Long-term effects of bilateral subthalamic nucleus stimulation on health-related quality of life in advanced Parkinson's disease.
We evaluated the long-term effects of subthalamic nucleus (STN) stimulation on health-related quality of life (HRQL) in patients with advanced Parkinson's disease (PD). STN stimulation improves motor function and decreases medication requirements in patients with advanced PD. The impact of STN stimulation on HRQL is less well established, especially beyond 1 year after surgery. We report HRQL outcomes for 18 patients with advanced PD. Patients were evaluated with the Parkinson's Disease Questionnaire-39 (PDQ-39), the Medical Outcome Study Short Form (SF-36), and the EuroQol visual analogue scale (VAS) before surgery, 6 months postoperatively, and at a long-term follow-up visit (mean, 35.9 months; range, 18-57 months after surgery). Preoperative scores on HRQL measures were compared to results obtained at short- and long-term follow-up evaluations. The VAS and all domains of the PDQ-39 except for cognition, communication, and social support showed marked improvements at 6 months after surgery. At the long-term follow-up, there were sustained improvements in the VAS (63% improvement; P = 0.0009) and in several domains of the PDQ-39 [mobility: 20%, P = 0.01; activities of daily living (ADL): 29%, P = 0.005; emotional well-being: 26%, P = 0.02; stigma: 43%, P = 0.003; and bodily discomfort: 35%, P = 0.007]. At the long-term evaluation, only the vitality domain of the SF-36 was significantly improved from baseline (16%; P = 0.01). In this selected group of patients, many of the short-term gains in HRQL persist beyond 18 months after STN implantation. Benefits in nonmotor aspects of HRQL such as bodily discomfort and stigma appear to be among the most durable.
Siderowf
Andrew
A
Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19107, USA. adsiderowf@pahosp.com
Jaggi
Jurg L
JL
Xie
Sharon X
SX
Loveland-Jones
Catherine
C
Leng
Lewis
L
Hurtig
Howard
H
Colcher
Amy
A
Stern
Matthew
M
Chou
Kelvin L
KL
Liang
Grace
G
Maccarone
Heather
H
Simuni
Tanya
T
Baltuch
Gordon
G
D000328:Adult; D000368:Aged; D003071:Cognition; D046690:Deep Brain Stimulation / Q000379:methods*; D004644:Emotions; D005260:Female; D006304:Health Status; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010300:Parkinson Disease / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D011788:Quality of Life; D016896:Treatment Outcome
D007980:Levodopa