Portal de Periódicos da CAPES

Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease

2021; Nature Portfolio; Volume: 7; Issue: 1 Linguagem: Inglês

10.1038/s41531-021-00174-x

2373-8057

Stefanie T. Jost, Veerle Visser‐Vandewalle, Alexandra Rizos, Philipp Alexander Loehrer, Monty Silverdale, Julian Evans, Michael Samuel, Jan Niklas Petry‐Schmelzer, Anna Sauerbier, Alexandra Gronostay, Michael T. Barbe, Gereon R. Fink, Keyoumars Ashkan, Angelo Antonini, Pablo Martínez‐Martin, К. Ray Chaudhuri, Lars Timmermann, Haidar S. Dafsari, Roongroj Bhidayasiri, Cristian Falup‐Pecurariu, Beomseok Jeon, Valentina Leta, Per Borghammer, Per Odin, Anette Schrag, Alexander Storch, Mayela Rodríguez‐Violante, Daniel Weintraub, Charles Adler, Paolo Barone, David J. Brooks, Richard G. Brown, Marc Cantillon, Camille Carroll, Miguel Coelho, Tove Henriksen, Joshua Shulman, Peter Jenner, Milica G. Kramberger, Padma Kumar, Mónica Kurtis, Simon J.G. Lewis, Irene Litvan, Kelly E. Lyons, Davide Martino, Mario Masellis, Hideki Mochizuki, James F. Morley, Melissa J. Nirenberg, Javier Pagonabarraga, Jalesh N. Panicker, Nicola Pavese, Eero Pekkonen, Ron Postuma, Raymond L. Rosales, Anthony H.V. Schapira, Tanya Simuni, Fabrizio Stocchi, Indu Subramanian, Michele Tagliati, Michèle Tinazzi, Jon B. Toledo, Yoshio Tsuboi, Richard Walker,

Transcranial Magnetic Stimulation Studies

Abstract To identify predictors of 36-month follow-up quality of life (QoL) outcome after bilateral subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson’s disease (PD). In this ongoing, prospective, multicenter international study (Cologne, Manchester, London) including 73 patients undergoing STN-DBS, we assessed the following scales preoperatively and at 6-month and 36-month follow-up: PD Questionnaire-8 (PDQ-8), NMSScale (NMSS), Scales for Outcomes in PD (SCOPA)-motor examination, -activities of daily living, and -complications, and levodopa equivalent daily dose (LEDD). We analyzed factors associated with QoL improvement at 36-month follow-up based on (1) 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 and receiver operating characteristic curves using a dichotomized variable “QoL responders”/“non-responders”. At both follow-ups, NMSS total score, SCOPA-motor examination, and -complications improved and LEDD was reduced significantly. PDQ-8 improved at 6-month follow-up with subsequent decrements in gains at 36-month follow-up when 61.6% of patients were categorized as “QoL non-responders”. Correlations, linear, and logistic regression analyses found greater PDQ-8 improvements in patients with younger age, worse PDQ-8, and worse specific NMS at baseline, such as ‘difficulties experiencing pleasure’ and ‘problems sustaining concentration’. Baseline SCOPA scores were not associated with PDQ-8 changes. Our results provide evidence that 36-month QoL changes depend on baseline neuropsychological and neuropsychiatric non-motor symptoms burden. These findings highlight the need for an assessment of a wide range of non-motor and motor symptoms when advising and selecting individuals for DBS therapy.