Short-term quality of life after subthalamic stimulation depends on non-motor symptoms in Parkinson's disease

Autor: Lars Timmermann, Luisa Weiß, Haidar S. Dafsari, Veerle Visser-Vandewalle, K. Ray-Chaudhuri, Keyoumars Ashkan, Alexandra Rizos, Jan Niklas Petry-Schmelzer, Pablo Martinez-Martin, Angelo Antonini, Prashanth Reddy, Monty Silverdale, Michael Samuel, Julian Evans, Europar, Paul Reker
Rok vydání: 2018
Předmět:
Male
0301 basic medicine
Quality of Life/psychology
Time Factors
Parkinson's disease
Activities of daily living
Deep Brain Stimulation
medicine.medical_treatment
Logistic regression
Subthalamic nucleus
0302 clinical medicine
Quality of life
Activities of Daily Living
Deep brain stimulation
Prospective Studies
Registries
Prospective cohort study
Non motor symptoms
General Neuroscience
Parkinson's Disease Questionnaire
Aged
Female
Follow-Up Studies
Humans
Middle Aged
Parkinson Disease
Subthalamic Nucleus
Quality of Life
Neuroscience (all)
Biophysics
Neurology (clinical)
humanities
medicine.drug
medicine.medical_specialty
Levodopa
Scopa
Activities of Daily Living/psychology
lcsh:RC321-571
03 medical and health sciences
Deep Brain Stimulation/methods
medicine
lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry
business.industry
Parkinson Disease/diagnosis
medicine.disease
Subthalamic Nucleus/physiology
030104 developmental biology
Physical therapy
business
030217 neurology & neurosurgery
Zdroj: Dafsari, H S, Weiß, L, Silverdale, M, Rizos, A, Reddy, P, Ashkan, K, Evans, J, Reker, P, Petry-Schmelzer, J N, Samuel, M, Visser-Vandewalle, V, Antonini, A, Martinez-Martin, P, Ray-Chaudhuri, K & Timmermann, L 2018, ' Short-term quality of life after subthalamic stimulation depends on non-motor symptoms in Parkinson's disease ', Brain Stimulation . https://doi.org/10.1016/j.brs.2018.02.015
Brain Stimulation, Vol 11, Iss 4, Pp 867-874 (2018)
EUROPAR and the IPMDS (International Parkinson's and Movement Disorders Society) Non-Motor Parkinson's Disease Study Group 2018, ' Short-term quality of life after subthalamic stimulation depends on non-motor symptoms in Parkinson's disease ', Brain Stimulation, vol. 11, no. 4, pp. 867-874 . https://doi.org/10.1016/j.brs.2018.02.015
ISSN: 1935-861X
DOI: 10.1016/j.brs.2018.02.015
Popis: BACKGROUND: Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and non-motor symptoms (NMS) in advanced Parkinson's disease (PD). However, considerable inter-individual variability has been observed for QoL outcome.HYPOTHESIS: We hypothesized that demographic and preoperative NMS characteristics can predict postoperative QoL outcome.METHODS: In this ongoing, prospective, multicenter study (Cologne, Manchester, London) including 88 patients, we collected the following scales preoperatively and on follow-up 6 months postoperatively: PDQuestionnaire-8 (PDQ-8), NMSScale (NMSS), NMSQuestionnaire (NMSQ), Scales for Outcomes in PD (SCOPA)-motor examination, -complications, and -activities of daily living, levodopa equivalent daily dose. We dichotomized patients into "QoL responders"/"non-responders" and screened for factors associated with QoL improvement with (1) Spearman-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 using aforementioned "responders/non-responders" as dependent variable.RESULTS: All outcomes improved significantly on follow-up. However, approximately 44% of patients were categorized as "QoL non-responders". Spearman-correlations, linear and logistic regression analyses were significant for NMSS and NMSQ but not for SCOPA-motor examination. Post-hoc, we identified specific NMS (flat moods, difficulties experiencing pleasure, pain, bladder voiding) as significant contributors to QoL outcome.CONCLUSIONS: Our results provide evidence that QoL improvement after STN-DBS depends on preoperative NMS characteristics. These findings are important in the advising and selection of individuals for DBS therapy. Future studies investigating motor and non-motor PD clusters may enable stratifying QoL outcomes and help predict patients' individual prospects of benefiting from DBS.
Databáze: OpenAIRE
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