title: Quality of life outcomes following surgical treatment of Parkinson's disease.
abstract: We assessed the impact of surgical treatment of Parkinson's disease on quality of life using generic quality of life instruments and utility scores. The Medical Outcomes Study short form health survey SF-36 and Parkinson's Disease Questionnaire PDQ-39 were used before and 3-6 months after surgery to assess quality of life, and the results were converted into utility valuations. Ninety-seven patients were studied; 33 underwent unilateral thalamotomy, 33 unilateral pallidotomy, 20 bilateral pallidotomy, six subthalamic nucleus (STN) lesions, four mixed lesions, and in one case bilateral STN stimulation. All dimensions of the SF-36 except role mental and mental health showed statistically significant improvement following surgery. The PDQ-39 recorded significant improvements in the mobility, stigma, and bodily discomfort dimensions. The rating scale and time trade-off scales showed statistically significant gains in utility of 8% and 3%, respectively. Gains were particularly marked in the bilateral pallidotomy group. Differences in patient characteristics and selection made direct comparisons between procedures unreliable. Quality of life in patients with advanced Parkinson's disease is amenable to measurement; such measurement provides tentative evidence of significant gains in quality of life following some neurosurgical procedures.
authors.affiliation: Health Economics Research Centre, Department of Public Health, University of Oxford, Oxford, United Kingdom. alastair.gray@ihs.ox.ac.uk
authors.forename: Alastair
authors.initials: A
authors.lastname: Gray
authors.forename: Iain
authors.initials: I
authors.lastname: McNamara
authors.forename: Tipu
authors.initials: T
authors.lastname: Aziz
authors.forename: Ralph
authors.initials: R
authors.lastname: Gregory
authors.forename: Peter
authors.initials: P
authors.lastname: Bain
authors.forename: Joanna
authors.initials: J
authors.lastname: Wilson
authors.forename: Richard
authors.initials: R
authors.lastname: Scott
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000601:surgery*; D005260:Female; D005917:Globus Pallidus / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D010300:Parkinson Disease / Q000601:surgery*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013788:Thalamus / Q000601:surgery