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

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

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  • 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; Sauerbier, Anna; Visser-Vandewalle, Veerle; Ashkan, Keyoumars; Silverdale, Monty; Evans, Julian; Loehrer, Philipp A; Rizos, Alexandra; Petry-Schmelzer, Jan Niklas; Reker, Paul; Fink, Gereon Rudolf; Franklin, Jeremy; Samuel, Michael; Schnitzler, Alfons; Barbe, Michael Thomas; Antonini, Angelo; Martinez-Martin, Pablo; Timmermann, Lars; Ray-Chaudhuri, K; Dafsari, Haidar S
  • Erschienen: BMJ, 2020
  • Erschienen in: Journal of Neurology, Neurosurgery & Psychiatry
  • Sprache: Englisch
  • DOI: 10.1136/jnnp-2019-322614
  • ISSN: 0022-3050; 1468-330X
  • Schlagwörter: Psychiatry and Mental health ; Neurology (clinical) ; Surgery
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  • Beschreibung: <jats:sec><jats:title>Objective</jats:title><jats:p>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).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>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.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>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.</jats:p></jats:sec>