Category: Parkinson's Disease: Surgical Therapy
Objective: The APOSTIM study aimed to compare the quality of life (QoL) in Parkinson’s disease (PD) patients treated sequentially with continuous subcutaneous apomorphine infusion (CSAI) and subthalamic nucleus deep brain stimulation (STN-DBS).
Background: In PD, motor and non-motor fluctuations and dyskinesias significantly impair QoL. CSAI and STN-DBS are effective second-line therapies, but comparative longitudinal data are scarce.
Method: APOSTIM is an ancillary study of the French PREDISTIM cohort, which included PD patients who were candidates for STN-DBS between 2013 and 2020. In this multicenter study, 72 PD patients who received CSAI prior to STN-DBS were evaluated at baseline (V0, with CSAI) and 1 year post-STN-DBS (V1). QoL was assessed using PDQ-39, motor symptoms using MDS-UPDRS III and IV, and non-motor outcomes using MDS-UPDRS I, MoCA, letter verbal fluency, Hamilton Anxiety and Depression scales, LARS, and QUIP-RS.
Results: One year post-STN-DBS, mean PDQ-39 total score improved from 56.2 to 50.1 (–6.1 points, –10.9%; p = 0.006). Significant improvements were observed in activities of daily living (p = 0.005), emotional well-being (p = 0.05), cognition (p = 0.006), and bodily discomfort (p < 0.001). The communication subscore increased (p = 0.002). MDS-UPDRS IV-A (dyskinesias) decreased from 2.9 to 0.8/8 (–71.6%; p < 0.001), and IV-B (motor fluctuations) from 5.3 to 3.2/12 (–40.4%; p < 0.001) . Anxiety and depression scores improved by 30.1% (p=0.001) and 20.3% (p=0.03), while behavioral addictions decreased from 61.1% to 25% (p<0.001). OFF MDS-UPDRS III scores remained stable, but slight cognitive decline was observed (MoCA: from 27.1 to 25.9; p = 0.009).
Conclusion: STN-DBS provides significant improvements in QoL, motor complications, and selected non-motor symptoms in PD patients previously treated with CSAI, suggesting that STN-DBS may provide superior benefit in comparison to CSAI to achieve optimal control of advanced PD symptoms.
To cite this abstract in AMA style:
F. Fluchere, S. Drapier, C. Moreau, F. Ory-Magne, E. Hainque, A. Marques Gagniere, B. Jarraya, S. Thobois, S. Ansquer, C. Giordana, D. Guehl, S. Frismand, T. Rouaud, M. Tir, A. Roland, D. Devos, A. Eusebio, JP. Azulay. APOSTIM study: a prospective study on quality of life in Parkinsonian patients sequentially treated with apomorphine infusion and STN stimulation [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/apostim-study-a-prospective-study-on-quality-of-life-in-parkinsonian-patients-sequentially-treated-with-apomorphine-infusion-and-stn-stimulation/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/apostim-study-a-prospective-study-on-quality-of-life-in-parkinsonian-patients-sequentially-treated-with-apomorphine-infusion-and-stn-stimulation/