Effect of bilateral subthalamic deep brain stimulation on diphasic dyskinesia

OBJECTIVES: The goal of this study was to assess the effect of bilateral subthalamic deep brain stimulation (STN DBS) on levodopa-induced diphasic dyskinesia in patients with Parkinson disease (PD). PATIENTS AND METHODS: Six PD patients with diphasic dyskinesia were included in this study. Prior to surgery, the duration and severity of dyskinesia were determined in each patient, along with the Unified Parkinson Disease Rating Scale score and Hoehn and Yahr stage. Bilateral STN electrode implantation was performed during a single operation. RESULTS: The median duration of the follow-up period was 21.5 months (range 14-24 months). STN DBS had a beneficial effect on diphasic dyskinesia in all patients. At the last follow-up, 3 patients had no dyskinesia and 1 had only a small amount of peak-dose dyskinesia. One patient showed a reduction in the duration of diphasic dyskinesia, despite a lack of reduction in the total duration of dyskinesia. In the last patient, although the total duration of dyskinesia increased, the pattern of dyskinesia changed from severe painful disabling dyskinesia to the less severe peak-dose type of dyskinesia. There were no intraoperative or postoperative surgical complications. CONCLUSIONS: Bilateral STN DBS is good at reducing diphasic dyskinesia, and it can be a good therapeutic option for patients with diphasic dyskinesia.