Objective: To evaluate the influence of pretreatment subclinical apathy on patient QOL following subthalamic nucleus DBS (STN-DBS) in PD patients 12 months after surgery.

Background: Deep brain stimulation (DBS) is an established surgical treatment for Parkinson’s disease (PD). DBS is associated with improvement in motor symptoms, including motor fluctuation related to levodopa treatment. However, non-motor symptoms such as apathy may impair postoperative quality of life (QOL) despite improvement in motor symptoms.

Methods: Twenty-five consecutive PD patients without apathy (defined as >14 points on the Starkstein Apathy Scale [AS]) before surgery who underwent simultaneous bilateral STN-DBS were enrolled. The variables included clinician- and patient-based symptom ratings, including the Unified Parkinson’s disease Rating Scale (UPDRS) motor score, the AS, and the Parkinson’s disease Questionnaire (PDQ-39); and medications used. Values influencing the post-operative PDQ-39 score were evaluated.

Results: Degrees of improvement in motor symptoms and motor fluctuations differed in all patients. Six patients (24%) developed apathy 1 month after DBS. A positive correlation was observed between baseline apathy scale and PDQ-39 score at 12 months. Multiple logistic regression analysis also revealed that a baseline apathy scale score (> 8) was a significant predictor of blunted improvement in QOL after STN-DBS (p = 0.003).

Conclusions: Patients with baseline AS scores > 8 points showed less improvement in QOL after STN-DBS. More intensive evaluation of preoperative mood symptoms, especially in patients with an AS score > 8, or changes in the procedure, may result in better outcomes.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-subclinical-apathy-prior-to-deep-brain-stimulation-on-the-quality-of-life-of-patients-with-parkinsons-disease/