RT Journal Article
SR Electronic
T1 A prospective, controlled study of non-motor effects of subthalamic stimulation in Parkinson’s disease: results at the 36-month follow-up
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 687
OP 694
DO 10.1136/jnnp-2019-322614
VO 91
IS 7
A1 Stefanie Theresa Jost
A1 Anna Sauerbier
A1 Veerle Visser-Vandewalle
A1 Keyoumars Ashkan
A1 Monty Silverdale
A1 Julian Evans
A1 Philipp A Loehrer
A1 Alexandra Rizos
A1 Jan Niklas Petry-Schmelzer
A1 Paul Reker
A1 Gereon Rudolf Fink
A1 Jeremy Franklin
A1 Michael Samuel
A1 Alfons Schnitzler
A1 Michael Thomas Barbe
A1 Angelo Antonini
A1 Pablo Martinez-Martin
A1 Lars Timmermann
A1 K Ray-Chaudhuri
A1 Haidar S Dafsari
A1 ,
YR 2020
UL http://jnnp.bmj.com/content/91/7/687.abstract
AB Objective To examine 36-month effects of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on non-motor symptoms (NMS) compared with standard-of-care medical treatment (MED) in Parkinson’s disease (PD).Methods Here we report the 36-month follow-up of a prospective, observational, controlled, international multicentre study of the NILS cohort. Assessments included NMSScale (NMSS), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD (SCOPA)-motor examination, -activities of daily living, and -complications, and levodopa equivalent daily dose (LEDD). Propensity score matching resulted in a pseudo-randomised sub-cohort balancing baseline demographic and clinical characteristics between the STN-DBS and MED groups. Within-group longitudinal outcome changes were analysed using Wilcoxon signed-rank and between-group differences of change scores with Mann-Whitney U test. Strength of clinical responses was quantified with Cohen’s effect size. In addition, bivariate correlations of change scores were explored.Results Propensity score matching applied on the cohort of 151 patients (STN-DBS n=67, MED n=84) resulted in a well-balanced sub-cohort including 38 patients per group. After 36 months, STN-DBS significantly improved NMSS, PDQ-8, SCOPA-motor examination and -complications and reduced LEDD. Significant between-group differences, all favouring STN-DBS, were found for NMSS, SCOPA-motor complications, LEDD (large effects), motor examination and PDQ-8 (moderate effects). Furthermore, significant differences were found for the sleep/fatigue, urinary (large effects) and miscellaneous NMSS domains (moderate effects). NMSS total and PDQ-8 change scores correlated significantly.Conclusions This study provides Class IIb evidence for beneficial effects of STN-DBS on NMS at 36-month follow-up which also correlated with quality of life improvements. This highlights the importance of NMS for DBS outcomes assessments.