Randomized Controlled Trial

. 2019 Mar 5;92(10):e1109-e1120.

doi: 10.1212/WNL.0000000000007037. Epub 2019 Feb 8.

Quality of life predicts outcome of deep brain stimulation in early Parkinson disease

W M Michael Schuepbach¹, Lisa Tonder¹, Alfons Schnitzler¹, Paul Krack¹, Joern Rau¹, Andreas Hartmann¹, Thomas D Hälbig¹, Fanny Pineau¹, Andrea Falk¹, Laura Paschen¹, Stephen Paschen¹, Jens Volkmann¹, Haidar S Dafsari¹, Michael T Barbe¹, Gereon R Fink¹, Andrea Kühn¹, Andreas Kupsch¹, Gerd-H Schneider¹, Eric Seigneuret¹, Valerie Fraix¹, Andrea Kistner¹, P Patrick Chaynes¹, Fabienne Ory-Magne¹, Christine Brefel-Courbon¹, Jan Vesper¹, Lars Wojtecki¹, Stéphane Derrey¹, David Maltête¹, Philippe Damier¹, Pascal Derkinderen¹, Friederike Sixel-Döring¹, Claudia Trenkwalder¹, Alireza Gharabaghi¹, Tobias Wächter¹, Daniel Weiss¹, Marcus O Pinsker¹, Jean-Marie Regis¹, Tatiana Witjas¹, Stephane Thobois¹, Patrick Mertens¹, Karina Knudsen¹, Carmen Schade-Brittinger¹, Jean-Luc Houeto¹, Yves Agid¹, Marie Vidailhet¹, Lars Timmermann¹, Günther Deuschl²; EARLYSTIM study group

Collaborators, Affiliations

Collaborators

EARLYSTIM study group:
Virginie Czernecki, Helke Hesekamp, Niklaus Meier, Velina Negovanska, Marie-Laure Welter, Jean-Christophe Corvol, Philippe Cornu, Soledad Navarro, Bettina Möller, Adelheid Nebel, Karsten Witt, Jan Raethjen, Maximilian Mehdorn, Ingo G Meister, Jens Kuhn, Josef Kessler, Doreen Gruber, Katharina Faust, Stephan Chabardes, Pierre Pollak, Oliver Rascol, Christophe Arbus, Lola Danet, Romain Lefaucheur, Isabelle Benatru, Olivier Colin, Solene Ansquer, Stefan J Groiss, Saskia Elben, Christian Hartmann, Martin Südmeyer, Florian Amtage, Rejko Krueger, Severine Ledily, Anne Sauvaget, Wenke Schmidt, Alexandro Eusebio, Jean Philippe Azulay, Gustavo Polo, Serge Pinto, Johannes Levin, Wolfgang H Oertel

Affiliations

¹ From the Département de Neurologie (W.M.M.S., A.H., T.D.H., F.P., Y.A., M.V.), Hôpital Pitié-Salpêtrière, Centre d'Investigation Clinique 1422, Institut du Cerveau et de la Moelle Epinière, Institut National de Santé et en Recherche Médicale, Assistance Publique Hôpitaux de Paris, France; Institute of Neurology (W.M.M.S.), Konolfingen; Department of Neurology (W.M.M.S.), University Hospital Bern and University of Bern, Switzerland; Medtronic (L.T.), Minneapolis, MN; Institute of Clinical Neuroscience & Medical Psychology and Department of Neurology (A.D., L.W.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Movement Disorder Unit, Neurology (P.K.), CHU Grenoble Alpes; Grenoble Institut des Neurosciences (P.K., V.F., A. Kistner), University Grenoble Alpes; Inserm U1216 (P.K., V.F., A. Kistner), Grenoble, France; Department of Clinical Neurosciences (Neurology) (P.K.), Faculty of Medicine, University of Geneva, Switzerland; Coordinating Center for clinical trials of the Philipps University of Marburg (J.R., C.S.-B.); Neurochirurgische Klinik im Neurozentrum (A.F., L.P., S.P., J. Volkmann, K.K., G.D.),Christian-Albrechts-Universität Kiel; Neurologische Klinik und Poliklinik (J. Volkmann), Universitätsklinikum Würzburg; Department of Neurology (H.S.D., M.T.B., G.R.F., L.T.), University Hospital Cologne; Research Centre Jülich (G.R.F.); Klinik für Neurologie (T.D.H., A. Kühn, A. Kupsch) and Klinik für Neurochirurgie (G.-H.S.), Campus Virchow, Charité-Universitätsmedizin Berlin; Praxis Kupsch (A. Kupsch), Berlin, Germany; Service de Neurochirurgie (E.S.) and Service de Neurologie (V.F.), Hôpital Michallon, Centre Hospitalo-Universitaire, Grenoble; Departments of Neurosurgery (P.P.C.), Neurology (F.O.-M., C.B.-C.), and Clinical Pharmacology (C.B.-C.), University Hospital of Toulouse; ToNIC (F.O.-M., C.B.-C.), Toulouse Neuroimaging Center, University of Toulouse, Inserm, UPS, France; Department of Neurosurgery (J. Vesper), Universitätsklinikum Düsseldorf, Germany; Departments of Neurosurgery (S.D.) and Neurology (D.M.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Service de Neurologie (P. Damier, P. Derkinderen), CHU Nantes, Hôpital Laënnec, France; Paracelsus-Elena-Klinik Kassel (F.S.-D., C.T.); Department of Neurosurgery (C.T.), University Medical Center Göttingen; Division of Functional and Restorative Neurosurgery and Centre for Integrative Neuroscience (A.G.), Tübingen; Abteilung für Neurologie (T.W.), Reha-Zentrum Bad Gögging, Passauer Wolf; Department for Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (D.W.), University of Tübingen; Division of Stereotactic and Functional Neurosurgery (M.O.P.), University Medical Center Freiburg, Germany; Departments of Functional and Stereotactic Neurosurgery and Radiosurgery (J.-.M.R.) and Neurology (T.W.), Timone University Hospital, INSERM, Marseille; Institut des Sciences Cognitives Marc Jeannerod (S.T.), CNRS, UMR 5229, Université de Lyon; Centre Expert Parkinson (S.T.), Service de Neurologie C, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurosurgery (P.M.), University Hospital of Neurology and Neurosurgery, Hospices Civils de Lyon, Université de Lyon; Department of Neurology (J.-L.H.), INSERM-1402, Centre Hospitalier Universitaire de Poitiers, University of Poitiers, France; and Universitätsklinikum Giessen und Marburg (L.T.), Marburg Campus, Germany.
² From the Département de Neurologie (W.M.M.S., A.H., T.D.H., F.P., Y.A., M.V.), Hôpital Pitié-Salpêtrière, Centre d'Investigation Clinique 1422, Institut du Cerveau et de la Moelle Epinière, Institut National de Santé et en Recherche Médicale, Assistance Publique Hôpitaux de Paris, France; Institute of Neurology (W.M.M.S.), Konolfingen; Department of Neurology (W.M.M.S.), University Hospital Bern and University of Bern, Switzerland; Medtronic (L.T.), Minneapolis, MN; Institute of Clinical Neuroscience & Medical Psychology and Department of Neurology (A.D., L.W.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Movement Disorder Unit, Neurology (P.K.), CHU Grenoble Alpes; Grenoble Institut des Neurosciences (P.K., V.F., A. Kistner), University Grenoble Alpes; Inserm U1216 (P.K., V.F., A. Kistner), Grenoble, France; Department of Clinical Neurosciences (Neurology) (P.K.), Faculty of Medicine, University of Geneva, Switzerland; Coordinating Center for clinical trials of the Philipps University of Marburg (J.R., C.S.-B.); Neurochirurgische Klinik im Neurozentrum (A.F., L.P., S.P., J. Volkmann, K.K., G.D.),Christian-Albrechts-Universität Kiel; Neurologische Klinik und Poliklinik (J. Volkmann), Universitätsklinikum Würzburg; Department of Neurology (H.S.D., M.T.B., G.R.F., L.T.), University Hospital Cologne; Research Centre Jülich (G.R.F.); Klinik für Neurologie (T.D.H., A. Kühn, A. Kupsch) and Klinik für Neurochirurgie (G.-H.S.), Campus Virchow, Charité-Universitätsmedizin Berlin; Praxis Kupsch (A. Kupsch), Berlin, Germany; Service de Neurochirurgie (E.S.) and Service de Neurologie (V.F.), Hôpital Michallon, Centre Hospitalo-Universitaire, Grenoble; Departments of Neurosurgery (P.P.C.), Neurology (F.O.-M., C.B.-C.), and Clinical Pharmacology (C.B.-C.), University Hospital of Toulouse; ToNIC (F.O.-M., C.B.-C.), Toulouse Neuroimaging Center, University of Toulouse, Inserm, UPS, France; Department of Neurosurgery (J. Vesper), Universitätsklinikum Düsseldorf, Germany; Departments of Neurosurgery (S.D.) and Neurology (D.M.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Service de Neurologie (P. Damier, P. Derkinderen), CHU Nantes, Hôpital Laënnec, France; Paracelsus-Elena-Klinik Kassel (F.S.-D., C.T.); Department of Neurosurgery (C.T.), University Medical Center Göttingen; Division of Functional and Restorative Neurosurgery and Centre for Integrative Neuroscience (A.G.), Tübingen; Abteilung für Neurologie (T.W.), Reha-Zentrum Bad Gögging, Passauer Wolf; Department for Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (D.W.), University of Tübingen; Division of Stereotactic and Functional Neurosurgery (M.O.P.), University Medical Center Freiburg, Germany; Departments of Functional and Stereotactic Neurosurgery and Radiosurgery (J.-.M.R.) and Neurology (T.W.), Timone University Hospital, INSERM, Marseille; Institut des Sciences Cognitives Marc Jeannerod (S.T.), CNRS, UMR 5229, Université de Lyon; Centre Expert Parkinson (S.T.), Service de Neurologie C, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurosurgery (P.M.), University Hospital of Neurology and Neurosurgery, Hospices Civils de Lyon, Université de Lyon; Department of Neurology (J.-L.H.), INSERM-1402, Centre Hospitalier Universitaire de Poitiers, University of Poitiers, France; and Universitätsklinikum Giessen und Marburg (L.T.), Marburg Campus, Germany. g.deuschl@neurologie.uni-kiel.de.

PMID: 30737338
PMCID: PMC6442017
DOI: 10.1212/WNL.0000000000007037

Randomized Controlled Trial

Quality of life predicts outcome of deep brain stimulation in early Parkinson disease

W M Michael Schuepbach et al. Neurology. 2019.

. 2019 Mar 5;92(10):e1109-e1120.

doi: 10.1212/WNL.0000000000007037. Epub 2019 Feb 8.

Authors

Collaborators

EARLYSTIM study group:
Virginie Czernecki, Helke Hesekamp, Niklaus Meier, Velina Negovanska, Marie-Laure Welter, Jean-Christophe Corvol, Philippe Cornu, Soledad Navarro, Bettina Möller, Adelheid Nebel, Karsten Witt, Jan Raethjen, Maximilian Mehdorn, Ingo G Meister, Jens Kuhn, Josef Kessler, Doreen Gruber, Katharina Faust, Stephan Chabardes, Pierre Pollak, Oliver Rascol, Christophe Arbus, Lola Danet, Romain Lefaucheur, Isabelle Benatru, Olivier Colin, Solene Ansquer, Stefan J Groiss, Saskia Elben, Christian Hartmann, Martin Südmeyer, Florian Amtage, Rejko Krueger, Severine Ledily, Anne Sauvaget, Wenke Schmidt, Alexandro Eusebio, Jean Philippe Azulay, Gustavo Polo, Serge Pinto, Johannes Levin, Wolfgang H Oertel

Affiliations

¹ From the Département de Neurologie (W.M.M.S., A.H., T.D.H., F.P., Y.A., M.V.), Hôpital Pitié-Salpêtrière, Centre d'Investigation Clinique 1422, Institut du Cerveau et de la Moelle Epinière, Institut National de Santé et en Recherche Médicale, Assistance Publique Hôpitaux de Paris, France; Institute of Neurology (W.M.M.S.), Konolfingen; Department of Neurology (W.M.M.S.), University Hospital Bern and University of Bern, Switzerland; Medtronic (L.T.), Minneapolis, MN; Institute of Clinical Neuroscience & Medical Psychology and Department of Neurology (A.D., L.W.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Movement Disorder Unit, Neurology (P.K.), CHU Grenoble Alpes; Grenoble Institut des Neurosciences (P.K., V.F., A. Kistner), University Grenoble Alpes; Inserm U1216 (P.K., V.F., A. Kistner), Grenoble, France; Department of Clinical Neurosciences (Neurology) (P.K.), Faculty of Medicine, University of Geneva, Switzerland; Coordinating Center for clinical trials of the Philipps University of Marburg (J.R., C.S.-B.); Neurochirurgische Klinik im Neurozentrum (A.F., L.P., S.P., J. Volkmann, K.K., G.D.),Christian-Albrechts-Universität Kiel; Neurologische Klinik und Poliklinik (J. Volkmann), Universitätsklinikum Würzburg; Department of Neurology (H.S.D., M.T.B., G.R.F., L.T.), University Hospital Cologne; Research Centre Jülich (G.R.F.); Klinik für Neurologie (T.D.H., A. Kühn, A. Kupsch) and Klinik für Neurochirurgie (G.-H.S.), Campus Virchow, Charité-Universitätsmedizin Berlin; Praxis Kupsch (A. Kupsch), Berlin, Germany; Service de Neurochirurgie (E.S.) and Service de Neurologie (V.F.), Hôpital Michallon, Centre Hospitalo-Universitaire, Grenoble; Departments of Neurosurgery (P.P.C.), Neurology (F.O.-M., C.B.-C.), and Clinical Pharmacology (C.B.-C.), University Hospital of Toulouse; ToNIC (F.O.-M., C.B.-C.), Toulouse Neuroimaging Center, University of Toulouse, Inserm, UPS, France; Department of Neurosurgery (J. Vesper), Universitätsklinikum Düsseldorf, Germany; Departments of Neurosurgery (S.D.) and Neurology (D.M.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Service de Neurologie (P. Damier, P. Derkinderen), CHU Nantes, Hôpital Laënnec, France; Paracelsus-Elena-Klinik Kassel (F.S.-D., C.T.); Department of Neurosurgery (C.T.), University Medical Center Göttingen; Division of Functional and Restorative Neurosurgery and Centre for Integrative Neuroscience (A.G.), Tübingen; Abteilung für Neurologie (T.W.), Reha-Zentrum Bad Gögging, Passauer Wolf; Department for Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (D.W.), University of Tübingen; Division of Stereotactic and Functional Neurosurgery (M.O.P.), University Medical Center Freiburg, Germany; Departments of Functional and Stereotactic Neurosurgery and Radiosurgery (J.-.M.R.) and Neurology (T.W.), Timone University Hospital, INSERM, Marseille; Institut des Sciences Cognitives Marc Jeannerod (S.T.), CNRS, UMR 5229, Université de Lyon; Centre Expert Parkinson (S.T.), Service de Neurologie C, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurosurgery (P.M.), University Hospital of Neurology and Neurosurgery, Hospices Civils de Lyon, Université de Lyon; Department of Neurology (J.-L.H.), INSERM-1402, Centre Hospitalier Universitaire de Poitiers, University of Poitiers, France; and Universitätsklinikum Giessen und Marburg (L.T.), Marburg Campus, Germany.
² From the Département de Neurologie (W.M.M.S., A.H., T.D.H., F.P., Y.A., M.V.), Hôpital Pitié-Salpêtrière, Centre d'Investigation Clinique 1422, Institut du Cerveau et de la Moelle Epinière, Institut National de Santé et en Recherche Médicale, Assistance Publique Hôpitaux de Paris, France; Institute of Neurology (W.M.M.S.), Konolfingen; Department of Neurology (W.M.M.S.), University Hospital Bern and University of Bern, Switzerland; Medtronic (L.T.), Minneapolis, MN; Institute of Clinical Neuroscience & Medical Psychology and Department of Neurology (A.D., L.W.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Movement Disorder Unit, Neurology (P.K.), CHU Grenoble Alpes; Grenoble Institut des Neurosciences (P.K., V.F., A. Kistner), University Grenoble Alpes; Inserm U1216 (P.K., V.F., A. Kistner), Grenoble, France; Department of Clinical Neurosciences (Neurology) (P.K.), Faculty of Medicine, University of Geneva, Switzerland; Coordinating Center for clinical trials of the Philipps University of Marburg (J.R., C.S.-B.); Neurochirurgische Klinik im Neurozentrum (A.F., L.P., S.P., J. Volkmann, K.K., G.D.),Christian-Albrechts-Universität Kiel; Neurologische Klinik und Poliklinik (J. Volkmann), Universitätsklinikum Würzburg; Department of Neurology (H.S.D., M.T.B., G.R.F., L.T.), University Hospital Cologne; Research Centre Jülich (G.R.F.); Klinik für Neurologie (T.D.H., A. Kühn, A. Kupsch) and Klinik für Neurochirurgie (G.-H.S.), Campus Virchow, Charité-Universitätsmedizin Berlin; Praxis Kupsch (A. Kupsch), Berlin, Germany; Service de Neurochirurgie (E.S.) and Service de Neurologie (V.F.), Hôpital Michallon, Centre Hospitalo-Universitaire, Grenoble; Departments of Neurosurgery (P.P.C.), Neurology (F.O.-M., C.B.-C.), and Clinical Pharmacology (C.B.-C.), University Hospital of Toulouse; ToNIC (F.O.-M., C.B.-C.), Toulouse Neuroimaging Center, University of Toulouse, Inserm, UPS, France; Department of Neurosurgery (J. Vesper), Universitätsklinikum Düsseldorf, Germany; Departments of Neurosurgery (S.D.) and Neurology (D.M.), Rouen University Hospital and University of Rouen; INSERM U1239 (D.M.), Laboratory of Neuronal and Neuroendocrine Differentiation and Communication, Mont-Saint-Aignan; Service de Neurologie (P. Damier, P. Derkinderen), CHU Nantes, Hôpital Laënnec, France; Paracelsus-Elena-Klinik Kassel (F.S.-D., C.T.); Department of Neurosurgery (C.T.), University Medical Center Göttingen; Division of Functional and Restorative Neurosurgery and Centre for Integrative Neuroscience (A.G.), Tübingen; Abteilung für Neurologie (T.W.), Reha-Zentrum Bad Gögging, Passauer Wolf; Department for Neurodegenerative Diseases and Hertie Institute for Clinical Brain Research (D.W.), University of Tübingen; Division of Stereotactic and Functional Neurosurgery (M.O.P.), University Medical Center Freiburg, Germany; Departments of Functional and Stereotactic Neurosurgery and Radiosurgery (J.-.M.R.) and Neurology (T.W.), Timone University Hospital, INSERM, Marseille; Institut des Sciences Cognitives Marc Jeannerod (S.T.), CNRS, UMR 5229, Université de Lyon; Centre Expert Parkinson (S.T.), Service de Neurologie C, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Bron; Department of Neurosurgery (P.M.), University Hospital of Neurology and Neurosurgery, Hospices Civils de Lyon, Université de Lyon; Department of Neurology (J.-L.H.), INSERM-1402, Centre Hospitalier Universitaire de Poitiers, University of Poitiers, France; and Universitätsklinikum Giessen und Marburg (L.T.), Marburg Campus, Germany. g.deuschl@neurologie.uni-kiel.de.

PMID: 30737338
PMCID: PMC6442017
DOI: 10.1212/WNL.0000000000007037

Erratum in

Quality of life predicts outcome of deep brain stimulation in early Parkinson disease.
[No authors listed] [No authors listed] Neurology. 2019 Jun 11;92(24):1166. doi: 10.1212/WNL.0000000000007420. Neurology. 2019. PMID: 31182520 Free PMC article. No abstract available.

Abstract

Objective: To 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.

Methods: We performed a secondary analysis of data from the previously published EARLYSTIM study, a prospective randomized trial comparing STN-DBS (n = 124) to best medical treatment (n = 127) after 2 years follow-up with disease-specific QOL (39-item Parkinson's Disease Questionnaire summary index [PDQ-39-SI]) as the primary endpoint. Linear regression analyses of the baseline characteristics age, disease duration, duration of motor complications, and disease severity measured at baseline with the Unified Parkinson's Disease Rating Scale (UPDRS) (UPDRS-III "off" and "on" medications, UPDRS-IV) were conducted to determine predictors of change in PDQ-39-SI.

Results: PDQ-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.

Conclusion: Impaired QOL as subjectively evaluated by the patient is the most important predictor of benefit in patients with PD and early motor complications, fulfilling objective gold standard inclusion criteria for STN-DBS. Our results prompt systematically including evaluation of disease-specific QOL when selecting patients with PD for STN-DBS.

Clinicaltrialsgov identifier: NCT00354133.

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Figures

**Figure 1. Correlation between 39-item Parkinson's Disease Questionnaire summary index (PDQ-39-SI) at baseline and change to 24 months**
The relation between PDQ-39-SI at baseline and the improvement PDQ-39-SI between baseline and 24 months is shown. The correlation is more pronounced for the deep brain stimulation (DBS) group than for the best medical treatment (BMT) group.

**Figure 2. 39-Item Parkinson's Disease Questionnaire summary index (PDQ-39-SI) by baseline category**
Four categories of PDQ-39-SI baseline values were formed: 0–15, 15–30, 30–45, and >45 points. Higher values on the PDQ-39 scale mean worse quality of life. The ordinate indicates the change of PDQ-39-SI over the 2 years of the EARLYSTIM study period; negative values mean worsening of quality of life, positive values mean improvement. BMT = best medical treatment (i.e., control group); DBS = deep brain stimulation of the subthalamic nucleus plus best medical treatment; n = number of patients in each group. *DBS vs BMT statistically significant (adjusted model-based p values <0.05).

**Figure 3. Individual 39-item Parkinson's Disease Questionnaire summary index (PDQ-39-SI) change**
Change of quality of life (PDQ-39) depending on the baseline PDQ-39 (B). All data at the 3 visits (5, 12, and 24 months) of all patients are shown depending on the baseline value of the PDQ-39 (left column). The response is highlighted by colors (green, better; red, no change). Patients with higher PDQ-39 values at baseline show a better improvement.

See this image and copyright information in PMC

Comment in

Is outcome of subthalamic nucleus deep brain stimulation in Parkinson disease predictable?
Chen CC. Chen CC. Neurology. 2019 Mar 5;92(10):453-454. doi: 10.1212/WNL.0000000000007023. Epub 2019 Feb 8. Neurology. 2019. PMID: 30737340 No abstract available.
Reader response: Quality of life predicts outcome of deep brain stimulation in early Parkinson disease.
Sidiropoulos C. Sidiropoulos C. Neurology. 2020 Mar 3;94(9):412. doi: 10.1212/WNL.0000000000009044. Neurology. 2020. PMID: 32123061 No abstract available.
Author response: Quality of life predicts outcome of deep brain stimulation in early Parkinson disease.
Deuschl G, Schuepbach MWM, Schade-Brittinger C, Tonder L, Krack P. Deuschl G, et al. Neurology. 2020 Mar 3;94(9):413. doi: 10.1212/WNL.0000000000009045. Neurology. 2020. PMID: 32123062 No abstract available.

References

1. Limousin P, Krack P, Pollak P, et al. . Electrical stimulation of the subthalamic nucleus in advanced Parkinson's disease. N Engl J Med 1998;339:1105–1111. - PubMed
1. Lagrange E, Krack P, Moro E, et al. . Bilateral subthalamic nucleus stimulation improves health-related quality of life in PD. Neurology 2002;59:1976–1978. - PubMed
1. Deuschl G, Schade-Brittinger C, Krack P, et al. . A randomized trial of deep-brain stimulation for Parkinson's disease. N Engl J Med 2006;355:896–908. - PubMed
1. Schupbach M, Gargiulo M, Welter ML, et al. . Neurosurgery in Parkinson disease: a distressed mind in a repaired body? Neurology 2006;66:1811–1816. - PubMed
1. Deuschl G, Schupbach M, Knudsen K, et al. . Stimulation of the subthalamic nucleus at an earlier disease stage of Parkinson's disease: concept and standards of the EARLYSTIM-study. Parkinsonism Relat Disord 2013;19:56–61. - PubMed

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Quality of life predicts outcome of deep brain stimulation in early Parkinson disease

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Quality of life predicts outcome of deep brain stimulation in early Parkinson disease

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