Long-term independence and quality of life after subthalamic stimulation in Parkinson's disease.

Castrioto, Anna; Debû, Bettina; Cousin, Emilie; Pelissier, Pierre; Lhommée, Eugénie; Bichon, Amélie; Schmitt, Emmanuelle; Kistner, Andrea; Meoni, Sara; Seigneuret, Eric; Chabardes, Stephan; Krack, Paul; Moro, Elena; Fraix, Valérie (2022). Long-term independence and quality of life after subthalamic stimulation in Parkinson's disease. European journal of neurology, 29(9), pp. 2645-2653. Wiley 10.1111/ene.15436

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BACKGROUND

Studies on long-term non-motor outcomes of subthalamic nucleus stimulation in Parkinson's disease are scarce. This study reports on very-long term non-motor and motor outcomes in one of the largest cohorts of people with advanced Parkinson's disease, treated for more than ten years with subthalamic nucleus stimulation. The main outcome was to document the evolution of independence in activities of daily living. The secondary outcomes were to measure the change in quality of life, as well as non-motor and motor outcomes.

METHODS

Patients were studied preoperatively, at one year, and beyond 10 years after subthalamic stimulation with an established protocol including motor, non-motor and neuropsychological assessments.

RESULTS

Eighty-five people with PD were included. Independence scores in the off-medication condition (measured with the Schwab & England activities of daily living scale), as well as quality of life (measured with the PDQ37) remained improved at longest follow-up compared to preoperatively (respectively p < 0.001, p = 0.015). Cognitive scores, measured with the MDRS, significantly worsened compared to before and one-year after surgery (p < 0.001), without significant change in depression, measured with the BDI. Motor fluctuations, dyskinesias and off dystonia remained improved at longest follow-up (p < 0.001), with a significant reduction in dopaminergic treatment (45%, p < 0.001).

CONCLUSIONS

This study highlights the long-term improvement of subthalamic stimulation on independence and quality of life, despite the progression of disease and the occurrence of levodopa-resistant symptoms.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
UniBE Contributor:	Krack, Paul
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1468-1331
Publisher:	Wiley
Language:	English
Submitter:	Pubmed Import
Date Deposited:	08 Jun 2022 07:39
Last Modified:	05 Dec 2022 16:20
Publisher DOI:	10.1111/ene.15436
PubMed ID:	35666167
Uncontrolled Keywords:	Parkinson disease activities of Daily Living deep brain stimulation quality of life subthalamic nucleus
URI:	https://boris.unibe.ch/id/eprint/170457