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Parkinson’s Disease Multimodal Complex Treatment improves motor symptoms, depression and quality of life

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Abstract

Parkinson’s disease (PD) is the world’s fastest growing neurological disorder disabling patients through a broad range of motor and non-motor symptoms. For the clinical management, a multidisciplinary approach has increasingly been shown to be beneficial. In Germany, inpatient Parkinson’s Disease Multimodal Complex Treatment (PD-MCT) is a well-established and frequent approach, although data on its effectiveness are rare. We conducted a prospective real-world observational study in 47 subjects [age (M ± SD): 68.5 ± 9.0 years, disease duration: 8.5 ± 5.3 years, modified Hoehn and Yahr stage (median, IQR): 3, 2.5–3] aiming at evaluating the effectiveness of 14-day PD-MCT in terms of quality of life (Parkinson’s Disease Questionnaire, EuroQol), motor [Movement Disorder Society Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS III], Timed Up and Go Test, Purdue Pegboard Test) and non-motor symptoms (revised Beck Depression Inventory). Six weeks after hospital discharge, a follow-up examination was performed. PD patients with a predominantly moderate disability level benefited from PD-MCT in terms of health-related quality of life, motor symptoms and non-motor symptoms (depression). Significant improvements were found for social support, emotional well-being and bodily discomfort domains of health-related quality of life. Sustainable improvement occurred for motor symptoms and the subjective evaluation of health state. We found a higher probability of motor response especially for patients with moderate motor impairment (MDS-UPDRS III ≥ 33). In conclusion, Parkinson’s Disease Multimodal Complex Treatment improves motor symptoms, depression and quality of life. A more detailed selection of patients who will benefit best from this intervention should be examined in future studies.

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Acknowledgements

The authors would like to thank all the patients that took part. We particularly acknowledge the work of the therapeutic team of the Neurology Department at St. Josef-Hospital Bochum: Serpil Er, Sabine Dreifert, Martin Enders, Maximilian Hansmann, Stefanie Bojarzin, Karin Göpferich, Friederike Khatib, Tobias Kramer, Christian Prehn and Simon Sturm.

Funding

This study was funded by Deutsche Parkinson Vereinigung Bundesverband (Grant no. 33.17-92907).

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Authors and Affiliations

  1. Department of Neurology, St. Josef-Hospital, Ruhr University, Bochum, Germany

    Raphael Scherbaum, Elke Hartelt, Ralf Gold, Siegfried Muhlack & Lars Tönges

  2. Psychiatrische Gutachtenpraxis, Bochum, Germany

    Manuel Kinkel

  3. Neurodegeneration Research, Protein Research Unit Ruhr (PURE), Ruhr University, Bochum, Germany

    Ralf Gold & Lars Tönges

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  1. Raphael Scherbaum
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  6. Lars Tönges
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Contributions

Conceptualization: LT and MK; methodology: EH, LT, and RS; data collection: EH and RS; statistical evaluation and interpretation: EH, LT, and RS; writing—original draft preparation: RS and LT; writing—review and editing: EH, RG, SM, and MK; project administration and supervision: LT.

Corresponding author

Correspondence to Lars Tönges.

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Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical standard statement

Ethical approval was given by the Ethics Committee of the Medical Faculty of the Ruhr University Bochum (approval number 17–6119). The study was performed in accordance with the ethical standards of the Declaration of Helsinki and was registered in the German Clinical Trials Register (ID: DRKS00013361). Data were saved in a pseudonymized way and were processed according to local legal conditions.

Informed consent

All patients gave written informed consent prior to their inclusion in the study.

Electronic supplementary material

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Supplementary file1 (PDF 146 kb)

415_2019_9657_MOESM2_ESM.pdf

We provide electronic supplementary material, containing a description of PD-MCT components and four supplementary tables (Table S1 Components of Parkinson’s Disease Multimodal Complex Treatment, Table S2 Differences in demographics and clinical characteristics between study completers and dropouts at baseline, Table S3 Values of outcomes at baseline, discharge and follow-up, differences and statistical results of rmANOVA, Table S4 Patient’s Global Impression of Change) (PDF 273 kb)

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Scherbaum, R., Hartelt, E., Kinkel, M. et al. Parkinson’s Disease Multimodal Complex Treatment improves motor symptoms, depression and quality of life. J Neurol 267, 954–965 (2020). https://doi.org/10.1007/s00415-019-09657-7

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