Beneficial Effects of Bilateral Subthalamic Stimulation on Non-Motor Symptoms in Parkinson's Disease

Haidar Salimi Dafsari, Prashanth Reddy, Christiane Herchenbach, Stefanie Wawro, Jan Niklas Petry-Schmelzer, Veerle Visser-Vandewalle, Alexandra Rizos, Monty Silverdale, Keyoumars Ashkan, Michael Samuel, Julian Evans, Carlo A. Huber, Gereon R. Fink, Angelo Antonini, K. Ray Chaudhuri, Pablo Martinez-Martin, Lars Timmermann

Research output: Contribution to journalArticlepeer-review


Background: STN-DBS is well established to improve motor symptoms and quality of life in patients with PD. While non-motor symptoms are crucial for quality of life in these patients, only neuropsychiatric and neuropsychological symptoms have been systematically studied in a longitudinal design so far. However, these are only a part of the non-motor symptoms spectrum. Hypothesis: We hypothesized that STN-DBS is associated with a beneficial effect on a range of non-motor symptoms. Methods: In this multicenter, open, prospective, international study (EuroInf-study, UKCRN10084/DRKS00006735) we investigated non-motor effects of STN-DBS in "real-life" use. We evaluated Non-motor Symptom Scale, and Questionnaire, PD Questionnaire-8, Scales for Outcomes of PD motor examination and complications, and activities of daily living preoperatively and at 6 months follow-up in 60 consecutive patients (35 male, mean age: 61.6 ± 7.8 years, mean disease duration: 10.4 ± 4.2 years). Results: All outcomes improved significantly at 6 months follow-up (PD Questionaire-8, p = 0.006; activities of daily living, p = 0.012; all others, p <0.001; Wilcoxon signed-rank, respectively paired t-test; Bonferroni-correction). Post-hoc analyses of Non-motor Symptom Scale domains showed a significant reduction of sleep/fatigue and miscellaneous domains (p ≤ 0.001), perceptual problems/hallucinations (p = 0.036), and urinary (p = 0.018) scores. Effect sizes were "moderate" for Non-motor Symptom Scale, and motor complications, "large" for motor examination, and "small" for other outcomes. Conclusions: This study provides evidence that bilateral STN-DBS improves non-motor burden in patients with PD and opens the door to a more balanced evaluation of DBS outcomes. Further randomized studies are needed to confirm these findings and compare DBS non-motor effects to other invasive therapies of advanced PD.

Original languageEnglish
JournalBrain Stimulation
Publication statusAccepted/In press - May 18 2015


  • Deep brain stimulation
  • Non-Motor Symptom Scale
  • Nonmotor symptoms
  • Quality of life

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)
  • Biophysics


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