Abstract
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 language | English |
|---|---|
| Journal | Brain Stimulation |
| DOIs | |
| Publication status | Accepted/In press - May 18 2015 |
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Keywords
- Deep brain stimulation
- Non-Motor Symptom Scale
- Nonmotor symptoms
- Quality of life
ASJC Scopus subject areas
- Clinical Neurology
- Neuroscience(all)
- Biophysics
Cite this
Beneficial Effects of Bilateral Subthalamic Stimulation on Non-Motor Symptoms in Parkinson's Disease. / Dafsari, Haidar Salimi; Reddy, Prashanth; Herchenbach, Christiane; Wawro, Stefanie; Petry-Schmelzer, Jan Niklas; Visser-Vandewalle, Veerle; Rizos, Alexandra; Silverdale, Monty; Ashkan, Keyoumars; Samuel, Michael; Evans, Julian; Huber, Carlo A.; Fink, Gereon R.; Antonini, Angelo; Chaudhuri, K. Ray; Martinez-Martin, Pablo; Timmermann, Lars.
In: Brain Stimulation, 18.05.2015.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Beneficial Effects of Bilateral Subthalamic Stimulation on Non-Motor Symptoms in Parkinson's Disease
AU - Dafsari, Haidar Salimi
AU - Reddy, Prashanth
AU - Herchenbach, Christiane
AU - Wawro, Stefanie
AU - Petry-Schmelzer, Jan Niklas
AU - Visser-Vandewalle, Veerle
AU - Rizos, Alexandra
AU - Silverdale, Monty
AU - Ashkan, Keyoumars
AU - Samuel, Michael
AU - Evans, Julian
AU - Huber, Carlo A.
AU - Fink, Gereon R.
AU - Antonini, Angelo
AU - Chaudhuri, K. Ray
AU - Martinez-Martin, Pablo
AU - Timmermann, Lars
PY - 2015/5/18
Y1 - 2015/5/18
N2 - 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.
AB - 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.
KW - Deep brain stimulation
KW - Non-Motor Symptom Scale
KW - Nonmotor symptoms
KW - Quality of life
UR - http://www.scopus.com/inward/record.url?scp=84941729376&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84941729376&partnerID=8YFLogxK
U2 - 10.1016/j.brs.2015.08.005
DO - 10.1016/j.brs.2015.08.005
M3 - Article
C2 - 26385442
AN - SCOPUS:84941729376
JO - Brain Stimulation
JF - Brain Stimulation
SN - 1935-861X
ER -