Quality of life in advanced Parkinson’s disease after bilateral subthalamic stimulation: 2 years follow-up study

Sobstyl, Michał; Ząbek, Mirosław; Górecki, Wojciech; Mossakowski, Zbigniew

doi:10.1016/j.clineuro.2014.06.019

Cited by 22 publications

(20 citation statements)

References 20 publications

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“…23 We suspect that it was not the severity of motor function in the off state but some other factors like the daily OFF time that matters, and these results could be supported by some previous investigations. In our study, however, neither presurgical UPDRS-III scores nor the levodopa response was predictive to the QoL changes.…”

Section: Discussionsupporting

confidence: 70%

“…Actually, the correlation between motor functions/improvements and QoL changes after DBS surgery remain a matter of controversy. 23 We suspect that it was not the severity of motor function in the off state but some other factors like the daily OFF time that matters, and these results could be supported by some previous investigations. 5,24 It seems to be somewhat un- Thirdly, the nonmotor symptoms were assessed by NMSQ, but not NMSS.…”

Section: Discussionsupporting

confidence: 70%

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Predictors to quality of life improvements after subthalamic stimulation in Parkinson’s disease

et al. 2018

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Introduction Subthalamic deep brain stimulation (STN DBS) has been reported to improve the quality of life (QoL) related to Parkinson's disease (PD). However, not all subjects are satisfied with the postsurgical QoL outcome. We aimed to detect the related factors and possible predictors to QoL improvement for those PD patients one year after STN DBS. Materials and Methods A total of 45 PD patients with bilateral STN DBS surgery were included and followed up for 1 year. The Reliable Change Index (RCI) was adapted to determine the individual postsurgical QoL outcome. The changes of QoL were correlated with baseline parameters and the changes of progression parameters using Pearson's correlation. The exploratory stepwise regressions were adopted to detect the extents of baseline variables and progression parameters. The predictors to QoL outcome were detected using the logistic regression analysis. Results A total of 51.1% of the patients reported a better QoL, 40.0% of patients reported an unchanged QoL, while 8.9% of patients reported a worsening of QoL. The subdomains of mobility, activity of daily living, cognition, and bodily discomfort improved significantly after the surgery. The presurgical factors including QoL, dopaminergic medication burden, disease stages, depression scores, and postsurgical reductions in depression and nonmotor scores were found to correlate with QoL changes. Furthermore, the greater presurgical QoL burden, lesser dopaminergic medication exposure, and earlier disease stages were predictors to QoL improvements. Conclusion The clinicians should carefully evaluate the nonmotor symptoms and life quality in those patients at relatively earlier stages and with lower medicine dosage to get more successful DBS outcomes.

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Section: Discussionsupporting

confidence: 70%

Section: Discussionsupporting

confidence: 70%

Predictors to quality of life improvements after subthalamic stimulation in Parkinson’s disease

et al. 2018

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“…However there was steady worsening in mood and anxiety at 2, 4, 6 and 12 months compared to baseline when combining the STN and GPi groups. Furthermore, the changes in LEDD did not correlate with changes in mood or UPDRS II scores in both groups [43] or with QOL at 1 year post STN DBS in another study [44]. Similarly we did not find a correlation between LEDD and Q-LES in our cohort, but we observed significant positive correlation between the change in LEDD and change in BDI scores in all patients but not in TNM(+) subgroup.…”

Section: Discussioncontrasting

confidence: 68%

Stimulation-Induced Transient Nonmotor Psychiatric Symptoms following Subthalamic Deep Brain Stimulation in Patients with Parkinson's Disease: Association with Clinical Outcomes and Neuroanatomical Correlates

Abulseoud

Kasasbeh

Min

et al. 2016

Stereotact Funct Neurosurg

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Background: The clinical and neurobiological underpinnings of transient nonmotor (TNM) psychiatric symptoms during the optimization of stimulation parameters in the course of subthalamic nucleus deep brain stimulation (STN-DBS) remain under intense investigation. Methods: Forty-nine patients with refractory Parkinson's disease underwent bilateral STN-DBS implants and were enrolled in a 24-week prospective, naturalistic follow-up study. Patients who exhibited TNM psychiatric manifestations during DBS parameter optimization were evaluated for potential associations with clinical outcome measures. Results: Twenty-nine TNM+ episodes were reported by 15 patients. No differences between TNM+ and TNM- groups were found in motor outcome. However, unlike the TNM- group, TNM+ patients did not report improvement in subsyndromal depression or quality of life. TNM+ episodes were more likely to emerge during bilateral monopolar stimulation of the medial STN. Conclusions: The occurrence of TNM psychiatric symptoms during optimization of stimulation parameters was associated with the persistence of subsyndromal depression and with lower quality of life ratings at 6 months. The neurobiological underpinnings of TNM symptoms are investigated yet remain difficult to explain.

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“…Before the surgical procedure, the global percentage of the patient was 61.19% and, 14 months after the DBS, it decreased to 21.05%. These results, comparable to literature data, [32][33][34] showed a significant decrease in the score, pointing to an improvement in his quality of life. However, the oral communication of this patient was impaired after the DBS, due to dysarthria that occurred as a complication of the procedure.…”

Section: Discussionsupporting

confidence: 90%

Deep Brain Stimulation for the Treatment of Juvenile Parkinsonism: Case Report

2019

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Juvenile parkinsonism (JP) is characterized by the clinical manifestation of Parkinson syndrome before the age of 21 years old. This entity is often associated with genetic mutations. After all the possibilities of clinical treatment have been exhausted, surgical treatment is recommended, performed via deep brain stimulation (DBS) in the subthalamic nucleus (STN) or in the internal segment of the globus pallidus (GPi). The present study aimed to report the case of a patient with JP who underwent DBS in the STN with good clinical response. Neuromodulation via DBS is an option for the treatment of JP. However, since this entity is very rare, and even more peculiar when treated surgically, more studies are necessary to evaluate DBS used to control refractory manifestations and levodopa-induced dyskinesia, as well as surgical complications that may occur, aiming to gather more knowledge of the surgical management of JP. Despite the dysarthria after the DBS, the patient presented a satisfactory response regarding the symptoms, corroborated by the Parkinson's Disease Questionnaire (PDQ-39) score, which was 61.19% before the procedure, and decreased to 21.05% 14 months after the DBS. Palavras-chaveResumo O parkinsonismo juvenil (PJ) é caracterizado pela manifestação clínica da síndrome de Parkinson antes dos 21 anos de idade. Esta entidade está frequentemente associada a mutações genéticas. Depois de esgotadas todas as possibilidades de tratamento clínico, institui-se o tratamento cirúrgico, que é realizado via estimulação cerebral profunda (ECP) no núcleo subtalâmico (NST) ou no globo pálido interno (GPi). O presente trabalho teve como objetivo relatar o caso de um paciente com PJ que foi submetido à ECP no NST com boa resposta clínica. A neuromodulação via ECP apresenta-se como uma opção de tratamento para o PJ. Contudo, em decorrência da raridade desta entidade, que se torna ainda mais peculiar quando abordada cirurgicamente, são necessários mais estudos que avaliem a ECP utilizada para controlar as manifestações refratárias e a discinesia induzida por levodopa, assim Ledismar José da Silva's ORCID is 0000-0002-3551-2650.

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Quality of life in advanced Parkinson’s disease after bilateral subthalamic stimulation: 2 years follow-up study

Cited by 22 publications

References 20 publications

Predictors to quality of life improvements after subthalamic stimulation in Parkinson’s disease

Predictors to quality of life improvements after subthalamic stimulation in Parkinson’s disease

Stimulation-Induced Transient Nonmotor Psychiatric Symptoms following Subthalamic Deep Brain Stimulation in Patients with Parkinson's Disease: Association with Clinical Outcomes and Neuroanatomical Correlates

Deep Brain Stimulation for the Treatment of Juvenile Parkinsonism: Case Report

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