Category: Parkinson's Disease: Non-Motor Symptoms
Objective: To compare bilateral subthalamic stimulation (STN-DBS) effects on quality of life (QoL), motor, and nonmotor symptoms (NMS) in ‘tremor-dominant’ and ‘postural instability and gait difficulty’ (PIGD) subtypes of Parkinson’s disease (PD).
Background: Subthalamic nucleus deep brain stimulation (STN-DBS) is a well-established treatment for patients with advanced PD improving QoL, motor symptoms, and NMS. Notably, the differential STN-DBS effects on the tremor-dominant and PIGD subtypes of PD are understudied, particularly concerning QoL and NMS.
Method: In this prospective, observational, international multicenter study, we examined PD patients preoperatively and at 6-month follow-up postoperatively. Assessments included the Unified PD Rating Scale-motor examination (UPDRS-III), Scales for Outcomes in PD (SCOPA)-activities of daily living (ADL) and -motor complications, PDQuestionnaire-8 (PDQ-8), NMSScale (NMSS), and levodopa-equivalent daily dose (LEDD). Within-group changes at follow-up were analyzed with Wilcoxon signed-rank or paired t-tests, if parametric tests were applicable. Between-group differences were explored with Mann-Whitney U or unpaired t-tests.
Results: This study included 64 PIGD and 33 tremor-dominant patients. At baseline, PIGD patients had worse ADL, motor complications, PDQ-8, and NMSS total scores. At follow-up, in both groups, motor complications and NMSS sleep/fatigue domain improved, and LEDD decreased. Additionally, specifically in tremor-dominant patients, the PDQ-8 bodily discomfort and stigma domains, and in PIGD patients, UPDRS-III and ADL, PDQ-8, and NMSS total scores improved. In the latter, the PDQ-8 mobility, ADL, communication, and bodily discomfort domains, and the NMSS perceptual problems/hallucinations, urinary, and miscellaneous domains improved. Between-group differences, all favoring the PIGD group, were found for the NMSS total score and its miscellaneous domain, and the PDQ-8 communication domain.
Conclusion: This study provides evidence of distinct QoL, motor, and nonmotor effect profiles of STN-DBS in PD motor subtypes. In the future, these differential STN effect profiles may allow advising personalized treatment decisions.
To cite this abstract in AMA style:
S. Jost, A. Konitsioti, P. Loehrer, K. Ashkan, A. Rizos, A. Sauerbier, M. Ghilardi, F. Rosenkranz, L. Strobel, A. Gronostay, M. Barbe, J. Evans, M. Silverdale, R. Cury, E. Fonoff, G. Fink, A. Antonini, C. Nimsky, K. Ray Chaudhuri, L. Timmermann, V. Visser-Vandewalle, P. Martinez-Martin, H. Dafsari. Nonmotor effects of subthalamic stimulation in Parkinson’s disease motor subtypes [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/nonmotor-effects-of-subthalamic-stimulation-in-parkinsons-disease-motor-subtypes/. Accessed May 19, 2025.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/nonmotor-effects-of-subthalamic-stimulation-in-parkinsons-disease-motor-subtypes/