Objective: The aim of the study is to evaluate the evolution of non-motor symptoms in Parkinson’s disease (PD) in patients treated with deep brain stimulation of the subthalamic nuclei (STN-DBS).

Background: PD is a neurodegenerative disease characterized by the progressive alteration of motor functions associated with non-motor symptoms. STN-DBS has been shown to have favorable effects on the motor symptoms in advanced stage disease. However, the impact of this therapy on non-motor complaints remains uncertain.

Method: This monocentric prospective study includes 22 patients with advanced PD who underwent STN-DBS with follow-up visits at 0, 3, 6, and 12 months. The motor symptoms were evaluated by MDS-UPDRS part II, III and IV. The evaluation of non-motor symptoms was based on MDS-UPDRS part I, NMSS, BDI, STAI-A, STAI-B and MMSE scales and neuropsychological assessments focused on spatial-temporal orientation and frontal, memory, language, and praxis functions.

Results: Over 12 months of follow-up, patients showed a statistically significant reduction in total NMSS scores (p < .001) and in NMSS domains 1 (p = .027), 2 (p < .001), 3 (p = .042), 4 (p = .038), 6 (p = .002), 7 (p = .002), and 9 (p < .001) scores but showed no significant change in NMSS domains 5 (p = .251) and 8 (p = .227), MDS-UPDRS part I (p = .372), BDI (p = .304), STAI-A (p = .144), STAI-B (p = .263), MMSE (p = .078) scores and neuropsychological assessments on spatial-temporal orientation (p = .220), frontal (p = .578), memory (p = .514), language (p = .404) and praxis functions (p = .130). While the motor evaluation showed a statistically significant reduction in MDS-UPDRS part II (p = .009), part III (p < .001) and part IV (p < .001).

Conclusion: This study shows the expected beneficial effect of STN-DBS in advanced PD patients on motor symptoms but also on non-motor symptoms regarding cardiovascular, sleep/fatigue, mood/cognition, perceptual problems/hallucinations, gastrointestinal tract, urinary and miscellaneous domains. No significant variation has been observed for the other non-motor scales. This may be explained by the lesser specificity and accuracy of the later scales.

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Weaver FM. Bilateral Deep Brain Stimulation vs Best Medical Therapy for Patients With Advanced Parkinson Disease: A Randomized Controlled Trial. Journal of the American Medical Association. 2009;301(1):63–73.
Williams A et al. Deep brain stimulation plus best medical therapy versus best medical therapy alone for advanced Parkinson’s disease (PD SURG trial): a randomised, open-label trial. The Lancet Neurology. 2010;9(6):581–591.
Okun MS et al. Subthalamic deep brain stimulation with a constant-current device in Parkinson’s disease: an open-label randomised controlled trial. The Lancet Neurology. 2012;11(2):140–149.
Schuepbach WMM et al. Neurostimulation for Parkinson’s Disease with Early Motor Complications. New England Journal of Medicine. 2013;368(7):610–622.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-deep-brain-stimulation-of-the-subthalamic-nuclei-on-non-motor-symptoms-in-parkinsons-disease-a-monocentric-prospective-study-with-a-12-month-follow-up/