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

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 unde...

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Autores principales:	Stefanie T. Jost, Veerle Visser-Vandewalle, Alexandra Rizos, Philipp A. 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 Martinez-Martin, K. Ray Chaudhuri, Lars Timmermann, Haidar S. Dafsari, EUROPAR and the International Parkinson and Movement Disorders Society Non-Motor Parkinson’s Disease Study Group
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/359ce1e31a7a403ea2d57249fe0994a5
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spelling	oai:doaj.org-article:359ce1e31a7a403ea2d57249fe0994a52021-12-02T17:47:18ZNon-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease10.1038/s41531-021-00174-x2373-8057https://doaj.org/article/359ce1e31a7a403ea2d57249fe0994a52021-06-01T00:00:00Zhttps://doi.org/10.1038/s41531-021-00174-xhttps://doaj.org/toc/2373-8057Abstract 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.Stefanie T. JostVeerle Visser-VandewalleAlexandra RizosPhilipp A. LoehrerMonty SilverdaleJulian EvansMichael SamuelJan Niklas Petry-SchmelzerAnna SauerbierAlexandra GronostayMichael T. BarbeGereon R. FinkKeyoumars AshkanAngelo AntoniniPablo Martinez-MartinK. Ray ChaudhuriLars TimmermannHaidar S. DafsariEUROPAR and the International Parkinson and Movement Disorders Society Non-Motor Parkinson’s Disease Study GroupNature PortfolioarticleNeurology. Diseases of the nervous systemRC346-429ENnpj Parkinson's Disease, Vol 7, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Stefanie T. Jost Veerle Visser-Vandewalle Alexandra Rizos Philipp A. 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 Martinez-Martin K. Ray Chaudhuri Lars Timmermann Haidar S. Dafsari EUROPAR and the International Parkinson and Movement Disorders Society Non-Motor Parkinson’s Disease Study Group Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease
description	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.
format	article
author	Stefanie T. Jost Veerle Visser-Vandewalle Alexandra Rizos Philipp A. 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 Martinez-Martin K. Ray Chaudhuri Lars Timmermann Haidar S. Dafsari EUROPAR and the International Parkinson and Movement Disorders Society Non-Motor Parkinson’s Disease Study Group
author_facet	Stefanie T. Jost Veerle Visser-Vandewalle Alexandra Rizos Philipp A. 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 Martinez-Martin K. Ray Chaudhuri Lars Timmermann Haidar S. Dafsari EUROPAR and the International Parkinson and Movement Disorders Society Non-Motor Parkinson’s Disease Study Group
author_sort	Stefanie T. Jost
title	Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease
title_short	Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease
title_full	Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease
title_fullStr	Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease
title_full_unstemmed	Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease
title_sort	non-motor predictors of 36-month quality of life after subthalamic stimulation in parkinson disease
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/359ce1e31a7a403ea2d57249fe0994a5
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Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease

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