Universität zu Köln

Witt, Karsten, Daniels, Christine, Krack, Paul ORCID: 0000-0002-3508-7295, Volkmann, Jens ORCID: 0000-0002-9570-593X, 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 and Deuschl, Guenther ORCID: 0000-0002-4176-9196 (2011). Negative impact of borderline global cognitive scores on quality of life after subthalamic nucleus stimulation in Parkinson's disease. J. Neurol. Sci., 310 (1-2). S. 261 - 267. AMSTERDAM: ELSEVIER SCIENCE BV. ISSN 0022-510X

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Abstract

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) significantly improves quality of life (QoL) in Parkinson's disease (PD). Dementia is considered as a contraindication for STN-DBS. However, no controlled study assessed the impact of STN-DBS on the QoL and motor outcome in PD patients with a borderline global cognitive impairment. We studied clinical baseline and progression parameters in a cohort of STN-DBS patients with a global cognitive score still in the non-demented range but scoring in the lowest quartile of the Mattis Dementia Rating Scale (MDRS), a measure of global cognitive functioning. Data from a German randomised controlled study comparing DBS (60 patients) with best medical treatment (BMT, 59 patients) were analysed. Changes in patients' QoL scores were assessed using the Parkinson's disease questionnaire (PDQ-39) at baseline and at the 6 months follow up. Patients were split into four groups according to their MDRS performance at baseline and these groups were compared in the context of motor outcome and QoL Twelve out of sixty patients of the STN-DBS group scored in the lowest quartile of the MDRS (range between one hundred thirty and one hundred thirty seven points). An individual analysis revealed that 3 of 12 patients showed a clinical relevant improvement in QoL whereas the group statistics did not reveal any significant improvement in QoL measures after STN-DBS compared to the BMT group. Since this failure to improve in QoL cannot be explained by a failure to improve in motor functions, stimulation settings and psychiatric scales after STN-DBS, the failure to improve in QoL in patients with a borderline global cognitive score might be specifically related to lower cognitive functioning. (C) 2011 Elsevier B.V. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Witt, Karsten UNSPECIFIED UNSPECIFIED UNSPECIFIED 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 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
URN:	urn:nbn:de:hbz:38-485367
DOI:	10.1016/j.jns.2011.06.028
Journal or Publication Title:	J. Neurol. Sci.
Volume:	310
Number:	1-2
Page Range:	S. 261 - 267
Date:	2011
Publisher:	ELSEVIER SCIENCE BV
Place of Publication:	AMSTERDAM
ISSN:	0022-510X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DEEP-BRAIN-STIMULATION; GERMAN VERSION; RATING-SCALE; ISSUES; RELIABILITY; TRIAL Multiple languages Clinical Neurology; Neurosciences Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48536