Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease

Medientyp: E-Artikel

Titel: Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease

Beteiligte: Jost, Stefanie T. [VerfasserIn]; Visser-Vandewalle, Veerle [VerfasserIn]; Barbe, Michael T. [VerfasserIn]; Fink, Gereon Rudolf [VerfasserIn]; Ashkan, Keyoumars [VerfasserIn]; Antonini, Angelo [VerfasserIn]; Martinez-Martin, Pablo [VerfasserIn]; Chaudhuri, K. Ray [VerfasserIn]; Timmermann, Lars [VerfasserIn]; Dafsari, Haidar S. [VerfasserIn]; Bhidayasiri, Roongroj [VerfasserIn]; Falup-Pecurariu, Cristian [VerfasserIn]; Rizos, Alexandra [VerfasserIn]; Jeon, Beomseok [VerfasserIn]; Leta, Valentina [VerfasserIn]; Borghammer, Per [VerfasserIn]; Odin, Per [VerfasserIn]; Schrag, Anette [VerfasserIn]; Storch, Alexander [VerfasserIn]; Violante, Mayela Rodriguez [VerfasserIn]; Weintraub, Daniel [VerfasserIn]; Adler, Charles [VerfasserIn]; Barone, Paolo [VerfasserIn]; Loehrer, Philipp A. [VerfasserIn]; [...]

Erschienen: Nature Publ. Group, 2021

Sprache: Englisch

DOI: https://doi.org/10.1038/s41531-021-00174-x

ISSN: 2373-8057

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Beschreibung: To identify predictors of 36-month follow-up quality of life (QoL) outcome after bilateral subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson’s disease (PD). In this ongoing, prospective, multicenter international study (Cologne, Manchester, London) including 73 patients undergoing STN-DBS, we assessed the following scales preoperatively and at 6-month and 36-month follow-up: PD Questionnaire-8 (PDQ-8), NMSScale (NMSS), Scales for Outcomes in PD (SCOPA)-motor examination, -activities of daily living, and -complications, and levodopa equivalent daily dose (LEDD). We analyzed factors associated with QoL improvement at 36-month follow-up based on (1) 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 and receiver operating characteristic curves using a dichotomized variable “QoL responders”/“non-responders”. At both follow-ups, NMSS total score, SCOPA-motor examination, and -complications improved and LEDD was reduced significantly. PDQ-8 improved at 6-month follow-up with subsequent decrements in gains at 36-month follow-up when 61.6% of patients were categorized as “QoL non-responders”. Correlations, linear, and logistic regression analyses found greater PDQ-8 improvements in patients with younger age, worse PDQ-8, and worse specific NMS at baseline, such as ‘difficulties experiencing pleasure’ and ‘problems sustaining concentration’. Baseline SCOPA scores were not associated with PDQ-8 changes. Our results provide evidence that 36-month QoL changes depend on baseline neuropsychological and neuropsychiatric non-motor symptoms burden. These findings highlight the need for an assessment of a wide range of non-motor and motor symptoms when advising and selecting individuals for DBS therapy.

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