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. 2022 Sep;29(9):2645-2653.
doi: 10.1111/ene.15436. Epub 2022 Jun 24.

Long-term independence and quality of life after subthalamic stimulation in Parkinson disease

Anna Castrioto  1 , Bettina Debû  1 , Emilie Cousin  2   3 , Pierre Pelissier  1 , Eugénie Lhommée  1 , Amélie Bichon  1 , Emmanuelle Schmitt  1 , Andrea Kistner  1 , Sara Meoni  1 , Eric Seigneuret  4 , Stephan Chabardes  1 , Paul Krack  5 , Elena Moro  1 , Valérie Fraix  1
Affiliations

Long-term independence and quality of life after subthalamic stimulation in Parkinson disease

Anna Castrioto et al. Eur J Neurol. 2022 Sep.

Abstract

Background and purpose: Studies on long-term nonmotor outcomes of subthalamic nucleus stimulation in Parkinson disease (PD) are scarce. This study reports on very long-term non-motor and motor outcomes in one of the largest cohorts of people with advanced PD, treated for >10 years with subthalamic nucleus stimulation. The main outcome was to document the evolution of independence in activities of daily living. The secondary outcomes were to measure the change in quality of life, as well as non-motor and motor outcomes.

Methods: Patients were studied preoperatively, at 1 year, and beyond 10 years after subthalamic stimulation with an established protocol including motor, non-motor, and neuropsychological assessments.

Results: Eighty-five people with PD were included. Independence scores in the off-medication condition (measured with the Schwab & England Activities of Daily Living Scale) as well as quality of life (measured with the Parkinson's Disease Questionnaire [PDQ]-37) remained improved at longest follow-up compared to preoperatively (respectively, p < 0.001, p = 0.015). Cognitive scores, measured with the Mattis Dementia Rating Scale, significantly worsened compared to before and 1 year after surgery (p < 0.001), without significant change in depression, measured with the Beck Depression Inventory. Motor fluctuations, dyskinesias, and off dystonia remained improved at longest follow-up (p < 0.001), with a significant reduction in dopaminergic treatment (45%, p < 0.001).

Conclusions: This study highlights the long-term improvement of subthalamic stimulation on independence and quality of life, despite the progression of disease and the occurrence of levodopa-resistant symptoms.

Keywords: Parkinson disease; activities of daily living; deep brain stimulation; quality of life; subthalamic nucleus.

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Conflict of interest statement

A.C. declares research grants from France Parkinson Association and Medtronic, and lecturing fees from AbbVie. S.M. declares research grants from Medtronic. S.C. serves as a consultant for Medtronic and Boston Scientific. P.K. declares grants from the Swiss National Science Foundation, Roger de Spoelberch Foundation, Bertarelli Foundation, Annemarie Opprecht Foundation, Parkinson Schweiz, Michael J. Fox Foundation, Aleva Neurotherapeutics, and Boston Scientific, and personal fees (lecturing fees to employing institution/travel expenses to scientific meetings) from Boston Scientific, Bial, and Zambon outside the submitted work. E.M. has received honoraria from Abbott, Medtronic, and Kyowa. V.F. hs received honoraria from AbbVie, and lecturing fees from Medtronic and Boston Scientific. None of the other authors has any conflict of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Parkinson's Disease Questionnaire‐37 subscores at different follow‐up visits. *Comparison of preoperative versus 1 year postoperative values is statistically significant. §Comparison of preoperative versus 1 year postoperative values is statistically significant [Colour figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

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