A multiple regression model (adjusted for disease severity, disease duration, active contacts above the STN, use of amantadine, high pre-operative levodopa-equivalent dose (LED), sex, and interaction between active contacts above the STN and amantadine use) was created to describe the relationship between dyskinesia scores and LED prior to DBS.
The beta band power correlated in both experimental sessions with the patient's clinical state (Pearson correlation coefficient <i>r</i> = 0.506, <i>p</i> < 0.001, and <i>r</i> = 0.477, <i>p</i> < 0.001). aDBS after LFP changes was effective (30% improvement without medication [3-way analysis of variance, interaction day × medication <i>p</i> = 0.036; 30.5 ± 3.4 vs 22.2 ± 3.3, <i>p</i> = 0.003]), safe, and well tolerated in patients performing regular daily activities and taking additional dopaminergic medication. aDBS was able to decrease DBS amplitude during motor "on" states compared to "off" states (paired <i>t</i> test <i>p</i> = 0.046), and this automatic adjustment of STN-DBS prevented dyskinesias.
In this study, we identified dyskinesias reduction and distance between the active electrodes and the third ventricle as determining factors of weight gain after STN-DBS implantation in PD patients.
Bilateral subthalamic nucleus DBS holds the most promising results for patients with tremor, severe motor fluctuations and dyskinesias from L-dopa, with the best improvements seen in daily activities and quality of life.