Evaluation of the effect of bilateral subthalamic nucleus deep brain stimulation on fatigue in Parkinson’s Disease as measured by the non-motor symptoms scale

Claudia Lazcano-Ocampo*, Daniel van Wamelen, Michael Samuel, Monty Silverdale, Alexandra Rizos, Anna Sauerbier, Julia Koch, Aleksandra Podlewska, Valentina Leta, Haidar S. Dafsari, Lars Timmermann, Keyoumars Ashkan, K. Ray Chaudhuri

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Background: Fatigue is a common and disabling non-motor symptom (NMS) in Parkinson’s disease (PD) patients. However, the effect of subthalamic nucleus (STN) deep brain stimulation (DBS) on fatigue has not been widely studied. Objective: To determine the effect of STN DBS on fatigue in PD patients, measured by the Non-motor symptoms scale (NMSS). Methods: Cross-sectional analysis of 50 patients with PD who underwent STN DBS at King’s College Hospital and Salford Royal Hospital with fatigue scores (measured by question number 4 from domain 2 (sleep/fatigue) of the NMSS as the primary outcome measure. Secondary outcome measures included the PD Sleep Scale (PDSS), Scales for Outcome in PD (SCOPA)-motor examination, activities of daily living, motor complications, Hoehn and Yahr (HY) stage and changes in Levodopa Equivalent Daily Dose (LEDD). Results: 50 patients with a mean follow-up period of 1.98 ± 1.36 years were studied. Significant improvement in median fatigue scores (4.00 (0.75–9.00) to 1.00 (0.00–4.50); p =.001) was observed. In addition, improvements in question 5 (sleep maintenance and fragmentation; 8.00 (4.00–12.00) to 0.00 (0.00–4.00); p <.001) and in domain 2 total score (sleep/fatigue; 20.00 (8.75–27.25) to 6.00 (0.75–16.00); p <.001) were also significant, together with improvements in NMSS total score, SCOPA scores and HY stage (p ≤.02). Moreover, LEDD but especially dopamine agonists LEDD was significantly reduced after DBS (310.00 (0.00–480.00) to 150.00 (0.00–300.00); p <.020). Conclusions: Even though open label and not using a validated fatigue scale, this observational analysis suggest that fatigue improves significantly after STN DBS with persisting benefits at two years follow-up.

Original languageEnglish
JournalBritish Journal of Neurosurgery
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • deep brain stimulation
  • fatigue
  • non-motor symptoms
  • Parkinson’s disease

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