| Autor: |
Lezcano E; Neurology Department, Cruces University Hospital, Plaza de Cruces s/n, 48903, Barakaldo, Spain.; Neurodegenerative Diseases Group, BioCruces Health Research Institute, Barakaldo, Spain., Gómez-Esteban JC; Neurology Department, Cruces University Hospital, Plaza de Cruces s/n, 48903, Barakaldo, Spain. JUANCARLOS.GOMEZESTEBAN@osakidetza.eus.; Neurodegenerative Diseases Group, BioCruces Health Research Institute, Barakaldo, Spain. JUANCARLOS.GOMEZESTEBAN@osakidetza.eus., Tijero B; Neurology Department, Cruces University Hospital, Plaza de Cruces s/n, 48903, Barakaldo, Spain.; Neurodegenerative Diseases Group, BioCruces Health Research Institute, Barakaldo, Spain., Bilbao G; Neurosurgery Department, Cruces University Hospital, Barakaldo, Spain., Lambarri I; Neurophysiology Department, Cruces University Hospital, Barakaldo, Spain., Rodriguez O; Radiology Department, Cruces University Hospital, Barakaldo, Spain., Villoria R; Radiology Department, Cruces University Hospital, Barakaldo, Spain., Dolado A; Radiology Department, Cruces University Hospital, Barakaldo, Spain., Berganzo K; Neurology Department, Cruces University Hospital, Plaza de Cruces s/n, 48903, Barakaldo, Spain.; Neurodegenerative Diseases Group, BioCruces Health Research Institute, Barakaldo, Spain., Molano A; Neurology Department, Cruces University Hospital, Plaza de Cruces s/n, 48903, Barakaldo, Spain., de Gopegui ER; Neurosurgery Department, Cruces University Hospital, Barakaldo, Spain., Pomposo I; Neurosurgery Department, Cruces University Hospital, Barakaldo, Spain., Gabilondo I; Neurodegenerative Diseases Group, BioCruces Health Research Institute, Barakaldo, Spain.; Neuropsychology of Severe Medical Conditions, Deusto University, Bilbao, Spain., Zarranz JJ; Neurology Department, Cruces University Hospital, Plaza de Cruces s/n, 48903, Barakaldo, Spain. |
| Abstrakt: |
Long-term impact of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on health-related quality of life (HRQOL) and associated factors in patients with Parkinson's disease (PD) are not clear. In this prospective study, we included 69 PD patients (64 % men, mean age 61.3 ± 7.4 and disease duration 13.2 ± 5.7 years) undergoing STN-DBS. They were evaluated preoperatively (baseline), 1 and 5 years postoperatively assessing 39-item Parkinson's Disease Questionnaire (PDQ-39), Schwab and England Activities of Daily Living Scale (SEADL), Unified Parkinson's Disease Rating Scale (UPDRS) off- and on-medication, patient diaries, dopaminergic treatment, mortality and surgical complications. Five years postoperatively, off-medication, there were improvements from baseline in UPDRS-II and III total (27.2 and 26.7 %, respectively) and SEADL (18.6 % more completely independent patients) (p < 0.05) scores, while on-medication, there was a deterioration in UPDRS-III (37.8 %, mainly axial signs) (p < 0.05) and minor improvements in SEADL (3.7 %). While at 1 year PDQ-39, the summary index improved substantially (36.5 %) (p < 0.05), at 5 years patients regressed (only 8.8 %) (p < 0.05), though changes in PDQ-39 subscores remained significant, with improvements in ADL (18.8 %), emotional well-being (19.0 %), stigma (36.4 %) and discomfort (20.6 %), despite worsening in communication (47.8 %) (p < 0.05). Lower preoperative PDQ-39 summary index and greater 1-year UPDRS-III-off total score gain predicted better long-term HRQOL. STN-DBS produces long-term improvements in HRQOL in PD. Preoperative HRQOL and short-term postoperative changes in off-medication motor status may predict long-term HRQOL in PD following STN-DBS. |
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