Dafsari, Haidar S., Martinez-Martin, Pablo ORCID: 0000-0003-0837-5280, Rizos, Alexandra, Trost, Maja, dos Santos Ghilardi, Maria Gabriela, Reddy, Prashanth, Sauerbier, Anna, Petry-Schmelzer, Jan Niklas ORCID: 0000-0003-0749-3840, Kramberger, Milica, Borgemeester, Robbert W. K., Barbe, Michael T., Ashkan, Keyoumars, Silverdale, Monty, Evans, Julian, Odin, Per, Fonoff, Erich Talamoni ORCID: 0000-0001-7831-9941, Fink, Gereon R. ORCID: 0000-0002-8230-1856, Henriksen, Tove, Ebersbach, Georg ORCID: 0000-0003-3403-6987, Pirtosek, Zvezdan ORCID: 0000-0002-5495-944X, Visser-Vandewalle, Veerle, Antonini, Angelo ORCID: 0000-0003-1040-2807, Timmermann, Lars, Chaudhuri, K. Ray, Schrag, Anette ORCID: 0000-0002-9872-6680, Weintraub, Daniel ORCID: 0000-0003-0633-7168, Barone, Paolo, Brooks, David J., Brown, Richard G., Jenner, Peter, Jeon, B., Lyons, Kelly, Pavese, Nicola, Politis, Marios, Postuma, Ronald B., Schapira, Anthony ORCID: 0000-0002-3018-3966, Stocchi, Fabrizio and Tsuboi, Yoshio (2019). EuroInf 2: Subthalamic stimulation, apomorphine, and levodopa infusion in Parkinson's disease. Mov. Disord., 34 (3). S. 353 - 366. HOBOKEN: WILEY. ISSN 1531-8257

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Abstract

Objective Real-life observational report of clinical efficacy of bilateral subthalamic stimulation (STN-DBS), apomorphine (APO), and intrajejunal levodopa infusion (IJLI) on quality of life, motor, and nonmotor symptoms (NMS) in Parkinson's disease (PD). Methods In this prospective, multicenter, international, real-life cohort observation study of 173 PD patients undergoing STN-DBS (n = 101), IJLI (n = 33), or APO (n = 39) were followed-up using PDQuestionnaire-8, NMSScale (NMSS), Unified PD Rating Scale (UPDRS)-III, UPDRS-IV, and levodopa equivalent daily dose (LEDD) before and 6 months after intervention. Outcome changes were analyzed with Wilcoxon signed-rank or paired t test when parametric tests were applicable. Multiple comparisons were corrected (multiple treatments/scales). Effect strengths were quantified with relative changes, effect size, and number needed to treat. Analyses were computed before and after propensity score matching, balancing demographic and clinical characteristics. Results In all groups, PDQuestionnaire-8, UPDRS-IV, and NMSS total scores improved significantly at follow-up. Levodopa equivalent daily dose was significantly reduced after STN-DBS. Explorative NMSS domain analyses resulted in distinct profiles: STN-DBS improved urinary/sexual functions, mood/cognition, sleep/fatigue, and the miscellaneous domain. IJLI improved the 3 latter domains and gastrointestinal symptoms. APO improved mood/cognition, perceptual problems/hallucinations, attention/memory, and the miscellaneous domain. Overall, STN-DBS and IJLI seemed favorable for NMSS total score, and APO favorable for neuropsychological/neuropsychiatric NMS and PDQuestionnaire-8 outcome. Conclusions This is the first comparison of quality of life, nonmotor. and motor outcomes in PD patients undergoing STN-DBS, IJLI, and APO in a real-life cohort. Distinct effect profiles were identified for each treatment option. Our results highlight the importance of holistic nonmotor and motor symptoms assessments to personalize treatment choices. (c) 2019 International Parkinson and Movement Disorder Society

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Dafsari, Haidar S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Martinez-Martin, PabloUNSPECIFIEDorcid.org/0000-0003-0837-5280UNSPECIFIED
Rizos, AlexandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Trost, MajaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
dos Santos Ghilardi, Maria GabrielaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reddy, PrashanthUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sauerbier, AnnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Petry-Schmelzer, Jan NiklasUNSPECIFIEDorcid.org/0000-0003-0749-3840UNSPECIFIED
Kramberger, MilicaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Borgemeester, Robbert W. K.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barbe, Michael T.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ashkan, KeyoumarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Silverdale, MontyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Evans, JulianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Odin, PerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fonoff, Erich TalamoniUNSPECIFIEDorcid.org/0000-0001-7831-9941UNSPECIFIED
Fink, Gereon R.UNSPECIFIEDorcid.org/0000-0002-8230-1856UNSPECIFIED
Henriksen, ToveUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ebersbach, GeorgUNSPECIFIEDorcid.org/0000-0003-3403-6987UNSPECIFIED
Pirtosek, ZvezdanUNSPECIFIEDorcid.org/0000-0002-5495-944XUNSPECIFIED
Visser-Vandewalle, VeerleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Antonini, AngeloUNSPECIFIEDorcid.org/0000-0003-1040-2807UNSPECIFIED
Timmermann, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chaudhuri, K. RayUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schrag, AnetteUNSPECIFIEDorcid.org/0000-0002-9872-6680UNSPECIFIED
Weintraub, DanielUNSPECIFIEDorcid.org/0000-0003-0633-7168UNSPECIFIED
Barone, PaoloUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brooks, David J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brown, Richard G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jenner, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jeon, B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lyons, KellyUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pavese, NicolaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Politis, MariosUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Postuma, Ronald B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schapira, AnthonyUNSPECIFIEDorcid.org/0000-0002-3018-3966UNSPECIFIED
Stocchi, FabrizioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tsuboi, YoshioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-155173
DOI: 10.1002/mds.27626
Journal or Publication Title: Mov. Disord.
Volume: 34
Number: 3
Page Range: S. 353 - 366
Date: 2019
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1531-8257
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
DEEP-BRAIN-STIMULATION; CARBIDOPA INTESTINAL GEL; QUALITY-OF-LIFE; NONMOTOR SYMPTOMS; SUBCUTANEOUS APOMORPHINE; DOUBLE-BLIND; MOTOR; NUCLEUS; NEUROSTIMULATION; HALLUCINATIONSMultiple languages
Clinical NeurologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/15517

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