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Subthalamic Deep Brain Stimulation for a Parkinson's Disease Patient With Duplication of SNCA

To the Editor: Deep brain stimulation (DBS) of the bilateral subthalamic nucleus (STN) is a widely accepted treatment for cardinal motor symptoms in advanced Parkinson’s disease (PD). Although the effect of STNDBS on cognitive function or psychiatric symptoms is still debated (1), many previous reported studies excluded patients with apparent dementia or psychiatric problems before the surgery; therefore, we should carefully screen for psychiatric or cognitive problems before introducing this therapy. Multiplication of SNCA is a known causative factor of autosomal dominant familial PD, which has a very similar phenotype to sporadic PD. A recent study indicated that patients with duplication of SNCA frequently showed psychiatric problems (2). However, there is only one report about STN-DBS of a patient with SNCA multiplication followed a short time after the surgery (3). Here, we report on a patient genetically proven to have SNCA duplication who received STN-DBS to improve motor fluctuation and to reduce the use of antiparkinsonian drugs for a longer period (four years) after the surgery.