期刊
BRAIN STIMULATION
卷 11, 期 4, 页码 867-874出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.brs.2018.02.015
关键词
Deep brain stimulation; Subthalamic nucleus; Non motor symptoms; Parkinson's Disease Questionnaire
资金
- Prof. Klaus Thiemann Foundation
- Felgenhauer Foundation
- Koeln Fortune Program
- German Research Foundation [KFO 219]
- National Institute for Health Research Mental Health Biomedical Research Centre and Dementia Unit at South London and Maudsley NHS Foundation Trust and King's College London
- Medtronic
- Parkinson's UK
- Ipsen
- SAPIENS Steering Brain Stimulation
- Sunovion
- Zambon
- AbbVie
- Angelini
- UCB
- Boehringer Ingelheim
- Cynapsus Therapeutics
- GE
- Boston Scientific
- Mundipharma
- Ever Neuro Pharma
- Horizon 2020 Project [643706]
- International Parkinson and Movement Disorder Society
- NIHR
- European Union
- St. Jude medical
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/nonresponders 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. (C) 2018 Published by Elsevier Inc.
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