Abstract Details

Title Bilateral STN-DBS in PD and Cardiovascular Autonomic Function outcome at One Year

Topic Movement Disorders

Presentation(s) P04 - (-)

Poster/Presentation
Number 183

Objective

Background BACKGROUND: Cardiovascular autonomic abnormalities, especially orthostatic hypotension, are a major cause of morbidity in late stages of disease and can be worsened with dopaminergic drugs. The effect of STN-DBS on autonomic functions are not clearly known with few published studies.

Design/Methods DESIGN/METHODS: In a longitudinal ongoing observational study from 2009-2012, 20 patients with IPD who underwent bilateral STN-DBS were evaluated prior to and at 12 months after surgery. Autonomic function testing was done after stopping anti parkinsonian medication at least for 6 hours and in patients who had undergone STN-DBS, the simulator was also switched off for half an hour prior to testing. All patients were evaluated with the following tests using WR works equipment: - heart rate variation to deep breathing, BP response to standing, heart rate variation to Valsalva, heart rate response to standing and diastolic blood pressure to hand grip. Patients were graded as per Ewing's criteria into normal, early, definite and severe autonomic dysfunction.

Results RESULTS: 20 patients with mean age of 51.3±8.8 years, disease duration of 8.9±4.4 years and M:F ratio of 60:40 were included. Mean UPDRSIII score in 'off' state was 50.7±9.2 and in 'on' state was 12±2.8. On autonomic function evaluation, the ratio of patients with normal, mild , definite and severe abnormalities prior to stimulator implantation were 30%, 45%, 10% and 15% and at 1 year after implantation were 10%, 25%, 40% and 25% respectively which was not significantly different on statistical analysis (Chi square test).

Conclusions CONCLUSIONS: Cardiovascular autonomic functions at 1 year follow up in patients with bilateral STN-DBS did not show significant worsening. STN-DBS may have a beneficial role by reducing levodopa dosage.

Authors/Disclosures
Rupam Borgohain, MD PRESENTER	No disclosure on file
Rukmini M. Kandadai, MD (Medwiz Healthcare Communications Pvt Ltd)	No disclosure on file
Afshan Jabeen	No disclosure on file
Meena A. Kanikannan, MD	No disclosure on file
	No disclosure on file
	No disclosure on file

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