Universität zu Köln

Jost, Stefanie Theresa, Sauerbier, Anna, Visser-Vandewalle, Veerle, Ashkan, Keyoumars, Silverdale, Monty, Evans, Julian, Loehrer, Philipp A., Rizos, Alexandra, Petry-Schmelzer, Jan Niklas, Reker, Paul, Fink, Gereon Rudolf, Franklin, Jeremy, Samuel, Michael, Schnitzler, Alfons ORCID: 0000-0002-6414-7939, Barbe, Michael Thomas, Antonini, Angelo ORCID: 0000-0003-1040-2807, Martinez-Martin, Pablo, Timmermann, Lars, Ray-Chaudhuri, K. and Dafsari, Haidar S. (2020). A prospective, controlled study of non-motor effects of subthalamic stimulation in Parkinson's disease: results at the 36-month follow-up. J. Neurol. Neurosurg. Psychiatry, 91 (7). S. 687 - 695. LONDON: BMJ PUBLISHING GROUP. ISSN 1468-330X

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Abstract

Objective To examine 36-month effects of bilateral subthalamic nucleus deep brain stimulation (STN-DBS) on non-motor symptoms (NMS) compared with standard-of-care medical treatment (MED) in Parkinson's disease (PD). Methods Here we report the 36-month follow-up of a prospective, observational, controlled, international multicentre study of the NILS cohort. Assessments included NMSScale (NMSS), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD (SCOPA)-motor examination, -activities of daily living, and -complications, and levodopa equivalent daily dose (LEDD). Propensity score matching resulted in a pseudo-randomised sub-cohort balancing baseline demographic and clinical characteristics between the STN-DBS and MED groups. Within-group longitudinal outcome changes were analysed using Wilcoxon signed-rank and between-group differences of change scores with Mann-Whitney U test. Strength of clinical responses was quantified with Cohen's effect size. In addition, bivariate correlations of change scores were explored. Results Propensity score matching applied on the cohort of 151 patients (STN-DBS n=67, MED n=84) resulted in a well-balanced sub-cohort including 38 patients per group. After 36 months, STN-DBS significantly improved NMSS, PDQ-8, SCOPA-motor examination and -complications and reduced LEDD. Significant between-group differences, all favouring STN-DBS, were found for NMSS, SCOPA-motor complications, LEDD (large effects), motor examination and PDQ-8 (moderate effects). Furthermore, significant differences were found for the sleep/fatigue, urinary (large effects) and miscellaneous NMSS domains (moderate effects). NMSS total and PDQ-8 change scores correlated significantly. Conclusions This study provides Class IIb evidence for beneficial effects of STN-DBS on NMS at 36-month follow-up which also correlated with quality of life improvements. This highlights the importance of NMS for DBS outcomes assessments.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Jost, Stefanie Theresa UNSPECIFIED UNSPECIFIED UNSPECIFIED Sauerbier, Anna UNSPECIFIED UNSPECIFIED UNSPECIFIED Visser-Vandewalle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Ashkan, Keyoumars UNSPECIFIED UNSPECIFIED UNSPECIFIED Silverdale, Monty UNSPECIFIED UNSPECIFIED UNSPECIFIED Evans, Julian UNSPECIFIED UNSPECIFIED UNSPECIFIED Loehrer, Philipp A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Rizos, Alexandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Petry-Schmelzer, Jan Niklas UNSPECIFIED UNSPECIFIED UNSPECIFIED Reker, Paul UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Gereon Rudolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Franklin, Jeremy UNSPECIFIED UNSPECIFIED UNSPECIFIED Samuel, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Schnitzler, Alfons UNSPECIFIED orcid.org/0000-0002-6414-7939 UNSPECIFIED Barbe, Michael Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Antonini, Angelo UNSPECIFIED orcid.org/0000-0003-1040-2807 UNSPECIFIED Martinez-Martin, Pablo UNSPECIFIED UNSPECIFIED UNSPECIFIED Timmermann, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Ray-Chaudhuri, K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Dafsari, Haidar S. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-328036
DOI:	10.1136/jnnp-2019-322614
Journal or Publication Title:	J. Neurol. Neurosurg. Psychiatry
Volume:	91
Number:	7
Page Range:	S. 687 - 695
Date:	2020
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1468-330X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DEEP-BRAIN-STIMULATION; NUCLEUS STIMULATION; RANDOMIZED-TRIAL; MOTOR; SCALE; NEUROSTIMULATION; PAIN Multiple languages Clinical Neurology; Psychiatry; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/32803