Razine, Rachid Gana, Moulay R. El Hassani, Nizar El Fatemi, Meryem Fikri, Siham Sanhaji, Hennou Tassine, Imane El Alaoui Balrhiti, Souad El Hadri, Najwa Ech-Cherif Kettani, Najia El Abbadi, Mourad Amor, Abdelmjid Moussaoui, Afifa Semlali, Saadia Aidi, El Hachmia Ait Benhaddou, Ali Benomar, Ahmed Bouhouche, Mohamed Yahyaoui, Abdeslam El Khamlichi, Abdessamad El Ouahabi, Rachid El Maaqili, Houyam Tibar, Yasser Arkha, Adyl Melhaoui, Abdelhamid Benazzouz, Wafa Regragui
• Format: Article
• Language: English
• Published: Frontiers Media S.A. 2018-07-01
• Series: Frontiers in Neurology
• Subjects: Parkinson disease; deep brain stimulation; subthalamic nucleus; quality of life; surgical benefit; clinical outcome
• Online Access: https://www.frontiersin.org/article/10.3389/fneur.2018.00532/full

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.