Subthalamic Stimulation Improves Quality of Life of Patients Aged 61 Years or Older With Short Duration of Parkinson’s Disease

Dafsari, Haidar S.; Reker, Paul; Silverdale, Monty; Reddy, Prashanth; Pilleri, Manuela; Martinez‐Martín, Pablo; Rizos, Alexandra; Perrier, Estelle; Weiß, Luisa; Ashkan, Keyoumars; Samuel, Michael; Evans, Julian; Visser‐Vandewalle, Veerle; Antonini, Angelo; Ray‐Chaudhuri, K.; Timmermann, Lars

doi:10.1111/ner.12740

Cited by 32 publications

(24 citation statements)

References 44 publications

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“…As a general trend in the STN‐DBS group, patient selection resulted in the lowest mean age at intervention, shortest disease duration, and least impairment for baseline clinical outcome parameters. Consistent with previous studies that have identified the relative importance of these factors, in this highly selected group, improvements were observed for QoL, motor, nonmotor outcomes. As mentioned previously, our results indicate that the beneficial effects of STN‐DBS may be particularly favorable if a reduction of dopaminergic medication may result in an improvement of specific nonmotor outcomes.…”

Section: Discussionsupporting

confidence: 90%

“…Clinical assessments were carried out at preoperative baseline (MedON/MedOFF) and at 6‐month follow‐up after surgery (MedON‐StimON) with the following scales: Motor disorder: UPDRS‐III, UPDRS‐IV, and Hoehn and Yahr scale were used to investigate motor impairment, complications, and global motor dysfunction The therapeutic medical regimen was recorded calculating the levodopa equivalent daily dose (LEDD) according to the method of Tomlinson et al The PD Questionaire‐8 (PDQ‐8) has previously been used in patients with PD and STN‐DBS, APO, and IJLI . The PDQ is recommended for QoL assessments by the Movement Disorders Society Scales Committee and has been commonly used studies on invasive therapies of advanced PD .…”

Section: Methodsmentioning

confidence: 99%

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EuroInf 2: Subthalamic stimulation, apomorphine, and levodopa infusion in Parkinson's disease

et al. 2019

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A BS TRACT: Objective: Real-life observational report of clinical efficacy of bilateral subthalamic stimulation (STN-DBS), apomorphine (APO), and intrajejunal levodopa infusion (IJLI) on quality of life, motor, and nonmotor symptoms (NMS) in Parkinson's disease (PD). Methods: In this prospective, multicenter, international, reallife cohort observation study of 173 PD patients undergoing STN-DBS (n = 101), IJLI (n = 33), or APO (n = 39) were followed-up using PDQuestionnaire-8, NMSScale (NMSS), Unified PD Rating Scale (UPDRS)-III, UPDRS-IV, and levodopa equivalent daily dose (LEDD) before and 6 months after intervention. Outcome changes were analyzed with Wilcoxon signed-rank or paired t test when parametric tests were applicable. Multiple comparisons were corrected (multiple treatments/scales). Effect strengths were quantified with relative changes, effect size, and number needed to treat. Analyses were computed before and after propensity score matching, balancing demographic and clinical characteristics. Results: In all groups, PDQuestionnaire-8, UPDRS-IV, and NMSS total scores improved significantly at follow-up. ---Levodopa equivalent daily dose was significantly reduced after STN-DBS. Explorative NMSS domain analyses resulted in distinct profiles: STN-DBS improved urinary/ sexual functions, mood/cognition, sleep/fatigue, and the miscellaneous domain. IJLI improved the 3 latter domains and gastrointestinal symptoms. APO improved mood/ cognition, perceptual problems/hallucinations, attention/ memory, and the miscellaneous domain. Overall, STN-DBS and IJLI seemed favorable for NMSS total score, and APO favorable for neuropsychological/neuropsychiatric NMS and PDQuestionnaire-8 outcome.Conclusions: This is the first comparison of quality of life, nonmotor. and motor outcomes in PD patients undergoing STN-DBS, IJLI, and APO in a real-life cohort. Distinct effect profiles were identified for each treatment option. Our results highlight the importance of holistic nonmotor and motor symptoms assessments to personalize treatment choices.

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

EuroInf 2: Subthalamic stimulation, apomorphine, and levodopa infusion in Parkinson's disease

et al. 2019

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“…More recently, a study by Choi et al found significant sustained improvements in sleep disturbances up to 3 years after STN-DBS [6]. But the study was limited by the single center design of their study, the cohort sample size (45 patients completed the last follow-up, and the mean disease duration of patients (17.2 years ± 6.2), which is longer than most DBS studies [12,18,49,51].…”

Section: Introductionmentioning

confidence: 94%

Beneficial effect of 24-month bilateral subthalamic stimulation on quality of sleep in Parkinson’s disease

et al. 2020

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Background Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and sleep symptoms in Parkinson's disease (PD). However, the long-term effects of STN-DBS on sleep and its relationship with QoL outcome are unclear. Methods In this prospective, observational, multicenter study including 73 PD patients undergoing bilateral STN-DBS, we examined PDSleep Scale (PDSS), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD-motor examination, -activities of daily living, and -complications (SCOPA-A, -B, -C), and levodopa-equivalent daily dose (LEDD) preoperatively, at 5 and 24 months follow-up. Longitudinal changes were analyzed with Friedman-tests or repeated-measures ANOVA, when parametric tests were applicable, and Bonferroni-correction for multiple comparisons. Post-hoc, visits were compared with Wilcoxon signed-rank/t-tests. The magnitude of clinical responses was investigated using effect size.

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“…Furthermore, from our relatively short follow-up, we cannot predict which factors contribute to long-term QoL improvement, in particular, as in some patients a relatively long time may be required to find stable effective stimulation parameters or to recover from medication withdrawal. A longer follow-up including neuropsychological and non-dopaminergic NMS as well as axial motor symptoms, such as falls, is required to address the long-term QoL outcome [46,47].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Short-term quality of life after subthalamic stimulation depends on non-motor symptoms in Parkinson's disease

et al. 2018

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Subthalamic Stimulation Improves Quality of Life of Patients Aged 61 Years or Older With Short Duration of Parkinson’s Disease

Abstract: Patients aged 61 years or older benefited from STN-DBS regardless of short (≤8 years) or longer (>8 years) disease duration. Our results contribute to the debate about DBS selection criteria and timing and call for prospective confirmation in a larger cohort.

Cited by 32 publications

References 44 publications

EuroInf 2: Subthalamic stimulation, apomorphine, and levodopa infusion in Parkinson's disease

EuroInf 2: Subthalamic stimulation, apomorphine, and levodopa infusion in Parkinson's disease

Beneficial effect of 24-month bilateral subthalamic stimulation on quality of sleep in Parkinson’s disease

Short-term quality of life after subthalamic stimulation depends on non-motor symptoms in Parkinson's disease

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