Quality of life predicts outcome of deep brain stimulation in early Parkinson disease.

Schüpbach, Michael; Tonder, Lisa; Schnitzler, Alfons; Krack, Paul; Rau, Joern; Hartmann, Andreas; Hälbig, Thomas D; Pineau, Fanny; Falk, Andrea; Paschen, Laura; Paschen, Stephen; Volkmann, Jens; Dafsari, Haidar S; Barbe, Michael T; Fink, Gereon R; Kühn, Andrea; Kupsch, Andreas; Schneider, Gerd-H; Seigneuret, Eric; Fraix, Valerie; ... (2019). Quality of life predicts outcome of deep brain stimulation in early Parkinson disease. Neurology, 92(10), e1109-e1120. American Academy of Neurology 10.1212/WNL.0000000000007037

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OBJECTIVE To investigate predictors for improvement of disease-specific quality of life (QOL) after deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson disease (PD) with early motor complications. METHODS We performed a secondary analysis of data from the previously published EARLYSTIM study, a prospective randomized trial comparing STN-DBS (n = 124) to best medical treatment (n = 127) after 2 years follow-up with disease-specific QOL (39-item Parkinson's Disease Questionnaire summary index [PDQ-39-SI]) as the primary endpoint. Linear regression analyses of the baseline characteristics age, disease duration, duration of motor complications, and disease severity measured at baseline with the Unified Parkinson's Disease Rating Scale (UPDRS) (UPDRS-III "off" and "on" medications, UPDRS-IV) were conducted to determine predictors of change in PDQ-39-SI. RESULTS PDQ-39-SI at baseline was correlated to the change in PDQ-39-SI after 24 months in both treatment groups (p < 0.05). The higher the baseline score (worse QOL) the larger the improvement in QOL after 24 months. No correlation was found for any of the other baseline characteristics analyzed in either treatment group. CONCLUSION Impaired QOL as subjectively evaluated by the patient is the most important predictor of benefit in patients with PD and early motor complications, fulfilling objective gold standard inclusion criteria for STN-DBS. Our results prompt systematically including evaluation of disease-specific QOL when selecting patients with PD for STN-DBS. CLINICALTRIALSGOV IDENTIFIER NCT00354133.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Schüpbach, Michael and Krack, Paul

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1526-632X

Publisher:

American Academy of Neurology

Language:

English

Submitter:

Chantal Kottler

Date Deposited:

18 Nov 2019 12:31

Last Modified:

18 Nov 2019 12:38

Publisher DOI:

10.1212/WNL.0000000000007037

PubMed ID:

30737338

BORIS DOI:

10.7892/boris.134778

URI:

https://boris.unibe.ch/id/eprint/134778

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