Premium
Quality of life outcome after subthalamic stimulation in Parkinson's disease depends on age
Author(s) -
Dafsari Haidar S.,
Reker Paul,
Stalinski Lisa,
Silverdale Monty,
Rizos Alexandra,
Ashkan Keyoumars,
Barbe Michael T.,
Fink Gereon R.,
Evans Julian,
Steffen Julia,
Samuel Michael,
Dembek Till A.,
VisserVandewalle Veerle,
Antonini Angelo,
RayChaudhuri K.,
MartinezMartin Pablo,
Timmermann Lars
Publication year - 2018
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.27222
Subject(s) - wilcoxon signed rank test , quality of life (healthcare) , activities of daily living , levodopa , parkinson's disease , medicine , bonferroni correction , deep brain stimulation , rating scale , subthalamic nucleus , prospective cohort study , cohort , psychology , physical therapy , disease , mann–whitney u test , developmental psychology , statistics , nursing , mathematics
Objective The purpose of this study was to investigate how quality of life outcome after bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson's disease (PD) depends on age. Methods In this prospective, open‐label, multicenter study including 120 PD patients undergoing bilateral STN‐DBS, we investigated the PDQuestionnaire‐8 (PDQ‐8), Unified PD Rating Scale‐III, Scales for Outcomes in PD–motor examination, complications, activities of daily living, and levodopa equivalent daily dose preoperatively and at 5 months follow‐up. Significant changes at follow‐up were analyzed with Wilcoxon signed‐rank test and Bonferroni correction for multiple comparisons. To explore the influence of age post hoc, the patients were classified into 3 age groups (≤59, 60‐69, ≥70 years). Intragroup changes were analyzed with Wilcoxon signed‐rank and intergroup differences with Kruskal‐Wallis tests. The strength of clinical responses was evaluated using effect size. Results The PDQuestionnaire‐8, Scales for Outcomes in PD–motor complications, activities of daily living, and levodopa equivalent daily dose significantly improved in the overall cohort and all age groups with no significant intergroup differences. However, PDQuestionnaire‐8 effect sizes for age groups ≤59, 60 to 69, and ≥70 years, respectively, were strong, moderate, and small. Furthermore, PDQuestionnaire‐8 domain analyses revealed that all domains except cognition and emotional well‐being significantly improved in patients aged ≤59 years, whereas only communication, activities of daily living, and stigma improved in patients aged 60‐69 years, and activities of daily living and stigma in patients aged ≥70 years. Conclusions Although quality of life, motor complications, and activities of daily living significantly improved in all age groups after bilateral STN‐DBS, the beneficial effect on overall quality of life was more pronounced and affected a wider range of quality of life domains in younger patients. © 2017 International Parkinson and Movement Disorder Society