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Quality of life predicts outcome of deep brain stimulation in early Parkinson disease
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Edité par CCSD ; American Academy of Neurology -
International audience. ObjectiveTo investigate predictors for improvement of disease-specific quality of life (QOL) after deep brain stimulation(DBS) of the subthalamic nucleus (STN) for Parkinson disease (PD) with early motor complications.MethodsWe performed a secondary analysis of data from the previously published EARLYSTIM study, a prospectiverandomized trial comparing STN-DBS (n = 124) to best medical treatment (n = 127) after 2 years follow-upwith disease-specific QOL (39-item Parkinson’s Disease Questionnaire summary index [PDQ-39-SI]) as theprimary endpoint. Linear regression analyses of the baseline characteristics age, disease duration, duration ofmotor complications, and disease severity measured at baseline with the Unified Parkinson’s Disease RatingScale (UPDRS) (UPDRS-III“off”and “on” medications, UPDRS-IV) were conducted to determine predictorsof change in PDQ-39-SI.ResultsPDQ-39-SI at baseline was correlated to the change in PDQ-39-SI after 24 months in both treatment groups(p < 0.05). The higher the baseline score (worse QOL) the larger the improvement in QOL after 24 months.No correlation was found for any of the other baseline characteristics analyzed in either treatment group.ConclusionImpaired QOL as subjectively evaluated by the patient is the most important predictor of benefit inpatients with PD and early motor complications, fulfilling objective gold standard inclusion criteria forSTN-DBS. Our results prompt systematically including evaluation of disease-specific QOL whenselecting patients with PD for STN-DBS.
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