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Long‐term effects of pallidal or subthalamic deep brain stimulation on quality of life in Parkinson's disease
Author(s) -
Volkmann Jens,
Albanese Alberto,
Kulisevsky Jaime,
Tornqvist AanaLena,
Houeto JeanLuc,
Pidoux Bernard,
Bonnet AnneMarie,
Mendes Alexandre,
Benabid AlimLouis,
Fraix Valerie,
Van Blercom Nadege,
Xie Jing,
Obeso José,
RodriguezOroz Maria Cruz,
Guridi Jurge,
Schnitzler Alfons,
Timmermann Lars,
Gironell Alexandre A.,
Molet Juan,
PascualSedano Benta,
Rehncrona Stig,
Moro Elena,
Lang Anthony C.,
Lozano Andres M.,
Bentivoglio Anna Rita,
Scerrati Massimo,
Contarino Maria Fiorella,
Romito Luigi,
Janssens Marc,
Agid Yves
Publication year - 2009
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.22496
Subject(s) - deep brain stimulation , subthalamic nucleus , psychosocial , quality of life (healthcare) , parkinson's disease , rating scale , psychology , physical therapy , medicine , physical medicine and rehabilitation , disease , psychiatry , developmental psychology , psychotherapist
We assessed the effects of deep brain stimulation of the subthalamic nucleus (STN‐DBS) or internal pallidum (GPi‐DBS) on health‐related quality of life (HrQoL) in patients with advanced Parkinson's disease participating in a previously reported multicenter trial. Sickness Impact Profile (SIP) questionnaires were available for analysis in a subgroup of n = 20/20 patients with GPi‐DBS and n = 45/49 patients with STN‐DBS at baseline, 6 and 36 months. The SIP provides a physical dimension and a psychosocial dimension sum score and 12 category scores: Alertness/Intellectual Behavior (AIB), Ambulation (A), Body Care and Movement (BCM), Communication (C), Eating (E), Emotional Behavior (EB), Home Management (HM), Mobility (M), Recreation and Pastimes (RP), Sleep and Rest (SR), Social Interaction (SI), and Work (W). Motor functioning was assessed by means of the Unified Parkinson's Disease Rating Scale and diaries. At 6 months significant improvements in off‐period motor symptoms and activities of daily living were paralleled by significant reductions in the total, physical, and psychosocial SIP score in both treatment groups. At 3 years, sustained improvements were observed in the physical dimension score, BCM, E, M, RP after STN‐DBS and M, SI after GPi‐DBS. All other SIP subscores approached baseline values, but were still the same or better (except C) whereas motor functioning remained stable after 36 months. STN‐DBS and GPi‐DBS led to significant early improvements in HrQoL. Despite sustained motor improvements many of these initial benefits were lost after 3 years. This may reflect either progression of the disease or adaptive changes in the subjective perception of health‐related wellbeing over time. © 2009 Movement Disorder Society