Objective: This retrospective study explored whether preoperative motor, cognitive, and affective parameters predict QoL and QoL components at 6 and 12 months after STN-DBS surgery.

Background: While subthalamic nucleus deep brain stimulation (STN-DBS) improves the quality of life (QoL) of patients with Parkinson’s disease (PD) [1], the clinical parameters that predict this improvement are still debated [2-4].

Method: QoL was assessed with the Parkinson’s Disease Questionnaire – 39 (PDQ-39) before (baseline), at 6 months (N=91) and at 12 months (N=63) after STN-DBS surgery. Changes in the PDQ-39 and its subdomains were analysed with Wilcoxon signed-rank tests. In total, seven motor, cognitive, and affective parameters recorded at baseline were used in multiple linear regressions to predict QoL and QoL subdomains.

Results: QoL improved significantly at 6-months following STN-DBS. After 12 months, this effect remained significant, but was less pronounced. At both time points, significant improvements in mobility, activities of daily living, stigma, and bodily discomfort were present. Correlation and linear regression analyses showed that preoperative QoL status as well as changes in QoL at 6 and 12 months after surgery were driven by preoperative motor (UPDRS-III medOFF and PIGD-subscore medOFF) and affective (HADS anxiety and depression) symptoms. In contrast, preoperative cognitive performance did not predict QoL at any time point.

Conclusion: Data show that preoperative motor and affective symptoms drive both QoL baseline status and changes in QoL after STN-DBS surgery. Thus, these clinical parameters need to be properly assessed, in order to provide comprehensive pre-surgical advice to patients suffering from PD.

References: [1] G. Deuschl, C. Schade-Brittinger, P. Krack, J. Volkmann, H. Schäfer, K. Bötzel, C. Daniels, A. Deutschländer, U. Dillmann, W. Eisner, A randomized trial of deep-brain stimulation for Parkinson’s disease, N. Engl. J. Med. 355(9) (2006) 896-908.
[2] D. Floden, R.M. Busch, S.E. Cooper, C.S. Kubu, A.G. Machado, Global cognitive scores do not predict outcome after subthalamic nucleus deep brain stimulation, Mov. Disord. 30(9) (2015) 1279-1283.
[3] J.-L. Jiang, S.-Y. Chen, S.-T. Tsai, Quality of life in patients with Parkinson’s disease after subthalamic stimulation: An observational cohort study for outcome prediction, Tzu-Chi Med. J. 31(2) (2019) 107.
[4] W.M. Schuepbach, L. Tonder, A. Schnitzler, P. Krack, J. Rau, A. Hartmann, T.D. Hälbig, F. Pineau, A. Falk, L. Paschen, Quality of life predicts outcome of deep brain stimulation in early Parkinson disease, Neurol. 92(10) (2019) e1109-e1120.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/preoperative-motor-deficits-and-depressive-symptoms-predict-quality-of-life-in-patients-with-parkinsons-disease-at-different-time-points-after-surgery-for-subthalamic-stimulation/