TY - JOUR
T1 - Short-term quality of life after subthalamic stimulation depends on non-motor symptoms in Parkinson's disease
AU - Dafsari, Haidar Salimi
AU - Weiß, Luisa
AU - Silverdale, Monty
AU - Rizos, Alexandra
AU - Reddy, Prashanth
AU - Ashkan, Keyoumars
AU - Evans, Julian
AU - Reker, Paul
AU - Petry-Schmelzer, Jan Niklas
AU - Samuel, Michael
AU - Visser-Vandewalle, Veerle
AU - Antonini, Angelo
AU - Martinez-Martin, Pablo
AU - Ray-Chaudhuri, K.
AU - Timmermann, Lars
AU - EUROPAR and the IPMDS Non Motor PD Study Group,
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Background: Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and non-motor symptoms (NMS) in advanced Parkinson's disease (PD). However, considerable inter-individual variability has been observed for QoL outcome. Hypothesis: We hypothesized that demographic and preoperative NMS characteristics can predict postoperative QoL outcome. Methods: In this ongoing, prospective, multicenter study (Cologne, Manchester, London) including 88 patients, we collected the following scales preoperatively and on follow-up 6 months postoperatively: PDQuestionnaire-8 (PDQ-8), NMSScale (NMSS), NMSQuestionnaire (NMSQ), Scales for Outcomes in PD (SCOPA)-motor examination, -complications, and –activities of daily living, levodopa equivalent daily dose. We dichotomized patients into “QoL responders”/“non-responders” and screened for factors associated with QoL improvement with (1) Spearman-correlations between baseline test scores and QoL improvement, (2) step-wise linear regressions with baseline test scores as independent and QoL improvement as dependent variables, (3) logistic regressions using aforementioned “responders/non-responders” as dependent variable. Results: All outcomes improved significantly on follow-up. However, approximately 44% of patients were categorized as “QoL non-responders”. Spearman-correlations, linear and logistic regression analyses were significant for NMSS and NMSQ but not for SCOPA-motor examination. Post-hoc, we identified specific NMS (flat moods, difficulties experiencing pleasure, pain, bladder voiding) as significant contributors to QoL outcome. Conclusions: Our results provide evidence that QoL improvement after STN-DBS depends on preoperative NMS characteristics. These findings are important in the advising and selection of individuals for DBS therapy. Future studies investigating motor and non-motor PD clusters may enable stratifying QoL outcomes and help predict patients’ individual prospects of benefiting from DBS.
AB - Background: Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and non-motor symptoms (NMS) in advanced Parkinson's disease (PD). However, considerable inter-individual variability has been observed for QoL outcome. Hypothesis: We hypothesized that demographic and preoperative NMS characteristics can predict postoperative QoL outcome. Methods: In this ongoing, prospective, multicenter study (Cologne, Manchester, London) including 88 patients, we collected the following scales preoperatively and on follow-up 6 months postoperatively: PDQuestionnaire-8 (PDQ-8), NMSScale (NMSS), NMSQuestionnaire (NMSQ), Scales for Outcomes in PD (SCOPA)-motor examination, -complications, and –activities of daily living, levodopa equivalent daily dose. We dichotomized patients into “QoL responders”/“non-responders” and screened for factors associated with QoL improvement with (1) Spearman-correlations between baseline test scores and QoL improvement, (2) step-wise linear regressions with baseline test scores as independent and QoL improvement as dependent variables, (3) logistic regressions using aforementioned “responders/non-responders” as dependent variable. Results: All outcomes improved significantly on follow-up. However, approximately 44% of patients were categorized as “QoL non-responders”. Spearman-correlations, linear and logistic regression analyses were significant for NMSS and NMSQ but not for SCOPA-motor examination. Post-hoc, we identified specific NMS (flat moods, difficulties experiencing pleasure, pain, bladder voiding) as significant contributors to QoL outcome. Conclusions: Our results provide evidence that QoL improvement after STN-DBS depends on preoperative NMS characteristics. These findings are important in the advising and selection of individuals for DBS therapy. Future studies investigating motor and non-motor PD clusters may enable stratifying QoL outcomes and help predict patients’ individual prospects of benefiting from DBS.
KW - Deep brain stimulation
KW - Non motor symptoms
KW - Parkinson's Disease Questionnaire
KW - Subthalamic nucleus
UR - http://www.scopus.com/inward/record.url?scp=85045261632&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85045261632&partnerID=8YFLogxK
U2 - 10.1016/j.brs.2018.02.015
DO - 10.1016/j.brs.2018.02.015
M3 - Article
C2 - 29655587
AN - SCOPUS:85045261632
VL - 11
SP - 867
EP - 874
JO - Brain Stimulation
JF - Brain Stimulation
SN - 1935-861X
IS - 4
ER -