Health-Related Quality of Life in Parkinson's Disease after Pallidotomy and Deep Brain Stimulation

We assessed the effects of deep brain stimulation of the subthalamic nucleus (STN-DBS) or internal pallidum (GPi-DBS) on health-related quality of life (HrQoL) in patients with advanced Parkinson's disease participating in a previously reported multicenter trial. Sickness Impact Profile (SIP) questionnaires were available for analysis in a subgroup of n = 20/20 patients with GPi-DBS and n = 45/49 patients with STN-DBS at baseline, 6 and 36 months. The SIP provides a physical dimension and a psychosocial dimension sum score and 12 category scores: Alertness/Intellectual Behavior (AIB), Ambulation (A), Body Care and Movement (BCM), Communication (C), Eating (E), Emotional Behavior (EB), Home Management (HM), Mobility (M), Recreation and Pastimes (RP), Sleep and Rest (SR), Social Interaction (SI), and Work (W). Motor functioning was assessed by means of the Unified Parkinson's Disease Rating Scale and diaries. At 6 months significant improvements in off-period motor symptoms and activities of daily living were paralleled by significant reductions in the total, physical, and psychosocial SIP score in both treatment groups. At 3 years, sustained improvements were observed in the physical dimension score, BCM, E, M, RP after STN-DBS and M, SI after GPi-DBS. All other SIP subscores approached baseline values, but were still the same or better (except C) whereas motor functioning remained stable after 36 months. STN-DBS and GPi-DBS led to significant early improvements in HrQoL. Despite sustained motor improvements many of these initial benefits were lost after 3 years. This may reflect either progression of the disease or adaptive changes in the subjective perception of health-related wellbeing over time.

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“…StraitsTröster et al 21 and Vingerhoets et al 22 described significant benefits on the SIP at short-term after uni- or FIG. 1.…”

Section: 10mentioning

confidence: 99%

Long‐term effects of pallidal or subthalamic deep brain stimulation on quality of life in Parkinson's disease

et al. 2009

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“…Patients treated with pallidotomy or pallidal stimulation showed similar improvement in HRQOL 3 to 4 months after surgery. [24][25][26] A control group was included in only one of these studies. 24 Further studies, preferably with a larger study population followed for a longer time period, are needed to evaluate HRQOL in Parkinson patients who undergo DBS of the STN.…”

Section: Fig 1 Amentioning

confidence: 99%

Health‐Related quality of life in patients with advanced Parkinson's disease treated with deep brain stimulation of the subthalamic nuclei

Just

Østergaard

2002

Movement Disorders

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Parkinson's disease (PD) is a progressive neurodegenerative disorder for which there is as yet no cure. It affects many aspects of patients' lives, only some of which can be monitored by available clinical rating scales. In the past decade, there has been a new emphasis on the use of health-related quality of life (HRQOL) measures to describe patient response to treatment. We describe patient-reported HRQOL in subjects who underwent bilateral deep brain stimulation (DBS) of the subthalamic nuclei (STN) for the treatment of PD, compared with a similar group of subjects who did not receive surgical treatment. A consecutive series of patients (n = 11) with advanced idiopathic PD were treated with DBS of the STN. This surgically treated group was compared prospectively with a similar group of patients (n =13) awaiting surgery. Self-reported HRQOL, measured by the Parkinson's Disease Questionnaire (PDQ-39) was evaluated at three time periods T(0), T(3), and T(6). The surgery group was evaluated according to the Unified Parkinson's Disease Rating Sale (UPDRS) before (T(0)), 3 (T(3)), and 6 months (T(6)) after surgery. HRQOL, UPDRS part II and III, duration of off periods, and dyskinesias improved significantly from T(0) to T(3) and from T(0) to T(6) for the surgery group but not for the nonsurgery group. Ten of the 11 patients treated with DBS of the STN reported a lower summary score (indicating better HRQOL) 6 months after surgery. The results of this prospective controlled study suggest that patients with advanced idiopathic PD treated with DBS of the STN obtain significant improvements in patient reported HRQOL and in clinical outcomes 3 and 6 months after surgery.

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“…At the urging of these authors, the Wilson-Cleary HRQL conceptual model has been empirically validated in various health conditions and populations, including coronary artery bypass surgery [36], dental treatment [3], HIV/AIDS [12,13,23,42,46,51,52], heart failure [2,7,25,32,34], Hodgkin's lymphoma [49], Parkinson's disease [10,48]), and in the examination of gender differences in HRQL among the elderly [41]. Wilson and Cleary acknowledged that applying their theoretical model to physical health conditions like rheumatoid arthritis or heart disease would be less problematic than using the model to explain and understand psychological or mental health conditions and stressed the need for added causal relationships between psychological symptom concepts and other variables in their model.…”

Section: Introductionmentioning

confidence: 99%

Understanding the relationships between health outcomes in generalized anxiety disorder clinical trials

Wyrwich¹,

Harnam²,

Locklear

et al. 2010

Qual Life Res

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Health-Related Quality of Life in Parkinson's Disease after Pallidotomy and Deep Brain Stimulation

Cited by 64 publications

References 36 publications

Long‐term effects of pallidal or subthalamic deep brain stimulation on quality of life in Parkinson's disease

Long‐term effects of pallidal or subthalamic deep brain stimulation on quality of life in Parkinson's disease

Health‐Related quality of life in patients with advanced Parkinson's disease treated with deep brain stimulation of the subthalamic nuclei

Understanding the relationships between health outcomes in generalized anxiety disorder clinical trials

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