Journal Article

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

Hu, Michele, Panicker Jalesh, Odin Per, Sauerbier Anna, Loehrer, Philipp A, Martinez-Martin, Pablo, Kramberger Milica, Tinazzi Michele, Roongroj, Bhidayasiri, Leta Valentina, Nirenberg, Melissa, Visser-Vandewalle Veerle, Schapira, Anthony, Samuel, Michael, Timmermann, Lars, Kurtis Mónica, Rosales, Raymond, Jeon Beomseok, Cantillon, Marc, Evans, Julian, Morley, James F, Adler, Charles, Subramanian Indu, Violante Mayela Rodriguez, Falup-Pecurariu Cristian, Ray, Chaudhuri K, Storch, Alexander, Henriksen Tove, Stocchi Fabrizio, Rizos, Alexandra, Walker, Richard, Fink, Gereon R, Carroll, Camille, Keyoumars, Ashkan, Postuma, Ron, Simuni Tanya, Gronostay Alexandra, Jost, Stefanie T, Brooks, David J, Petry-Schmelzer, Jan Niklas, Silverdale Monty, Pavese Nicola, Toledo, Jon, Barone, Paolo, Martino Davide, Dafsari, Haidar S, Jenner, Peter, Barbe, Michael T, Tsuboi Yoshio, Antonini, Angelo, Tagliati Michele, Pekkonen Eero, Brown, Richard, Litvan Irene, Schrag Anette, Pagonabarraga Javier, Kumar, Padma, Weintraub, Daniel, Coelho, Miguel, Mochizuki Hideki, Borghammer Per, Lewis, Simon, Lyons, Kelly, Masellis Mario

2021

Overview

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.

• Publisher: Nature Publishing Group
• Subject: Activities of daily living / Brain research / Deep brain stimulation / Drug dosages / Hospitals / Neurology / Neurosciences / Neurosurgery / Parkinson's disease / Quality of life / Questionnaires / Regression analysis / Variables