Category: Parkinson's Disease: Non-Motor Symptoms
Objective: To predict 36-month follow-up quality of life (QoL) outcome after bilateral subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson’s disease (PD).
Background: STN-DBS improves QoL, motor, and non-motor symptoms (NMS) in advanced PD. However, substantial inter-individual variability has been observed for postoperative QoL outcome and little is known about its relationship with demographic parameters and the evolution of non-motor and and motor symptoms following STN-DBS. We hypothesized that these parameters can predict long-term QoL outcome.
Method: Methods: In this ongoing, prospective, multicenter international study (Cologne, Manchester, London) including 82 patients undergoing STN-DBS, we assessed the following scales preoperatively and on 36-month follow-up postoperatively: PDQuestionnaire-8 (PDQ-8), NMSScale (NMSS), Scales for Outcomes in PD (SCOPA)-motor examination, -activities of daily living, and –complications, and levodopa equivalent daily dose (LEDD). We screened for factors associated with QoL improvement based on (1) correlations between baseline test scores and QoL improvement, (2) step-wise linear regression analysis with baseline test scores as independent and QoL improvement as dependent variables, (3) logistic regressions and receiver operating characteristic curves using a dichotomized variable “QoL responders”/“non-responders”.
Results: At 36-month follow-up, we observed significant improvement of the NMSS total score, SCOPA-motor examination and -complications, and a significant LEDD reduction. 63.4% of the patients were categorized as “QoL non-responders”. On the group level, PDQ-8 changes from preoperative baseline to 36-month follow-up were not significant. Correlations, linear, and logistic regression analyses were significant for the parameters: age at intervention, PDQ-8 at baseline and specific NMS, such as ‘difficulties experiencing pleasure’ and ‘problems sustaining concentration’, but not for SCOPA scores.
Conclusion: Our results provide evidence that long-term QoL changes after STN-DBS depend on age and specific preoperative NMS characteristics. These findings are important in the advising and selection of individuals for DBS therapy.
To cite this abstract in AMA style:S. Jost, L. Timmermann, A. Rizos, M. Silverdale, J. Evans, P. Loehrer, M. Samuel, J. Petry-Schmelzer, A. Sauerbier, M. Barbe, G. Fink, V. Visser-Vandewalle, K. Ashkan, A. Antonini, P. Martinez-Martin, K. Ray Chaudhuri, H. Dafsari. Long-term quality of life after subthalamic deep brain stimulation depends on non-motor symptoms in Parkinson’s disease [abstract]. Mov Disord. 2020; 35 (suppl 1). https://www.mdsabstracts.org/abstract/long-term-quality-of-life-after-subthalamic-deep-brain-stimulation-depends-on-non-motor-symptoms-in-parkinsons-disease/. Accessed December 7, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/long-term-quality-of-life-after-subthalamic-deep-brain-stimulation-depends-on-non-motor-symptoms-in-parkinsons-disease/