Objective: To examine 36-month effects of bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) on nonmotor symptoms (NMS) and self-reported quality of life compared to medical therapy in patients with Parkinson’s disease (PD).

Background: DBS in PD is an option, if medical therapy fails to control motor symptoms sufficiently. Previous research provided evidence for beneficial immediate and short-term effects of STN-DBS on NMS. So far, little is known about the long-term effects of STN-DBS on NMS.

Method: In this prospective, nonrandomized, real-life cohort observation we investigated 296 PD patients undergoing STN-DBS (n=66) or standard-of-care medical therapy (MED, n=230) at baseline and 36-month follow-up using the Non-Motor Symptom Scale (NMSS), PD Questionnaire-8 (PDQ-8), Scales for Outcomes in PD‑motor examination, ‑activities of daily living, and ‑complications (SCOPA-A,-B, -C), Clinical Impression of Severity Index for PD (CISI-PD), and levodopa-equivalent daily dose (LEDD). All analyses were conducted after propensity score matching, identifying matched sub-cohorts with well-balanced baseline characteristics between both groups. Longitudinal outcome changes within the groups were analyzed using Wilcoxon signed-rank tests, differences in change scores between the two groups with Mann-Whitney U tests. The strength of clinical response was quantified by relative changes and effect sizes. Additionally, explorative bivariate correlations of change scores were calculated.

Results: Comparing baseline with 36-month follow-up, STN-DBS significantly improved NMSS total score, CISI-PD as well as SCOPA-A and -C. Significant differences between change scores of STN-DBS and MED groups were found for the NMSS total score (large effect), and the domain scores for urinary functions, sleep/fatigue and miscellaneous (each moderate effects). Furthermore, the groups differed significantly regarding PDQ-8 and LEDD (moderate effects). CISI-PD, SCOPA-A and -C showed large effects. Change scores of NMSS and PDQ-8 were significantly correlated.

Conclusion: The reported results provide evidence that beneficial effects of STN-DBS on NMS extend up to three years. Furthermore, neurostimulation improved NMS burden and self-reported quality of life more than medical therapy alone.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/nonmotor-symptoms-in-parkinsons-disease-36-month-follow-up-study-comparing-bilateral-subthalamic-stimulation-and-standard-of-care-medication/