Category: Surgical Therapy: Parkinson's Disease
Objective: To investigate the pre-surgical correlates of quality of life (QoL) in patients with Parkinson’s disease (PD) eligible for deep brain stimulation (DBS).
Background: Optimizing QoL improvements after DBS requires a detailed understanding of the correlates and determinants of pre-surgical QoL. Comprehensive assessments of PDQ-39 correlates, the most widely reported measure, are lacking.
Method: RAD-PD collects patient reported outcomes related to disease, and motor and non-motor features of PD in a real-world setting. Quartiles of baseline PDQ-39 summary index (SI) scores were identified and analyzed according to individual features using the Kruskal-Wallis rank sum test, Pearson’s Chi-squared test, or Fisher’s exact test as appropriate. A pairwise correlation matrix investigated relationships between baseline features. PDQ-39 SI was compared to other QoL scores using Kendall’s rank correlation.
Results: Baseline data from N=148 registry participants were included. Each quartile of PDQ-39 SI scores was associated with decreasing age, increasing non-motor symptom burden (NMSS), worsening motor function (MDS-UPDRS part 3 OFF) and non-motor and motor experiences of ADL scores (MDS-UPDRS parts 1 and 2), worsening impulsivity (QUIP-RS), worsening depression (BDI-II) and anxiety (GAD-7) symptoms, and worsening Lawton IADL scores (p<0.05 for all). MoCA scores, severity of gait freezing, severity of motor complications, PD duration, phenotype and level of motor severity ON medications did not distinguish groups with worsening QoL. Among all participants, the strongest correlates of PDQ-39 SI were MDS-UPDRS parts 1 and 2, GAD-7, BDI, and NMSS (r range = 0.36-0.42), while MDS-UPDRS-3 OFF correlated most strongly with IADL (r= -0.24), PDQ-39 mobility (r=0.23) and MDS-UPDRS 3 ON (r=0.41). PDQ-39 SI correlates with PDQ-8 (r=0.82), EQ-5D (r= -0.48) and NeuroQoL Ability (r= -0.45).
Conclusion: Multiple features correlate with PDQ-39 in DBS-eligible PD patients. There is incremental contribution of non-motor symptoms to worsening QoL. Motor symptom severity correlates less meaningfully. Future work will investigate PDQ-39 SI changes after DBS, and how improvements in correlated features can be maximized after DBS to optimize QoL outcomes. In large-scale efforts like RAD-PD, PDQ-8 may be more efficient and NeuroQoL Ability may facilitate translation of QoL scores to functional abilities.
To cite this abstract in AMA style:J. Jimenez-Shahed, A. Berg, J. Kirk, M. York, J. Schwalb, M. Siddiqui, J. Mcinerney. Pre-surgical correlates of QoL (PDQ-39) in a DBS eligible PD population [abstract]. Mov Disord. 2023; 38 (suppl 1). https://www.mdsabstracts.org/abstract/pre-surgical-correlates-of-qol-pdq-39-in-a-dbs-eligible-pd-population/. Accessed September 22, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/pre-surgical-correlates-of-qol-pdq-39-in-a-dbs-eligible-pd-population/