Universität zu Köln

Maier, Franziska, Lewis, Catharine J., Horstkoetter, Nina, Eggers, Carsten, Kalbe, Elke, Maarouf, Mohammad, Kuhn, Jens, Zurowski, Mateusz ORCID: 0000-0002-6407-4629, Moro, Elena, Woopen, Christiane and Timmermann, Lars (2013). Patients' expectations of deep brain stimulation, and subjective perceived outcome related to clinical measures in Parkinson's disease: a mixed-method approach. J. Neurol. Neurosurg. Psychiatry, 84 (11). S. 1273 - 1282. LONDON: BMJ PUBLISHING GROUP. ISSN 1468-330X

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Abstract

Objective To study patients' expectations of subthalamic deep brain stimulation (STN-DBS) and their subjective perceived outcome, by using qualitative and quantitative methods in Parkinson's disease (PD). Methods PD patients were prospectively examined before and 3 months after surgery. Semistructured interviews regarding preoperative expectations and postsurgical subjective perceived outcome were conducted. These were analysed using content analysis. For statistical analyses, patients were classified according to their subjective perceived outcome, resulting in three different subjective outcome groups (negative, mixed, positive outcome). The groups were used for multiple comparisons between and within each group regarding motor impairment, quality of life (QoL), neuropsychiatric status and cognitive functioning, using standard instruments. A logistic regression analysis was conducted to find predictors of subjective negative outcome. Receiver operating characteristic curves were used to analyse cut-off scores for predictive tests. Results Of the 30 PD patients participating, 8 had a subjective negative outcome, 8 a mixed and 14 a positive outcome. All groups significantly improved in motor functioning. Patients with subjective negative outcome were characterised by preoperative unrealistic expectations, no postsurgical improvement in QoL, and significantly higher presurgical and postsurgical apathy and depression scores. Higher preoperative apathy and depression scores were significant predictors of negative subjective outcome. Cut-off scores for apathy and depression were identified. Conclusions The mixed-method approach proved useful in examining a patient's subjective perception of STN-DBS outcome. Our results show that significant motor improvement does not necessarily lead to a positive subjective outcome. Moreover, PD patients should be screened carefully before surgery regarding apathy and depression. (DRKS-ID: DRKS00003221).

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Maier, Franziska UNSPECIFIED UNSPECIFIED UNSPECIFIED Lewis, Catharine J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Horstkoetter, Nina UNSPECIFIED UNSPECIFIED UNSPECIFIED Eggers, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Kalbe, Elke UNSPECIFIED UNSPECIFIED UNSPECIFIED Maarouf, Mohammad UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Zurowski, Mateusz UNSPECIFIED orcid.org/0000-0002-6407-4629 UNSPECIFIED Moro, Elena UNSPECIFIED UNSPECIFIED UNSPECIFIED Woopen, Christiane UNSPECIFIED UNSPECIFIED UNSPECIFIED Timmermann, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-472195
DOI:	10.1136/jnnp-2012-303670
Journal or Publication Title:	J. Neurol. Neurosurg. Psychiatry
Volume:	84
Number:	11
Page Range:	S. 1273 - 1282
Date:	2013
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1468-330X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language QUALITY-OF-LIFE; SUBTHALAMIC NUCLEUS STIMULATION; BECK DEPRESSION INVENTORY; APATHY; RELIABILITY; MOVEMENT; VALIDITY Multiple languages Clinical Neurology; Psychiatry; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47219