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

2019; Lippincott Williams & Wilkins; Volume: 92; Issue: 10 Linguagem: Inglês

10.1212/wnl.0000000000007037

1526-632X

W.M. Michael Schuepbach, Lisa Tonder, Alfons Schnitzler, Paul Krack, Jörn Rau, Andréas Hartmann, Thomas D. Hälbig, Fanny Pineau, Andrea Falk, Laura Paschen, Steffen Paschen, Jens Volkmann, Haidar S. Dafsari, Michael T. Barbe, Gereon R. Fink, Andrea A. Kühn, Andreas Kupsch, Gerd‐Helge Schneider, Éric Seigneuret, Valérie Fraix, Andrea Kistner, Patrick Chaynes, Fabienne Ory‐Magne, Christine Brefel‐Courbon, Jan Vesper, Lars Wojtecki, Stéphane Derrey, David Maltête, Philippe Damier, Pascal Derkinderen, Friederike Sixel‐Döring, Claudia Trenkwalder, Alireza Gharabaghi, Tobias Wächter, Daniel Weiß, Marcus O. Pinsker, Jean-Marie Régis, Tatiana Witjas, Stéphane Thobois, Patrick Mertens, Karina Knudsen, Carmen Schade‐Brittinger, Jean‐Luc Houéto, Y. Agid, Marie Vidailhet, Lars Timmermann, Günther Deuschl, Virginie Czernecki, Helke Hesekamp, Niklaus Meier, Velina Negovanska, Marie‐Laure Welter, Jean‐Christophe Corvol, Philippe Cornu, Soledad Navarro, Bettina Möller, Adelheid Nebel, Karsten Witt, Jan Raethjen, H. Maximilian Mehdorn, Ingo G. Meister, Jens Kuhn, Josef Kessler, Doreen Gruber, Katharina Faust, Stéphan Chabardès, Pierre Pollak, Oliver Rascol, Christophe Arbus, Lola Danet, Romain Lefaucheur, Isabelle Bénatru, Olivier Colin, Solène Ansquer, Stefan Jun Groiss, Saskia Elben, Christian J. Hartmann, Martin Südmeyer, F. Amtage, Rejko Krueger, Severine Ledily, Anne Sauvaget, W Schmidt, Alexandro Eusebio, J.-P. Azulay, Gustavo Polo, Serge Pinto, Johannes Levin, Wolfgang H. Oertel,

Genetic Neurodegenerative Diseases

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 Parkinson9s 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. Clinicaltrials.gov identifier NCT00354133.