TY - JOUR
T1 - Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease
AU - Jost, Stefanie T.
AU - Visser-Vandewalle, Veerle
AU - Rizos, Alexandra
AU - Loehrer, Philipp A.
AU - Silverdale, Monty
AU - Evans, Julian
AU - Samuel, Michael
AU - Petry-Schmelzer, Jan Niklas
AU - Sauerbier, Anna
AU - Gronostay, Alexandra
AU - Barbe, Michael T.
AU - Fink, Gereon R.
AU - Ashkan, Keyoumars
AU - Antonini, Angelo
AU - Martinez-Martin, Pablo
AU - Chaudhuri, K. Ray
AU - Timmermann, Lars
AU - Dafsari, Haidar S.
AU - EUROPAR and the International Parkinson and Movement Disorders Society Non-Motor Parkinson’s Disease Study Group
AU - Bhidayasiri, Roongroj
AU - Falup-Pecurariu, Cristian
AU - Jeon, Beomseok
AU - Leta, Valentina
AU - Borghammer, Per
AU - Odin, Per
AU - Schrag, Anette
AU - Storch, Alexander
AU - Violante, Mayela Rodriguez
AU - Weintraub, Daniel
AU - Adler, Charles
AU - Barone, Paolo
AU - Brooks, David J.
AU - Brown, Richard
AU - Cantillon, Marc
AU - Carroll, Camille
AU - Coelho, Miguel
AU - Henriksen, Tove
AU - Hu, Michele
AU - Jenner, Peter
AU - Kramberger, Milica
AU - Kumar, Padma
AU - Kurtis, Mónica
AU - Lewis, Simon
AU - Litvan, Irene
AU - Lyons, Kelly
AU - Martino, Davide
AU - Masellis, Mario
AU - Mochizuki, Hideki
AU - Morley, James F.
AU - Nirenberg, Melissa
AU - Pagonabarraga, Javier
AU - Panicker, Jalesh
AU - Pavese, Nicola
AU - Pekkonen, Eero
AU - Postuma, Ron
AU - Rosales, Raymond
AU - Schapira, Anthony
AU - Simuni, Tanya
AU - Stocchi, Fabrizio
AU - Subramanian, Indu
AU - Tagliati, Michele
AU - Tinazzi, Michele
AU - Toledo, Jon
AU - Tsuboi, Yoshio
AU - Walker, Richard
N1 - Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2021/6/8
Y1 - 2021/6/8
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85107841229&partnerID=8YFLogxK
U2 - 10.1038/s41531-021-00174-x
DO - 10.1038/s41531-021-00174-x
M3 - Article
C2 - 34103534
AN - SCOPUS:85107841229
SN - 2373-8057
VL - 7
SP - 1
EP - 7
JO - npj Parkinson's Disease
JF - npj Parkinson's Disease
IS - 1
M1 - 48
ER -