In this retrospective study, we longitudinally analyzed axial impairment and falls in people with Parkinson’s disease (PD) and subthalamic nucleus deep brain stimulation (STN-DBS). Axial scores and falling frequency were examined at baseline, and 1, 10, and 15 years after surgery. Preoperative demographic and clinical data, including PD duration and severity, phenotype, motor and cognitive scales, medications, and vascular changes on neuroimaging were examined as possible risk factors through Kaplan–Meier and Cox regression analyses. Of 302 individuals examined before and at 1 year after surgery, 102 and 57 were available also at 10 and 15 years of follow-up, respectively. Axial scores were similar at baseline and at 1 year but worsened at 10 and 15 years. The prevalence rate of frequent fallers progressively increased from baseline to 15 years. Preoperative axial scores, frontal dysfunction and age at PD onset were risk factors for axial impairment progression after surgery. Axial scores, akinetic/rigid phenotype, age at disease onset and disease duration at surgery predicted frequent falls. Overall, axial signs progressively worsened over the long-term period following STN-DBS, likely related to the progression of PD, especially in a subgroup of subjects with specific risk factors.

在这项回顾性研究中，我们纵向分析了帕金森病 (PD) 和丘脑底核深部脑刺激 (STN-DBS) 患者的轴向损伤和跌倒。在基线、术后 1、10 和 15 年检查轴位评分和跌倒频率。通过 Kaplan-Meier 和 Cox 回归分析，检查了术前人口统计学和临床​​数据，包括 PD 持续时间和严重程度、表型、运动和认知量表、药物治疗以及神经影像学上的血管变化作为可能的危险因素。在手术前和手术后 1 年检查的 302 人中，分别有 102 人和 57 人在 10 年和 15 年的随访中可用。轴向评分在基线和 1 年时相似，但在 10 年和 15 年时恶化。频繁跌倒的患病率从基线逐渐增加到 15 岁。术前轴向评分、额叶功能障碍和 PD 发病年龄是术后轴向损伤进展的危险因素。轴位评分、运动障碍/僵硬表型、发病年龄和手术病程预测频繁跌倒。总体而言，在 STN-DBS 后的长期内，轴向体征逐渐恶化，可能与 PD 的进展有关，尤其是在具有特定风险因素的受试者亚组中。