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Brain Stimul. 2016 Jan-Feb;9(1):78-85. doi: 10.1016/j.brs.2015.08.005. Epub 2015 Aug 19.

Beneficial Effects of Bilateral Subthalamic Stimulation on Non-Motor Symptoms in Parkinson's Disease.

Author information

1
Department of Neurology, University Hospital Cologne, Cologne, Germany. Electronic address: haidar.dafsari@uk-koeln.de.
2
National Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK.
3
Department of Neurology, University Hospital Cologne, Cologne, Germany.
4
Department of Stereotaxy and Functional Neurosurgery, University Hospital Cologne, Germany.
5
Department of Neurology and Neurosurgery, Salford Royal Foundation Trust, Greater Manchester, UK.
6
Parkinson disease and Movement Disorders Unit, IRCCS Hospital San Camillo, Venice, Italy.
7
National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain.
8
Department of Neurology, University Hospital Cologne, Cologne, Germany. Electronic address: lars.timmermann@uk-koeln.de.

Abstract

BACKGROUND:

STN-DBS is well established to improve motor symptoms and quality of life in patients with PD. While non-motor symptoms are crucial for quality of life in these patients, only neuropsychiatric and neuropsychological symptoms have been systematically studied in a longitudinal design so far. However, these are only a part of the non-motor symptoms spectrum.

HYPOTHESIS:

We hypothesized that STN-DBS is associated with a beneficial effect on a range of non-motor symptoms.

METHODS:

In this multicenter, open, prospective, international study (EuroInf-study, UKCRN10084/DRKS00006735) we investigated non-motor effects of STN-DBS in "real-life" use. We evaluated Non-motor Symptom Scale, and Questionnaire, PD Questionnaire-8, Scales for Outcomes of PD motor examination and complications, and activities of daily living preoperatively and at 6 months follow-up in 60 consecutive patients (35 male, mean age: 61.6 ± 7.8 years, mean disease duration: 10.4 ± 4.2 years).

RESULTS:

All outcomes improved significantly at 6 months follow-up (PD Questionaire-8, p = 0.006; activities of daily living, p = 0.012; all others, p < 0.001; Wilcoxon signed-rank, respectively paired t-test; Bonferroni-correction). Post-hoc analyses of Non-motor Symptom Scale domains showed a significant reduction of sleep/fatigue and miscellaneous domains (p ≤ 0.001), perceptual problems/hallucinations (p = 0.036), and urinary (p = 0.018) scores. Effect sizes were "moderate" for Non-motor Symptom Scale, and motor complications, "large" for motor examination, and "small" for other outcomes.

CONCLUSIONS:

This study provides evidence that bilateral STN-DBS improves non-motor burden in patients with PD and opens the door to a more balanced evaluation of DBS outcomes. Further randomized studies are needed to confirm these findings and compare DBS non-motor effects to other invasive therapies of advanced PD.

KEYWORDS:

Deep brain stimulation; Non-Motor Symptom Scale; Nonmotor symptoms; Quality of life

PMID:
26385442
DOI:
10.1016/j.brs.2015.08.005
[Indexed for MEDLINE]

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