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Long-Term Effects of Pallidal or Subthalamic Deep Brain Stimulation on Quality of Life in Parkinson's Disease

Volkmann, Jens; Albanese, Alberto; Kulisevsky, Jaime; Törnqvist, Anna Lena LU ; Houeto, Jean-Luc; Pidoux, Bernard; Bonnet, Anne-Marie; Mendes, Alexandre; Benabid, Alim-Louis and Fraix, Valerie, et al. (2009) In Movement Disorders 24(8). p.1154-1161
Abstract
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... (More)
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. (C) 2009 Movement Disorder Society (Less)
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@article{db6bc797-0dee-46fc-ba25-d60f7e2eb046,
  abstract     = {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. (C) 2009 Movement Disorder Society},
  author       = {Volkmann, Jens and Albanese, Alberto and Kulisevsky, Jaime and Törnqvist, Anna Lena and Houeto, Jean-Luc and Pidoux, Bernard and Bonnet, Anne-Marie and Mendes, Alexandre and Benabid, Alim-Louis and Fraix, Valerie and Van Blercom, Nadege and Xie, Jing and Obeso, Jose and Cruz Rodriguez-Oroz, Maria and Guridi, Jurge and Schnitzler, Alfons and Timmermann, Lars and Gironell, Alexandre A. and Molet, Juan and Pascual-Sedano, Benta and Rehncrona, Stig and Moro, Elena and Lang, Anthony C. and Lozano, Andres M. and Bentivoglio, Anna Rita and Scerrati, Massimo and Contarino, Maria Fiorella and Romito, Luigi and Janssens, Marc and Agid, Yves},
  issn         = {0885-3185},
  keyword      = {stimulation,deep brain,quality of life,Parkinson's disease/parkinsonism,globus pallidus,subthalamic nucleus},
  language     = {eng},
  number       = {8},
  pages        = {1154--1161},
  publisher    = {John Wiley & Sons},
  series       = {Movement Disorders},
  title        = {Long-Term Effects of Pallidal or Subthalamic Deep Brain Stimulation on Quality of Life in Parkinson's Disease},
  url          = {http://dx.doi.org/10.1002/mds.22496},
  volume       = {24},
  year         = {2009},
}