Abstract
AbstractTo identify predictors of 36-month follow-up quality of life (QoL) outcome after bilateral subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson’s disease (PD). In this ongoing, prospective, multicenter international study (Cologne, Manchester, London) including 73 patients undergoing STN-DBS, we assessed the following scales preoperatively and at 6-month and 36-month follow-up: PD Questionnaire-8 (PDQ-8), NMSScale (NMSS), Scales for Outcomes in PD (SCOPA)-motor examination, -activities of daily living, and -complications, and levodopa equivalent daily dose (LEDD). We analyzed factors associated with QoL improvement at 36-month follow-up based on (1) correlations between baseline test scores and QoL improvement, (2) step-wise linear regressions with baseline test scores as independent and QoL improvement as dependent variables, (3) logistic regressions and receiver operating characteristic curves using a dichotomized variable “QoL responders”/“non-responders”. At both follow-ups, NMSS total score, SCOPA-motor examination, and -complications improved and LEDD was reduced significantly. PDQ-8 improved at 6-month follow-up with subsequent decrements in gains at 36-month follow-up when 61.6% of patients were categorized as “QoL non-responders”. Correlations, linear, and logistic regression analyses found greater PDQ-8 improvements in patients with younger age, worse PDQ-8, and worse specific NMS at baseline, such as ‘difficulties experiencing pleasure’ and ‘problems sustaining concentration’. Baseline SCOPA scores were not associated with PDQ-8 changes. Our results provide evidence that 36-month QoL changes depend on baseline neuropsychological and neuropsychiatric non-motor symptoms burden. These findings highlight the need for an assessment of a wide range of non-motor and motor symptoms when advising and selecting individuals for DBS therapy.
Recommended Citation
Jost, S.,
Dafsari, H.,
Visser-Vandewalle, V.,
Rizos, A.,
Loehrer, P.,
Silverdale, M.,
Evans, J.,
Samuel, M.,
Petry-Schmelzer, J.,
Sauerbier, A.,
Gronostay, A.,
Barbe, M.,
Fink, G.,
Ashkan, K.,
Antonini, A.,
Martinez-Martin, P.,
Chaudhuri, K.,
Timmermann, L.,
Bhidayasiri, R.,
Falup-Pecurariu, C.,
Jeon, B.,
Leta, V.,
Borghammer, P.,
Odin, P.,
Schrag, A.,
Storch, A.,
Violante, M.,
Weintraub, D.,
Adler, C.,
Barone, P.,
Brooks, D.,
Brown, R.,
Cantillon, M.,
Carroll, C.,
Coelho, M.,
Henriksen, T.,
Hu, M.,
Jenner, P.,
Kramberger, M.,
Kumar, P.,
Kurtis, M.,
Lewis, S.,
Litvan, I.,
Lyons, K.,
Martino, D.,
Masellis, M.,
Mochizuki, H.,
Morley, J.,
Nirenberg, M.,
Pagonabarraga, J.,
Panicker, J.,
Pavese, N.,
Pekkonen, E.,
Postuma, R.,
Rosales, R.,
Schapira, A.,
Simuni, T.,
Stocchi, F.,
Subramanian, I.,
Tagliati, M.,
Tinazzi, M.,
Toledo, J.,
Tsuboi, Y.,
&
Walker, R.
(2021)
'Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease',
Parkinson's Disease, 7(1).
Available at: 10.1038/s41531-021-00174-x
