Toedt, Inken, Al-Fatly, Bassam ORCID: 0000-0003-0067-6177, Granert, Oliver, Kuehn, Andrea A., Krack, Paul ORCID: 0000-0002-3508-7295, Rau, Joern, Timmermann, Lars ORCID: 0000-0002-5301-3580, Schnitzler, Alfons ORCID: 0000-0002-6414-7939, Paschen, Steffen, Helmers, Ann-Kristin, Hartmann, Andreas, Bardinet, Eric, Schuepbach, Michael, Barbe, Michael T. ORCID: 0000-0003-1149-8054, Dembek, Till A., Fraix, Valerie, Kuebler, Dorothee, Brefel-Courbon, Christine, Gharabaghi, Alireza ORCID: 0000-0002-9782-5281, Wojtecki, Lars, Pinsker, Marcus O., Thobois, Stephane, Damier, Philippe, Witjas, Tatiana, Houeto, Jean-Luc, Schade-Brittinger, Carmen, Vidailhet, Marie, Horn, Andreas ORCID: 0000-0002-0695-6025 and Deuschl, Guenther (2022). The Contribution of Subthalamic Nucleus Deep Brain Stimulation to the Improvement in Motor Functions and Quality of Life. Mov. Disord., 37 (2). S. 291 - 302. HOBOKEN: WILEY. ISSN 1531-8257

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Abstract

Background: Subthalamic nucleus deep brain stimulation (STN-DBS) effectively treats motor symptoms and quality of life (QoL) of advanced and fluctuating early Parkinson's disease. Little is known about the relation between electrode position and changes in symptom control and ultimately QoL. Objectives: The relation between the stimulated part of the STN and clinical outcomes, including the motor score of the Unified Parkinson's Disease Rating Scale (UPDRS) and the quality-of-life questionnaire, was assessed in a subcohort of the EARLYSTIM study. Methods: Sixty-nine patients from the EARLYSTIM cohort who underwent DBS, with a comprehensive clinical characterization before and 24 months after surgery, were included. Intercorrelations of clinical outcome changes, correlation between the affected functional parts of the STN, and changes in clinical outcomes were investigated. We further calculated sweet spots for different clinical parameters. Results: Improvements in the UPDRS III and Parkinson's Disease Questionnaire (PDQ-39) correlated positively with the extent of the overlap with the sensorimotor STN. The sweet spots for the UPDRS III (x = 11.6, y = -13.1, z = -6.3) and the PDQ-39 differed (x = 14.8, y = -12.4, z = -4.3) similar to 3.8 mm. Conclusions: The main influence of DBS on QoL is likely mediated through the sensory-motor basal ganglia loop. The PDQ sweet spot is located in a posteroventral spatial location in the STN territory. For aspects of QoL, however, there was also evidence of improvement through stimulation of the other STN subnuclei. More research is necessary to customize the DBS target to individual symptoms of each patient. (C) 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Toedt, InkenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Al-Fatly, BassamUNSPECIFIEDorcid.org/0000-0003-0067-6177UNSPECIFIED
Granert, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuehn, Andrea A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Krack, PaulUNSPECIFIEDorcid.org/0000-0002-3508-7295UNSPECIFIED
Rau, JoernUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Timmermann, LarsUNSPECIFIEDorcid.org/0000-0002-5301-3580UNSPECIFIED
Schnitzler, AlfonsUNSPECIFIEDorcid.org/0000-0002-6414-7939UNSPECIFIED
Paschen, SteffenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Helmers, Ann-KristinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hartmann, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bardinet, EricUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schuepbach, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Barbe, Michael T.UNSPECIFIEDorcid.org/0000-0003-1149-8054UNSPECIFIED
Dembek, Till A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fraix, ValerieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuebler, DorotheeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Brefel-Courbon, ChristineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gharabaghi, AlirezaUNSPECIFIEDorcid.org/0000-0002-9782-5281UNSPECIFIED
Wojtecki, LarsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pinsker, Marcus O.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Thobois, StephaneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Damier, PhilippeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Witjas, TatianaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Houeto, Jean-LucUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schade-Brittinger, CarmenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vidailhet, MarieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Horn, AndreasUNSPECIFIEDorcid.org/0000-0002-0695-6025UNSPECIFIED
Deuschl, GuentherUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-698105
DOI: 10.1002/mds.28952
Journal or Publication Title: Mov. Disord.
Volume: 37
Number: 2
Page Range: S. 291 - 302
Date: 2022
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1531-8257
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
PARKINSONS-DISEASE PATIENTS; NONMOTOR SYMPTOMS; TARGET; NEUROSTIMULATION; CONNECTIVITY; ACTIVATIONMultiple languages
Clinical NeurologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/69810

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