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Long-term impact on quality of life of subthalamic nucleus stimulation in Parkinson’s disease

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Abstract

Long-term impact of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on health-related quality of life (HRQOL) and associated factors in patients with Parkinson’s disease (PD) are not clear. In this prospective study, we included 69 PD patients (64 % men, mean age 61.3 ± 7.4 and disease duration 13.2 ± 5.7 years) undergoing STN-DBS. They were evaluated preoperatively (baseline), 1 and 5 years postoperatively assessing 39-item Parkinson’s Disease Questionnaire (PDQ-39), Schwab and England Activities of Daily Living Scale (SEADL), Unified Parkinson’s Disease Rating Scale (UPDRS) off- and on-medication, patient diaries, dopaminergic treatment, mortality and surgical complications. Five years postoperatively, off-medication, there were improvements from baseline in UPDRS-II and III total (27.2 and 26.7 %, respectively) and SEADL (18.6 % more completely independent patients) (p < 0.05) scores, while on-medication, there was a deterioration in UPDRS-III (37.8 %, mainly axial signs) (p < 0.05) and minor improvements in SEADL (3.7 %). While at 1 year PDQ-39, the summary index improved substantially (36.5 %) (p < 0.05), at 5 years patients regressed (only 8.8 %) (p < 0.05), though changes in PDQ-39 subscores remained significant, with improvements in ADL (18.8 %), emotional well-being (19.0 %), stigma (36.4 %) and discomfort (20.6 %), despite worsening in communication (47.8 %) (p < 0.05). Lower preoperative PDQ-39 summary index and greater 1-year UPDRS-III-off total score gain predicted better long-term HRQOL. STN-DBS produces long-term improvements in HRQOL in PD. Preoperative HRQOL and short-term postoperative changes in off-medication motor status may predict long-term HRQOL in PD following STN-DBS.

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Authors and Affiliations

  1. Neurology Department, Cruces University Hospital, Plaza de Cruces s/n, 48903, Barakaldo, Spain

    Elena Lezcano, Juan Carlos Gómez-Esteban, Beatriz Tijero, Koldo Berganzo, Ana Molano & Juan José Zarranz

  2. Neurodegenerative Diseases Group, BioCruces Health Research Institute, Barakaldo, Spain

    Elena Lezcano, Juan Carlos Gómez-Esteban, Beatriz Tijero, Koldo Berganzo & Iñigo Gabilondo

  3. Neurosurgery Department, Cruces University Hospital, Barakaldo, Spain

    Gaizka Bilbao, Edurne Ruiz de Gopegui & Iñigo Pomposo

  4. Neurophysiology Department, Cruces University Hospital, Barakaldo, Spain

    Imanol Lambarri

  5. Radiology Department, Cruces University Hospital, Barakaldo, Spain

    Olivia Rodriguez, Rafael Villoria & Ainara Dolado

  6. Neuropsychology of Severe Medical Conditions, Deusto University, Bilbao, Spain

    Iñigo Gabilondo

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  1. Elena Lezcano
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Correspondence to Juan Carlos Gómez-Esteban.

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Lezcano, E., Gómez-Esteban, J.C., Tijero, B. et al. Long-term impact on quality of life of subthalamic nucleus stimulation in Parkinson’s disease. J Neurol 263, 895–905 (2016). https://doi.org/10.1007/s00415-016-8077-4

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  • DOI: https://doi.org/10.1007/s00415-016-8077-4

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