Universität zu Köln

Daniels, Christine, Krack, Paul ORCID: 0000-0002-3508-7295, Volkmann, Jens ORCID: 0000-0002-9570-593X, Raethjen, Jan, Pinsker, Markus O., Kloss, Manja, Tronnier, Volker, Schnitzler, Alfons ORCID: 0000-0002-6414-7939, Wojtecki, Lars, Boetzel, Kai, Danek, Adrian ORCID: 0000-0001-8857-5383, Hilker, Ruediger, Sturm, Volker, Kupsch, Andreas, Karner, Elfriede, Deuschl, Guenther ORCID: 0000-0002-4176-9196 and Witt, Karsten (2011). Is improvement in the quality of life after subthalamic nucleus stimulation in Parkinson's disease predictable? Mov. Disord., 26 (14). S. 2516 - 2522. MALDEN: WILEY-BLACKWELL. ISSN 0885-3185

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Abstract

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) significantly improves quality of life (QoL) in PD. However, QoL fails to improve in a relevant proportion of patients. We studied clinical baseline and progression parameters associated with improvement in QoL after DBS. Data from a German randomized, controlled study comparing DBS (60 patients) with best medical treatment (59 patients) were analyzed. Changes in patients' QoL were assessed using the Parkinson's Disease Questionnaire (PDQ-39) at baseline and at the 6-month follow-up. For the STN-DBS patients, the changes in PDQ-39 were correlated with predefined clinical preoperative and progression parameters. Scores for QoL improved after STN-DBS for 57% of the patients, and for 43% patients, they did not improve. Patients with improvement in QoL showed significantly higher cumulative daily off time. Changes in the PDQ-39 showed a significant positive correlation with the cumulative daily off time at baseline. Logistic regression analysis revealed that 1 additional hour off time at baseline increases the odds for improvement on PDQ-39 by a factor of 1.33 (odds ratio). In the postoperative course, changes in the PDQ-39 significantly correlated with the reduction of cumulative daily off time, an improvement on the UPDRS (UPDRS III off), and positive mood changes. Among the baseline parameters, the cumulative daily off time is the strongest predictor for improvement in disease-related QoL after DBS. Improvement in QoL after STN-DBS is also correlated with changes in motor functions and changes in depression and anxiety. (c) 2011 Movement Disorder Society

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Daniels, Christine UNSPECIFIED UNSPECIFIED UNSPECIFIED Krack, Paul UNSPECIFIED orcid.org/0000-0002-3508-7295 UNSPECIFIED Volkmann, Jens UNSPECIFIED orcid.org/0000-0002-9570-593X UNSPECIFIED Raethjen, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Pinsker, Markus O. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kloss, Manja UNSPECIFIED UNSPECIFIED UNSPECIFIED Tronnier, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Schnitzler, Alfons UNSPECIFIED orcid.org/0000-0002-6414-7939 UNSPECIFIED Wojtecki, Lars UNSPECIFIED UNSPECIFIED UNSPECIFIED Boetzel, Kai UNSPECIFIED UNSPECIFIED UNSPECIFIED Danek, Adrian UNSPECIFIED orcid.org/0000-0001-8857-5383 UNSPECIFIED Hilker, Ruediger UNSPECIFIED UNSPECIFIED UNSPECIFIED Sturm, Volker UNSPECIFIED UNSPECIFIED UNSPECIFIED Kupsch, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Karner, Elfriede UNSPECIFIED UNSPECIFIED UNSPECIFIED Deuschl, Guenther UNSPECIFIED orcid.org/0000-0002-4176-9196 UNSPECIFIED Witt, Karsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-484142
DOI:	10.1002/mds.23907
Journal or Publication Title:	Mov. Disord.
Volume:	26
Number:	14
Page Range:	S. 2516 - 2522
Date:	2011
Publisher:	WILEY-BLACKWELL
Place of Publication:	MALDEN
ISSN:	0885-3185
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DEEP-BRAIN-STIMULATION; TRIAL Multiple languages Clinical Neurology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48414