A prospective, controlled study of non-motor effects of subthalamic stimulation in Parkinson’s disease: results at the 36-month follow-up

Medientyp: E-Artikel

Titel: A prospective, controlled study of non-motor effects of subthalamic stimulation in Parkinson’s disease: results at the 36-month follow-up

Beteiligte: Jost, Stefanie Theresa [VerfasserIn]; Sauerbier, Anna [VerfasserIn]; Fink, Gereon Rudolf [VerfasserIn]; Franklin, Jeremy [VerfasserIn]; Samuel, Michael [VerfasserIn]; Schnitzler, Alfons [VerfasserIn]; Barbe, Michael Thomas [VerfasserIn]; Antonini, Angelo [VerfasserIn]; Martinez-Martin, Pablo [VerfasserIn]; Timmermann, Lars [VerfasserIn]; Ray-Chaudhuri, K. [VerfasserIn]; Dafsari, Haidar S [VerfasserIn]; Visser-Vandewalle, Veerle [VerfasserIn]; Ashkan, Keyoumars [VerfasserIn]; Silverdale, Monty [VerfasserIn]; Evans, Julian [VerfasserIn]; Loehrer, Philipp A [VerfasserIn]; Rizos, Alexandra [VerfasserIn]; Petry-Schmelzer, Jan Niklas [VerfasserIn]; Reker, Paul [VerfasserIn]

Erschienen: BMJ Publishing Group, 2020

Sprache: Englisch

DOI: https://doi.org/10.1136/jnnp-2019-322614

ISSN: 0368-329X; 0266-8637; 1468-330X; 0022-3050

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Beschreibung: 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.

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