Beneficial effect of 24-month bilateral subthalamic stimulation on quality of sleep in Parkinson’s disease

EUROPAR, the IPMDS Non Motor P.D. Study Group

doi:10.1007/s00415-020-09743-1

Beneficial effect of 24-month bilateral subthalamic stimulation on quality of sleep in Parkinson’s disease

EUROPAR, the IPMDS Non Motor P.D. Study Group

Research output: Contribution to journal › Article › peer-review

26 Citations (Scopus)

Abstract

Background: Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and sleep symptoms in Parkinson’s disease (PD). However, the long-term effects of STN-DBS on sleep and its relationship with QoL outcome are unclear. Methods: In this prospective, observational, multicenter study including 73 PD patients undergoing bilateral STN-DBS, we examined PDSleep Scale (PDSS), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD-motor examination, -activities of daily living, and -complications (SCOPA-A, -B, -C), and levodopa-equivalent daily dose (LEDD) preoperatively, at 5 and 24 months follow-up. Longitudinal changes were analyzed with Friedman-tests or repeated-measures ANOVA, when parametric tests were applicable, and Bonferroni-correction for multiple comparisons. Post-hoc, visits were compared with Wilcoxon signed-rank/t-tests. The magnitude of clinical responses was investigated using effect size. Results: Significant beneficial effects of STN-DBS were observed for PDSS, PDQ-8, SCOPA-A, -B, and -C. All outcomes improved significantly at 5 months with subsequent decrements in gains at 24 months follow-up which were significant for PDSS, PDQ-8, and SCOPA-B. Comparing baseline and 24 months follow-up, we observed significant improvements of PDSS (small effect), SCOPA-A (moderate effect), -C, and LEDD (large effects). PDSS and PDQ-8 improvements correlated significantly at 5 and 24 months follow-up. Conclusions: In this multicenter study with a 24 months follow-up, we report significant sustained improvements after bilateral STN-DBS using a PD-specific sleep scale and a significant relationship between sleep and QoL improvements. This highlights the importance of sleep in holistic assessments of DBS outcomes.

Original language	English
Pages (from-to)	1830-1841
Number of pages	12
Journal	Journal of Neurology
Volume	267
Issue number	6
DOIs	https://doi.org/10.1007/s00415-020-09743-1
Publication status	Published - 1 Jun 2020

Keywords

Deep brain stimulation
Non-motor symptoms
Parkinson’s disease sleep scale
Quality of life
Subthalamic nucleus

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10.1007/s00415-020-09743-1

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@article{e60a205ac28b4665b3e1991a4eca2504,

title = "Beneficial effect of 24-month bilateral subthalamic stimulation on quality of sleep in Parkinson{\textquoteright}s disease",

abstract = "Background: Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and sleep symptoms in Parkinson{\textquoteright}s disease (PD). However, the long-term effects of STN-DBS on sleep and its relationship with QoL outcome are unclear. Methods: In this prospective, observational, multicenter study including 73 PD patients undergoing bilateral STN-DBS, we examined PDSleep Scale (PDSS), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD-motor examination, -activities of daily living, and -complications (SCOPA-A, -B, -C), and levodopa-equivalent daily dose (LEDD) preoperatively, at 5 and 24 months follow-up. Longitudinal changes were analyzed with Friedman-tests or repeated-measures ANOVA, when parametric tests were applicable, and Bonferroni-correction for multiple comparisons. Post-hoc, visits were compared with Wilcoxon signed-rank/t-tests. The magnitude of clinical responses was investigated using effect size. Results: Significant beneficial effects of STN-DBS were observed for PDSS, PDQ-8, SCOPA-A, -B, and -C. All outcomes improved significantly at 5 months with subsequent decrements in gains at 24 months follow-up which were significant for PDSS, PDQ-8, and SCOPA-B. Comparing baseline and 24 months follow-up, we observed significant improvements of PDSS (small effect), SCOPA-A (moderate effect), -C, and LEDD (large effects). PDSS and PDQ-8 improvements correlated significantly at 5 and 24 months follow-up. Conclusions: In this multicenter study with a 24 months follow-up, we report significant sustained improvements after bilateral STN-DBS using a PD-specific sleep scale and a significant relationship between sleep and QoL improvements. This highlights the importance of sleep in holistic assessments of DBS outcomes.",

keywords = "Deep brain stimulation, Non-motor symptoms, Parkinson{\textquoteright}s disease sleep scale, Quality of life, Subthalamic nucleus",

author = "{EUROPAR, the IPMDS Non Motor P.D. Study Group} and Dafsari, {Haidar S.} and Kallol Ray-Chaudhuri and Keyoumars Ashkan and Lena Sachse and Picabo Mahlstedt and Monty Silverdale and Alexandra Rizos and Marian Strack and Jost, {Stefanie T.} and Paul Reker and Michael Samuel and Veerle Visser-Vandewalle and Julian Evans and Angelo Antonini and Pablo Martinez-Martin and Lars Timmermann and Kallol Ray-Chaudhuri and Anette Schrag and Daniel Weintraub and Paolo Barone and Brooks, {David J.} and Brown, {Richard G.} and Peter Jenner and B. Jeon and Kelly Lyons and Nicola Pavese and Marios Politis and Postuma, {Ronald B.} and Anthony Schapira and Fabrizio Stocchi and Yoshio Tsuboi and Anna Sauerbier",

year = "2020",

month = jun,

day = "1",

doi = "10.1007/s00415-020-09743-1",

language = "English",

volume = "267",

pages = "1830--1841",

journal = "Journal of Neurology",

issn = "0340-5354",

publisher = "Springer",

number = "6",

}

TY - JOUR

T1 - Beneficial effect of 24-month bilateral subthalamic stimulation on quality of sleep in Parkinson’s disease

AU - EUROPAR, the IPMDS Non Motor P.D. Study Group

AU - Dafsari, Haidar S.

AU - Ray-Chaudhuri, Kallol

AU - Ashkan, Keyoumars

AU - Sachse, Lena

AU - Mahlstedt, Picabo

AU - Silverdale, Monty

AU - Rizos, Alexandra

AU - Strack, Marian

AU - Jost, Stefanie T.

AU - Reker, Paul

AU - Samuel, Michael

AU - Visser-Vandewalle, Veerle

AU - Evans, Julian

AU - Antonini, Angelo

AU - Martinez-Martin, Pablo

AU - Timmermann, Lars

AU - Ray-Chaudhuri, Kallol

AU - Schrag, Anette

AU - Weintraub, Daniel

AU - Barone, Paolo

AU - Brooks, David J.

AU - Brown, Richard G.

AU - Jenner, Peter

AU - Jeon, B.

AU - Lyons, Kelly

AU - Pavese, Nicola

AU - Politis, Marios

AU - Postuma, Ronald B.

AU - Schapira, Anthony

AU - Stocchi, Fabrizio

AU - Tsuboi, Yoshio

AU - Sauerbier, Anna

PY - 2020/6/1

Y1 - 2020/6/1

N2 - Background: Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and sleep symptoms in Parkinson’s disease (PD). However, the long-term effects of STN-DBS on sleep and its relationship with QoL outcome are unclear. Methods: In this prospective, observational, multicenter study including 73 PD patients undergoing bilateral STN-DBS, we examined PDSleep Scale (PDSS), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD-motor examination, -activities of daily living, and -complications (SCOPA-A, -B, -C), and levodopa-equivalent daily dose (LEDD) preoperatively, at 5 and 24 months follow-up. Longitudinal changes were analyzed with Friedman-tests or repeated-measures ANOVA, when parametric tests were applicable, and Bonferroni-correction for multiple comparisons. Post-hoc, visits were compared with Wilcoxon signed-rank/t-tests. The magnitude of clinical responses was investigated using effect size. Results: Significant beneficial effects of STN-DBS were observed for PDSS, PDQ-8, SCOPA-A, -B, and -C. All outcomes improved significantly at 5 months with subsequent decrements in gains at 24 months follow-up which were significant for PDSS, PDQ-8, and SCOPA-B. Comparing baseline and 24 months follow-up, we observed significant improvements of PDSS (small effect), SCOPA-A (moderate effect), -C, and LEDD (large effects). PDSS and PDQ-8 improvements correlated significantly at 5 and 24 months follow-up. Conclusions: In this multicenter study with a 24 months follow-up, we report significant sustained improvements after bilateral STN-DBS using a PD-specific sleep scale and a significant relationship between sleep and QoL improvements. This highlights the importance of sleep in holistic assessments of DBS outcomes.

AB - Background: Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and sleep symptoms in Parkinson’s disease (PD). However, the long-term effects of STN-DBS on sleep and its relationship with QoL outcome are unclear. Methods: In this prospective, observational, multicenter study including 73 PD patients undergoing bilateral STN-DBS, we examined PDSleep Scale (PDSS), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD-motor examination, -activities of daily living, and -complications (SCOPA-A, -B, -C), and levodopa-equivalent daily dose (LEDD) preoperatively, at 5 and 24 months follow-up. Longitudinal changes were analyzed with Friedman-tests or repeated-measures ANOVA, when parametric tests were applicable, and Bonferroni-correction for multiple comparisons. Post-hoc, visits were compared with Wilcoxon signed-rank/t-tests. The magnitude of clinical responses was investigated using effect size. Results: Significant beneficial effects of STN-DBS were observed for PDSS, PDQ-8, SCOPA-A, -B, and -C. All outcomes improved significantly at 5 months with subsequent decrements in gains at 24 months follow-up which were significant for PDSS, PDQ-8, and SCOPA-B. Comparing baseline and 24 months follow-up, we observed significant improvements of PDSS (small effect), SCOPA-A (moderate effect), -C, and LEDD (large effects). PDSS and PDQ-8 improvements correlated significantly at 5 and 24 months follow-up. Conclusions: In this multicenter study with a 24 months follow-up, we report significant sustained improvements after bilateral STN-DBS using a PD-specific sleep scale and a significant relationship between sleep and QoL improvements. This highlights the importance of sleep in holistic assessments of DBS outcomes.

KW - Deep brain stimulation

KW - Non-motor symptoms

KW - Parkinson’s disease sleep scale

KW - Quality of life

KW - Subthalamic nucleus

UR - http://www.scopus.com/inward/record.url?scp=85081215296&partnerID=8YFLogxK

U2 - 10.1007/s00415-020-09743-1

DO - 10.1007/s00415-020-09743-1

M3 - Article

AN - SCOPUS:85081215296

SN - 0340-5354

VL - 267

SP - 1830

EP - 1841

JO - Journal of Neurology

JF - Journal of Neurology

IS - 6

ER -

Beneficial effect of 24-month bilateral subthalamic stimulation on quality of sleep in Parkinson’s disease

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Keywords

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