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Research Article| Volume 9, ISSUE 1, P78-85, January 2016

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Beneficial Effects of Bilateral Subthalamic Stimulation on Non-Motor Symptoms in Parkinson's Disease

Published:August 19, 2015DOI:https://doi.org/10.1016/j.brs.2015.08.005

      Highlights

      • Investigated bilateral STN-DBS motor, non-motor and quality of life effects in 60 patients with PD.
      • Significant improvement of quality of life, non-motor and motor symptoms on 6 months follow-up.
      • Significant non-motor benefit on sleep/fatigue, miscellaneous, perceptual problems, urinary domain.

      Abstract

      Background

      STN-DBS is well established to improve motor symptoms and quality of life in patients with PD. While non-motor symptoms are crucial for quality of life in these patients, only neuropsychiatric and neuropsychological symptoms have been systematically studied in a longitudinal design so far. However, these are only a part of the non-motor symptoms spectrum.

      Hypothesis

      We hypothesized that STN-DBS is associated with a beneficial effect on a range of non-motor symptoms.

      Methods

      In this multicenter, open, prospective, international study (EuroInf-study, UKCRN10084/DRKS00006735) we investigated non-motor effects of STN-DBS in “real-life” use. We evaluated Non-motor Symptom Scale, and Questionnaire, PD Questionnaire-8, Scales for Outcomes of PD motor examination and complications, and activities of daily living preoperatively and at 6 months follow-up in 60 consecutive patients (35 male, mean age: 61.6 ± 7.8 years, mean disease duration: 10.4 ± 4.2 years).

      Results

      All outcomes improved significantly at 6 months follow-up (PD Questionaire-8, p = 0.006; activities of daily living, p = 0.012; all others, p < 0.001; Wilcoxon signed-rank, respectively paired t-test; Bonferroni-correction). Post-hoc analyses of Non-motor Symptom Scale domains showed a significant reduction of sleep/fatigue and miscellaneous domains (p ≤ 0.001), perceptual problems/hallucinations (p = 0.036), and urinary (p = 0.018) scores. Effect sizes were “moderate” for Non-motor Symptom Scale, and motor complications, “large” for motor examination, and “small” for other outcomes.

      Conclusions

      This study provides evidence that bilateral STN-DBS improves non-motor burden in patients with PD and opens the door to a more balanced evaluation of DBS outcomes. Further randomized studies are needed to confirm these findings and compare DBS non-motor effects to other invasive therapies of advanced PD.

      Abbreviations:

      6MFU (6 months follow-up), ADL (activities of daily living), DBS (deep brain stimulation), LEDD (Levodopa equivalent daily dose), NMS (non-motor symptoms), NMSS (NMS Scale), NMSQ (NMS questionnaire), PD (Parkinson's disease), PDQ (PD questionnaire), QoL (quality of life), SPES/SCOPA (short Parkinson's evaluation scale/scales for outcomes in Parkinson's disease), STN (subthalamic nucleus), UPDRS (Unified Parkinson's Disease Rating Scale)

      Keywords

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