Quality of life predicts outcome of deep brain stimulation in early Parkinson disease
W.M. Michael Schuepbach
(1, 2, 3)
,
Lisa Tonder
(4)
,
Alfons Schnitzler
(5)
,
Paul Krack
(6)
,
Joern Rau
(7)
,
Andreas Hartmann
(8)
,
Thomas Hälbig
(9)
,
Fanny Pineau
(10)
,
Andrea Falk
(11)
,
Laura Paschen
(12)
,
Stephen Paschen
(13)
,
Jens Volkmann
(14)
,
Haidar Dafsari
(15, 16)
,
Michael Barbe
(15)
,
Gereon Fink
(17)
,
Andrea Kühn
(18, 19)
,
Andreas Kupsch
(20)
,
Gerd-H. Schneider
(21)
,
Eric Seigneuret
(22)
,
Valérie Fraix
(23)
,
Andrea Kistner
(24)
,
P. Patrick Chaynes
(25)
,
Fabienne Ory-Magne
(26)
,
Christine Brefel-Courbon
(26)
,
Jan Vesper
(5)
,
Lars Wojtecki
(5)
,
Stéphane Derrey
(27, 28, 29, 30)
,
David Maltête
(31)
,
Philippe Damier
(32)
,
Pascal Derkinderen
(33)
,
Friederike Sixel-Döring
(34, 7)
,
Claudia Trenkwalder
(35)
,
Alireza Gharabaghi
(36)
,
Tobias Wächter
(37)
,
Daniel Weiss
(38)
,
Marcus O. Pinsker
(14)
,
Jean-Marie Regis
(39)
,
Tatiana Witjas
(39)
,
Stéphane Thobois
(40)
,
Patrick Mertens
(41)
,
Karina Knudsen
(42)
,
Carmen Schade-Brittinger
(43)
,
Jean-Luc Houeto
(44, 45)
,
Yves Agid
(46)
,
Marie Vidailhet
(47)
,
Lars Timmermann
(5)
,
Günther Deuschl
(14)
1
UNIBE -
Universität Bern [Bern]
2 ICM - Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute
3 CIC AP-HP (pitie-Salpetriere)/inserm
4 Medtronic Inc [Minneapolis, MI, USA]
5 Heinrich Heine Universität Düsseldorf = Heinrich Heine University [Düsseldorf]
6 UNIGE - Université de Genève = University of Geneva
7 Philipps Universität Marburg = Philipps University of Marburg
8 CIC Neurosciences - Centre d'investigation clinique Neurosciences [CHU Pitié Salpêtrière]
9 NeuroCure Clinical Research Center (NCRC), Charité University Medical Center, Charité (Campus Mitte), Berlin, Germany.
10 CHU Pitié-Salpêtrière [AP-HP]
11 Department of Neuroscience, Karolinska institutet, Stockholm, Sweden
12 Department of Neurology, University Medical Center Schleswig-Holstein, Arnold-Heller-Street 3, Kiel 24105, Germany.
13 Department of Neurology, Christian-Albrechts-University, Kiel, Germany.
14 CAU - Christian-Albrechts-Universität zu Kiel
15 University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany.
16 National Parkinson Foundation Centre of Excellence, King's College Hospital, London, UK.
17 University of Cologne
18 Department of Neurology, Movement Disorder and Neuromodulation Unit, Charité-Universitätsmedizin, Berlin, Germany.
19 NeuroCure Clinical Research Center, Charité-Universitätsmedizin, Berlin, Germany.
20 Charité - UniversitätsMedizin = Charité - University Hospital [Berlin]
21 Department of Neurology & Neurosurgery, Charite University Medicine Berlin, Campus Virchow Klinikum & Benjamin Franklin, Berlin, Germany.
22 CHU - Centre Hospitalier Universitaire [Grenoble]
23 GIN - Grenoble Institut des Neurosciences
24 UM des troubles du mouvement
25 Service d'Anatomie et Cytopathologie [Toulouse]
26 CIC 1436 - Centre d'investigation clinique de Toulouse
27 Service de neurochirurgie [CHU Rouen]
28 ADEN - Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau
29 UNIROUEN - Université de Rouen Normandie
30 IRIB - Institute for Research and Innovation in Biomedicine
31 Service de neurologie [Rouen]
32 Clinique neurologique
33 Neuropathies du système nerveux entérique et pathologies digestives; implication des cellules gliales entériques
34 Paracelsus-Elena-Klinik, Kassel, Germany.
35 Paracelsus Elena Klinik
36 Department of Neurosurgery, University of Tuebingen
37 Center of Neurology, Hertie Institute for Clinical Brain Research, University of Tuebingen
38 University of Vermont [Burlington]
39 TIMONE - Hôpital de la Timone [CHU - APHM]
40 Service de Neurologie
41 Service Public de Wallonie
42 Department of Nuclear Medicine and PET Centre Aarhus University Hospital, Institute of Clinical Medicine Aarhus University, Norrebrogade 44, Building 10, 8000, Aarhus C, Denmark.
43 Somnomar
44 Service de neurologie [Poitiers]
45 CIC - Poitiers
46 Neurologie et thérapeutique expérimentale
47 CRICM - Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière
2 ICM - Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute
3 CIC AP-HP (pitie-Salpetriere)/inserm
4 Medtronic Inc [Minneapolis, MI, USA]
5 Heinrich Heine Universität Düsseldorf = Heinrich Heine University [Düsseldorf]
6 UNIGE - Université de Genève = University of Geneva
7 Philipps Universität Marburg = Philipps University of Marburg
8 CIC Neurosciences - Centre d'investigation clinique Neurosciences [CHU Pitié Salpêtrière]
9 NeuroCure Clinical Research Center (NCRC), Charité University Medical Center, Charité (Campus Mitte), Berlin, Germany.
10 CHU Pitié-Salpêtrière [AP-HP]
11 Department of Neuroscience, Karolinska institutet, Stockholm, Sweden
12 Department of Neurology, University Medical Center Schleswig-Holstein, Arnold-Heller-Street 3, Kiel 24105, Germany.
13 Department of Neurology, Christian-Albrechts-University, Kiel, Germany.
14 CAU - Christian-Albrechts-Universität zu Kiel
15 University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany.
16 National Parkinson Foundation Centre of Excellence, King's College Hospital, London, UK.
17 University of Cologne
18 Department of Neurology, Movement Disorder and Neuromodulation Unit, Charité-Universitätsmedizin, Berlin, Germany.
19 NeuroCure Clinical Research Center, Charité-Universitätsmedizin, Berlin, Germany.
20 Charité - UniversitätsMedizin = Charité - University Hospital [Berlin]
21 Department of Neurology & Neurosurgery, Charite University Medicine Berlin, Campus Virchow Klinikum & Benjamin Franklin, Berlin, Germany.
22 CHU - Centre Hospitalier Universitaire [Grenoble]
23 GIN - Grenoble Institut des Neurosciences
24 UM des troubles du mouvement
25 Service d'Anatomie et Cytopathologie [Toulouse]
26 CIC 1436 - Centre d'investigation clinique de Toulouse
27 Service de neurochirurgie [CHU Rouen]
28 ADEN - Nutrition, inflammation et dysfonctionnement de l'axe intestin-cerveau
29 UNIROUEN - Université de Rouen Normandie
30 IRIB - Institute for Research and Innovation in Biomedicine
31 Service de neurologie [Rouen]
32 Clinique neurologique
33 Neuropathies du système nerveux entérique et pathologies digestives; implication des cellules gliales entériques
34 Paracelsus-Elena-Klinik, Kassel, Germany.
35 Paracelsus Elena Klinik
36 Department of Neurosurgery, University of Tuebingen
37 Center of Neurology, Hertie Institute for Clinical Brain Research, University of Tuebingen
38 University of Vermont [Burlington]
39 TIMONE - Hôpital de la Timone [CHU - APHM]
40 Service de Neurologie
41 Service Public de Wallonie
42 Department of Nuclear Medicine and PET Centre Aarhus University Hospital, Institute of Clinical Medicine Aarhus University, Norrebrogade 44, Building 10, 8000, Aarhus C, Denmark.
43 Somnomar
44 Service de neurologie [Poitiers]
45 CIC - Poitiers
46 Neurologie et thérapeutique expérimentale
47 CRICM - Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière
Andreas Hartmann
- Function : Author
- PersonId : 13447
- IdHAL : andreas-hartmann
- IdRef : 075941228
Philippe Damier
- Function : Author
- PersonId : 760632
- ORCID : 0000-0003-3869-0564
- IdRef : 099118076
Pascal Derkinderen
- Function : Author
- PersonId : 759566
- ORCID : 0000-0001-8792-2582
Alireza Gharabaghi
- Function : Author
- PersonId : 890013
Marie Vidailhet
- Function : Author
- PersonId : 758783
- ORCID : 0000-0002-2409-9143
- IdRef : 074466208
Günther Deuschl
- Function : Author
- PersonId : 761301
- ORCID : 0000-0002-4176-9196
- IdRef : 05661800X
Abstract
Objective
To investigate predictors for improvement of disease-specific quality of life (QOL) after deep brain stimulation
(DBS) of the subthalamic nucleus (STN) for Parkinson disease (PD) with early motor complications.
Methods
We performed a secondary analysis of data from the previously published EARLYSTIM study, a prospective
randomized trial comparing STN-DBS (n = 124) to best medical treatment (n = 127) after 2 years follow-up
with disease-specific QOL (39-item Parkinson’s Disease Questionnaire summary index [PDQ-39-SI]) as the
primary endpoint. Linear regression analyses of the baseline characteristics age, disease duration, duration of
motor complications, and disease severity measured at baseline with the Unified Parkinson’s Disease Rating
Scale (UPDRS) (UPDRS-III“off”and “on” medications, UPDRS-IV) were conducted to determine predictors
of change in PDQ-39-SI.
Results
PDQ-39-SI at baseline was correlated to the change in PDQ-39-SI after 24 months in both treatment groups
(p < 0.05). The higher the baseline score (worse QOL) the larger the improvement in QOL after 24 months.
No correlation was found for any of the other baseline characteristics analyzed in either treatment group.
Conclusion
Impaired QOL as subjectively evaluated by the patient is the most important predictor of benefit in
patients with PD and early motor complications, fulfilling objective gold standard inclusion criteria for
STN-DBS. Our results prompt systematically including evaluation of disease-specific QOL when
selecting patients with PD for STN-DBS.