% 0期刊文章%戴安娜Angelika Olszewska %一个阿方索法萨诺%雷纳托·p·穆尼奥斯%卡而言拉米雷斯戈麦斯% Anthony e . Lang % T启动多巴胺受体激动剂而不是左旋多巴在早期帕金森病不延迟DBS的必要性。(p13 - 11.011) % D R 10.1212 / WNL 2023%。0000000000201761 % J首页神经病学% P V 100% N 17补充2% 0090% X目的:确定是否存在区别左旋多巴/多巴胺受体激动剂(DA)第一次治疗和并发症(MC)禁用电机的发展促使考虑脑深部刺激(DBS)。背景:在左旋多巴是最有效的对症治疗帕金森病(PD),这是与MC风险增加有关治疗的第一个五年相比DA第一治疗有效的/有副作用更少。设计/方法:我们进行了一个大型的回顾性队列研究1627 PD患者参加DBS西方医院,诊所在多伦多加拿大(03/2004-02/2022)。PD病人苍白球interna (GPi) /丘脑核(STN) DBS在≥2005解决禁用MC被包括在内。结果:438例患者符合入选标准(352 STN / 86 GPi DBS)。疾病持续时间中值为9年(2 - 30)。312收到了左旋多巴/ 126 DA(无显著差异在目标选择/金刚烷胺使用)。持续时间从第一treatment-DBS评估(左旋多巴平均8,差4;达9中值,差4,p = 0.64)或DBS外科手术(左旋多巴值10,差5;DA值10,差5 p = 075),没有差别(age-at-diagnosis调整的,性别,金刚烷胺)。在最长的两项研究,只有1/5-1/3原始队列随访14年后的用于评估(前进行DBS建立MC治疗PD)。 Large studies including younger patients at greater risk of MC/with intermediate disease duration, are lacking. 49% of our patients was diagnosed at age ≤ 50, had a long follow up, sufficient to allow the development of disabling MC, but without major mortality/morbidity. Our final sample size was >2x larger than three of the longest studies combined (Hely;2005/Hauser;2007/Katzenschlager;2008)Conclusions: This is the only study to date to evaluate the duration between L-dopa/DA first treatment and the MC development of sufficient severity to warrant DBS consideration. The results suggests these are independent of the first treatment type.Disclosure: Dr. Olszewska has nothing to disclose. Dr. Fasano has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott. Dr. Fasano has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abbvie. Dr. Fasano has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ipsen. Dr. Fasano has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Medtronic. Dr. Fasano has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Boston Scientific. Dr. Fasano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbott. Dr. Fasano has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic. Dr. Fasano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sunovion. Dr. Fasano has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ceregate. The institution of Dr. Fasano has received research support from Boston Scientific. The institution of Dr. Fasano has received research support from Medtronic. The institution of Dr. Fasano has received research support from Abbvie. Dr. Fasano has received publishing royalties from a publication relating to health care. Dr. Munhoz has nothing to disclose. Carolina Ramírez Gómez has nothing to disclose. Dr. Lang has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbvie, Acorda, AFFiRis, Biogen, Denali, Janssen, Intracellular, Kallyope, Lundbeck, Paladin, Retrophin, Roche, Sun Pharma, Theravance, and Corticobasal Degeneration Solutions, Sun Pharma, Medichem, Medtronic, AbbVie and Sunovion. The institution of Dr. Lang has received research support from AbbVie. Dr. Lang has received publishing royalties from a publication relating to health care. %U