Tödt, Inken; Al-Fatly, Bassam; Granert, Oliver; Kühn, Andrea A; Krack, Paul; Rau, Joern; Timmermann, Lars; Schnitzler, Alfons; Paschen, Steffen; Helmers, Ann-Kristin; Hartmann, Andreas; Bardinet, Eric; Schuepbach, Michael; Barbe, Michael T; Dembek, Till A; Fraix, Valerie; Kübler, Dorothee; Brefel-Courbon, Christine; Gharabaghi, Alireza; Wojtecki, Lars; ... (2022). The Contribution of Subthalamic Nucleus Deep Brain Stimulation to the Improvement in Motor Functions and Quality of Life. Movement disorders, 37(2), pp. 291-301. Wiley 10.1002/mds.28952
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BACKGROUND
Subthalamic nucleus deep brain stimulation (STN-DBS) effectively treats motor symptoms and quality of life (QoL) of advanced and fluctuating early Parkinson's disease. Little is known about the relation between electrode position and changes in symptom control and ultimately QoL.
OBJECTIVES
The relation between the stimulated part of the STN and clinical outcomes, including the motor score of the Unified Parkinson's Disease Rating Scale (UPDRS) and the quality-of-life questionnaire, was assessed in a subcohort of the EARLYSTIM study.
METHODS
Sixty-nine patients from the EARLYSTIM cohort who underwent DBS, with a comprehensive clinical characterization before and 24 months after surgery, were included. Intercorrelations of clinical outcome changes, correlation between the affected functional parts of the STN, and changes in clinical outcomes were investigated. We further calculated sweet spots for different clinical parameters.
RESULTS
Improvements in the UPDRS III and Parkinson's Disease Questionnaire (PDQ-39) correlated positively with the extent of the overlap with the sensorimotor STN. The sweet spots for the UPDRS III (x = 11.6, y = -13.1, z = -6.3) and the PDQ-39 differed (x = 14.8, y = -12.4, z = -4.3) ~3.8 mm.
CONCLUSIONS
The main influence of DBS on QoL is likely mediated through the sensory-motor basal ganglia loop. The PDQ sweet spot is located in a posteroventral spatial location in the STN territory. For aspects of QoL, however, there was also evidence of improvement through stimulation of the other STN subnuclei. More research is necessary to customize the DBS target to individual symptoms of each patient. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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, Schüpbach, Michael |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1531-8257 |
Publisher: |
Wiley |
Language: |
English |
Submitter: |
Chantal Kottler |
Date Deposited: |
01 Nov 2022 15:40 |
Last Modified: |
05 Dec 2022 16:27 |
Publisher DOI: |
10.1002/mds.28952 |
PubMed ID: |
35112384 |
Uncontrolled Keywords: |
Parkinson's disease deep brain stimulation quality of life subthalamic nucleus deep brain stimulation |
BORIS DOI: |
10.48350/174401 |
URI: |
https://boris.unibe.ch/id/eprint/174401 |
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