{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T17:54:35Z","timestamp":1755798875211},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The objective of this study was to evaluate clinical features and response to deep brain stimulation (DBS) in G2019S <jats:italic>LRRK2<\/jats:italic>-Parkinson disease (LRRK2-PD) and idiopathic PD (IPD).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors conducted a clinic-based cohort study of PD patients recruited from the Mount Sinai Beth Israel Genetics database of PD studies. The cohort included 87 participants with LRRK2-PD (13 who underwent DBS) and 14 DBS participants with IPD enrolled between 2009 and 2017. The baseline clinical features, including motor ratings and levodopa-equivalent daily dose (LEDD), were compared among LRRK2-PD patients with and without DBS, between LRRK2-PD with DBS and IPD with DBS, and between LRRK2-PD with subthalamic nucleus (STN) and internal segment of the globus pallidus (GPi) DBS. Longitudinal motor scores (Unified Parkinson\u2019s Disease Rating Scale\u2013part III) and medication usage were also assessed pre- and postoperatively.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Compared to LRRK2-PD without DBS (n = 74), the LRRK2-PD with DBS cohort (n = 13) had a significantly younger age of onset, longer disease duration, were more likely to have dyskinesia, and were less likely to experience hand tremor at disease onset. LRRK2-PD participants were also more likely to be referred for surgery because of severe dyskinesia (11\/13 [85%] vs 6\/14 [43%], p = 0.04) and were less likely to be referred for medically refractory tremor (0\/13 [0%] vs 6\/14 [43%], p = 0.02) than were IPD patients. Among LRRK2-PD patients, both STN-DBS and GPi-DBS targets were effective, although the sample size was small for both groups. There were no revisions or adverse effects reported in the GPi-DBS group, while 2 of the LRRK2-PD participants who underwent STN-DBS required revisions and a third reported depression as a stimulation-related side effect. Medication reduction favored the STN group.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>The LRRK2-PD cohort referred for DBS had a slightly different profile, including earlier age of onset and dyskinesia. Both the STN and GPi DBS targets were effective in symptom suppression. Patients with G2019S<jats:italic> LRRK2<\/jats:italic> PD were well-suited for DBS therapy and had favorable motor outcomes regardless of the DBS target. LRRK2-DBS patients had longer disease durations and tended to have more dyskinesia. Dyskinesia commonly served as the trigger for DBS surgical candidacy. Medication-refractory tremor was not a common indication for surgery in the <jats:italic>LRRK2<\/jats:italic> cohort.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2021.7.jns21190","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T08:01:11Z","timestamp":1639123271000},"page":"184-191","source":"Crossref","is-referenced-by-count":9,"title":["Clinical profiles and outcomes of deep brain stimulation in G2019S LRRK2 Parkinson disease"],"prefix":"10.3171","volume":"137","author":[{"given":"Katherine","family":"Leaver","sequence":"first","affiliation":[{"name":"Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Viser","sequence":"additional","affiliation":[{"name":"Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian H.","family":"Kopell","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto A.","family":"Ortega","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan","family":"Miravite","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael S.","family":"Okun","sequence":"additional","affiliation":[{"name":"Department of Neurology, Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonya","family":"Elango","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Raymond","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan B.","family":"Bressman","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Saunders-Pullman","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mount Sinai Beth Israel, and Icahn School of Medicine, Mount Sinai, New York, New York;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta San","family":"Luciano","sequence":"additional","affiliation":[{"name":"Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, California; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"b1","series-title":"Neuron","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1016\/j.neuron.2004.11.005","article-title":"Mutations in LRRK2 cause autosomal-dominant parkinsonism with pleomorphic pathology","volume":"44","author":"Zimprich A","year":"2004","unstructured":"Zimprich A, Biskup S, Leitner P, Lichtner P, Farrer M, Lincoln S,  Mutations in LRRK2 cause autosomal-dominant parkinsonism with pleomorphic pathology. 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