title: Bilateral subthalamic nucleus stimulation and quality of life in advanced Parkinson's disease.
abstract: We examined the impact of the subthalamic nuclei (STN) deep brain stimulation (DBS) on the health-related quality of life (QoL) of patients with advanced Parkinson's disease (PD). Seventeen consecutive patients with refractory motor fluctuations and dyskinesia were included in the study (mean age, 60.9 +/- 7.7 years [range, 43-74 years]; disease duration, 16.4 +/- 8.5 years [range, 7-38 years]; mean off-medication Hoehn and Yahr stage, 4.23 +/- 0.66 [range, 2.5-5]). Each patient's assessment was carried out using common rating scales, following the Core Assessment Program for Intracerebral Transplantation (CAPIT) protocol. Dyskinesia and emotional state were evaluated through the Abnormal Involuntary Movement Scale (AIMS) and the Hospital Anxiety and Depression Scale (HAD). QoL was assessed by means of the Parkinson's Disease Questionnaire Spanish version (PDQ-39). Significant benefit was obtained in the motor manifestations and complications of disease, as well as in the functional state and mood (P < 0.001). Some QoL dimensions (mobility and activities of daily living) and the PDQ-39 Summary Index (PDQ-39SI) showed a significant improvement (P < 0.001). Benefit was modest (P < 0.05) for three other domains (emotional well-being, stigma, bodily discomfort) and nil for the rest. There was no correlation between the change obtained in the QoL (PDQ-39SI) and in the other variables. As measured by the PDQ-39, STN-DBS significantly improves important aspects of QoL in patients with advanced PD.
authors.affiliation: Department of Applied Epidemiology, National Center of Epidemiology, I.S. Carlos III, Madrid, Spain. pmartinez@isciii.es
authors.forename: Pablo
authors.initials: P
authors.lastname: Martínez-Martín
authors.forename: Francesc
authors.initials: F
authors.lastname: Valldeoriola
authors.forename: Eduardo
authors.initials: E
authors.lastname: Tolosa
authors.forename: Manuela
authors.initials: M
authors.lastname: Pilleri
authors.forename: José Luis
authors.initials: JL
authors.lastname: Molinuevo
authors.forename: Jordi
authors.initials: J
authors.lastname: Rumià
authors.forename: Enric
authors.initials: E
authors.lastname: Ferrer
mesh_terms: D000328:Adult; D000368:Aged; D004292:Dominance, Cerebral / Q000502:physiology*; D004599:Electric Stimulation Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010300:Parkinson Disease / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D020531:Subthalamic Nucleus / Q000503:physiopathology*