Quality of Life after Deep Brain Stimulation in Patients with Advanced Parkinson’s Disease

Česká verzia

Authors: M. Baláž; M. Bočková; M. Bareš; I. Rektorová; V. Dírerová; I. Rektor
Authors place of work: Centrum pro abnormní pohyby a parkinsonizmus I. neurologická klinika LF MU a FN u sv. Anny v Brně
Published in the journal: Cesk Slov Neurol N 2011; 74/107(5): 564-568
Category: Short Communication

Summary

Goal:
The object of the study was to describe the effect of deep brain stimulation of the subthalamic nucleus on various aspects of quality of life in patients with Parkinson’s disease.

Patients and methods:
Quality of life was assessed by means of the PDQ-39 questionnaire for 26 patients 12 and 36 months after deep brain stimulation to treat advanced Parkinson’s disease.

Results:
Patient quality of life, according to the PDQ-39 summary index, improved by 46% three years after surgery (p <0.001). UPDRS III scores improved by 39% in the first year, and by 31% in the third year after DBS (p <0.001).

Conclusion:
We observed statistically significant improvements in quality of life for all patients both 12 and 36 months after deep brain stimulation. The improvement was most conspicuous in the motor subscales. However, benefit in the social aspects of Parkinson’s disease (stigma, social support, communication) was also evident. Deep brain stimulation appears to have a long-lasting positive effect on the quality of life in patients with Parkinson’s disease.

Key words:
deep brain stimulation – quality of life – Parkinson’s disease

Zdroje

1. Kanovský P, Kubová D, Bares M, Hortová H, Streitová H, Znojil V et al. Levodopa-induced dyskinesias and the continuous subcutaneous infusions of apomorphine: results of two-years, prospective follow-up. Mov Disord 2002; 17(1): 188–191.

2. Chrastina J, Zbořilová E, Smrčka V, Nádvorník P. Renesance stereotaktické léčby parkinsonského třesu. Cesk Slov Neurol N 1996; 59/92(5): 265–268.

3. Schrag A, Hovris A, Morley D, Quinn N, Jahanshahi M. Young versus older-onset Parkinson’s disease: impact of disease and psychosocial consequences. Mov Disord 2003; 18(11): 1250–1256.

4. Smeding HM, Speelman JD, Huizenga HM, Schuurman PR, Schmand B. Predictors of cognitive and psychosocial outcome after STN DBS in Parkinson’s Disease. J Neurol Neurosurg Psychiatry 2011; 82(7): 754–760.

5. Schrag A, Jahanshahi M, Quinn N. What contributes to quality of life in patients with Parkinson’s disease? J Neurol Neurosurg Psychiatry 2000; 69(3): 308–312.

6. Voon V, Kubu C, Krack P, Houeto JL, Tröster AI. Deep brain stimulation: neuropsychological and neuropsychiatric issues. Mov Disord 2006; 21 (Suppl 14): S305–S327.

7. Parsons TD, Rogers SA, Braaten AJ, Woods SP, Tröster AI. Cognitive sequelae of subthalamic nucleus deep brain stimulation in Parkinson’s disease: a meta-analysis. Lancet Neurol 2006; 5(7): 578–588.

8. Baláž M, Rektor I. Neuropsychologické a kognitivní vlivy hluboké mozkové stimulace subtalamického jádra u pacientů s Parkinsonovou nemocí. Neurol Prax 2008; 9(5): 278–282.

9. Volkmann J, Albanese A, Kulisevsky J, Tornqvist AL, Houeto JL, Pidoux B et al. Long-term effects of pallidal or subthalamic deep brain stimulation on quality of life in Parkinson’s disease. Mov Disord 2009; 24(8): 1154–1161.

10. Ferrara J, Diamond A, Hunter C, Davidson A, Almaguer M, Jankovic J. Impact of STN-DBS on life and health satisfaction in patients with Parkinson’s disease. J Neurol Neurosurg Psychiatry 2010; 81(3): 315–319.

11. Deuschl G, Schade-Brittinger C, Krack P, Volkmann J, Schäfer H, Bötzel K et al. A randomized trial of deep-brain stimulation for Parkinson’s disease. N Engl J Med 2006; 355(9): 896–908.

12. Just H, Ostergaard K. Health-related quality of life in patients with advanced Parkinson’s disease treated with deep brain stimulation of the subthalamic nuclei. Mov Disord 2002; 17(3): 539–545.

13. Lezcano E, Gómez-Esteban JC, Zarranz JJ, Lambarri I, Madoz P, Bilbao G et al. Improvement in quality of life in patients with advanced Parkinson’s disease following bilateral deep-brain stimulation in subthalamic nucleus. Eur J Neurol 2004; 11(7): 451–454.

14. Urgošík D,Vladyka V. Neurochirurgická léčba Parkinsonovy nemoci. In: Růžička E, Roth J, Kaňovský P et al (eds). Parkinsonova nemoc a parkinsonské syndromy. Extrapyramidová onemocnění II. Praha: Galén 2000: 200–209.

15. Urgošík D, Jech R, Růžička E. Hluboká mozková stimulace u nemocných s extrapyramidovými poruchami pohybu stereotaktická procedura a intraoperační nálezy. Cesk Slov Neurol N 2011; 74/107(2): 175–186.

16. Defer GL, Widner H, Marié RM, Rémy P, Levivier M. Core assessment program for surgical interventional therapies in Parkinson’s disease (CAPSIT-PD). Mov Disord 1999; 14(4): 572–584.

17. Peto V, Jenkinson C, Fitzpatrick R, Greenhall R. The development and validation of a short measure of functioning and well being for individuals with Parkinson’s disease. Qual Life Res 1995; 4(3): 241–248.

18. Erola T, Karinen P, Heikkinen E, Tuominen J, Haapaniemi T, Koivukangas J et al. Bilateral subthalamic nucleus stimulation improves health-related quality of life in Parkinsonian patients. Parkinsonism Relat Disord 2005; 11(2): 89–94.

19. Lyons KE, Pahwa R. Long-term benefits in quality of life provided by bilateral subthalamic stimulation in patients with Parkinson disease. J Neurosurg 2005; 103(2): 252–255.

20. Martínez-Martín P, Valldeoriola F, Tolosa E, Pilleri M, Molinuevo JL, Rumià J et al. Bilateral subthalamic nucleus stimulation and quality of life in advanced Parkinson’s disease. Mov Disord 2002; 17(2): 372–377.

21. Lagrange E, Krack P, Moro E, Ardouin C, Van Blercom N, Chabardes S et al. Bilateral subthalamic nucleus stimulation improves health-related quality of life in PD. Neurology 2002; 59(12): 1976–1978.

22. Barone P, Antonini A, Colosimo C, Marconi R, Morgante L, Avarello TP et al. The PRIAMO study: a multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson’s disease. Mov Disord 2009; 24(11): 1641–1649.

23. Morgante L, Morgante F, Moro E, Epifanio A, Girlanda P, Ragonese P et al. How many Parkinsonian patients are suitable candidates for deep brain stimulation of subthalamic nucleus? Results of a questionnaire. Parkinsonism Relat Disord 2007; 13(8): 528–531.

24. Emre M. Treatment of dementia associated with Parkinson’s disease. Parkinsonism Relat Disord 2007; 13 (Suppl 3): S457–S461.

25. Burn DJ, Tröster AI. Neuropsychiatric complications of medical and surgical therapies for Parkinson’s disease. J Geriatr Psychiatry Neurol 2004; 17(3): 172–180.

26. Telecká S, Baláž M, Rektorová I, Fanfrdlová Z, Rektor I. Jeden rok po hluboké mozkové stimulaci pacientů s Parkinsonovou nemocí – neuropsychologické výsledky. Cesk Slov Neurol N 2010; 73/106(1): 57–61.