Age at onset (years) |
56 |
46 |
59 |
Age at DBS (years) |
63 (L STN was revised at age 65) |
58 |
70 |
Age at LCIG (years) |
71 |
64 |
72 |
DBS target |
Bilateral STN |
Bilateral STN |
Bilateral GPi |
Reason for DBS |
Wearing off and dyskinesia |
Wearing off and dyskinesia |
Wearing off, dyskinesia, and off-dystonia |
Reason for LCIG |
Wearing off, dyskinesia, and hallucination due to DA |
Wearing off and dyskinesia |
Wearing off |
Four-condition test*
|
|
|
|
Off-medication/Off-stim |
40 |
48 |
87 |
Off-medication/On-stim |
26 (-35.0%) |
35 (-27.0%) |
80 (-8.1%) |
On-medication/Off-stim |
19 (-52.5%) |
30 (-37.5%) |
65 (-25.3%) |
On-medication/On-stim |
15 (-62.5%) |
28 (-41.2%) |
54 (-37.9%) |
UPDRS part III scores† (on-medication/on-stim) |
19/15 |
39/33 |
43/33 |
UPDRS part IV scores†
|
8/7 |
8/2 |
NA |
LEDD (mg)†
|
652.5/960 |
1,327.5/1,246 |
1,430/1,688.5 |
LCIG settings |
|
|
|
Morning dose (mL) |
8.0 |
6.8 |
13.0 |
Continuous dose (mL/h) |
2.5 |
3.0 |
4.0 |
Extra doses (mL) |
1.0 |
1.0 |
1.0 |
DBS settings (pre-LCIG) |
L STN1: 1(−)C(+), 2.6 mA, 60 µs, 125 Hz |
L STN: 2(−)C(+), 2.6 mA, 60 µs, 130 Hz |
L GPi: 2(−)C(+), 3.2 mA, 90 µs, 130 Hz |
L STN2: 2(−)C(+), 2.4 mA, 60 µs, 125 Hz |
R STN1: 1(−)C(+), 2.3 mA, 60 µs, 125 Hz |
R GPi1: 3(−)C(+), 3.1 mA, 60 µs, 125 Hz |
R STN1: 1(−)C(+), 2.5 mA, 60 µs, 125 Hz |
R STN2: 2(−)C(+), 2.5 mA, 60 µs, 125 Hz |
R GPi2: 2(−)1(+), 3.0 mA, 60 µs, 125 Hz |
R STN2: 2(−)C(+), 2.0 mA, 60 µs, 125 Hz |
|
|
DBS settings (post-LCIG) |
L STN1: 1(−)C(+), 2.6 mA, 60 µs, 125 Hz |
L STN: 2(−)C(+), 1.9 mA, 60 µs, 200 Hz |
L GPi: 2(−)C(+), 2.9 mA, 90 µs, 130 Hz |
L STN2: 2(−)C(+), 2.4 mA, 60 µs, 125 Hz |
R STN1: 1(−)C(+), 2.3 mA, 60 µs, 125 Hz |
R GPi1: 3(−)C(+), 3.2 mA, 60 µs, 125 Hz |
R STN1: 1(−)C(+), 2.3 mA, 60 µs, 125 Hz |
R STN2: 2(−)C(+), 2.5 mA, 60 µs, 125 Hz |
R GPi2: 2(−)1(+), 3.3 mA, 60 µs, 125 Hz |
R STN2: 2(−)C(+), 2.0 mA, 60 µs, 125 Hz |
|
|
Oral medications (pre-LCIG) |
Levodopa/carbidopa 100/10 mg (1/2 tablet ×5), levodopa/carbidopa/entacapone 50/5/100 (×5), pramipexole 2 mg, and selegiline 5 mg |
Levodopa/carbidopa/entacapone 50/10/100 mg (×11), entacapone 100 mg (×11), cabergoline 3 mg, pramipexole 4.125 mg, zonisamide 25 mg, droxidopa 600 mg, donepezil 10 mg, and clonazepam 0.5 mg |
Levodopa/carbidopa (100/10 mg) 1,100 mg (6×, q3h), entacapone 600 mg (6×, q3h), amantadine 100 mg, and donepezil 10 mg |
Oral medications (post-LCIG) |
Donepezil 5 mg, memantine 20 mg, quetiapine 50 mg, clonazepam 0.5 mg, and etizolam 0.5 mg |
Pramipexole LA 1.5 mg, donepezil 10 mg, and droxidopa 300 mg |
Rotigotine 13.5/24 h (overnight) and donepezil 10 mg |
Outcomes |
1. Motor fluctuations improved with LCIG |
1. Motor fluctuations improved with LCIG |
1. Motor fluctuations improved with LCIG |
2. Hallucination improved with the discontinuation of DA |
2. Right-sided dyskinesia improved with DBS adjustment on the left side |
2. Dyskinesia improved by increasing bilateral GPi stim |
3. Left-sided dyskinesia improved with DBS adjustment on the right side |
3. LCIG discontinued after a month because of inability to maintain use |