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Non-motor predictors of 36-month quality of life after subthalamic stimulation in Parkinson disease

Research output: Contribution to journalArticlepeer-review

EUROPAR and the International Parkinson and Movement Disorders Society Non-Motor Parkinson’s Disease Study Group

Original languageEnglish
Article number48
Journalnpj Parkinson's Disease
Issue number1
PublishedDec 2021

Bibliographical note

Funding Information: This paper is independent research funded by the German Research Foundation (Grant KFO 219). Funding Information: S.T.J. reports no financial disclosures. Veerle Visser-Vandewalle is a member of the advisory boards and reports consultancies for Medtronic, Boston Scientific and St. Jude Medical. She received a grant from SAPIENS Steering Brain Stimulation. A.R. has received honorarium from UCB and was supported by a grant from Medtronic. P.A.L. was funded by the SUCCESS-Program of the University of Marburg, the Parkinson’s Foundation, and the Stiftung zur Förderung junger Neurowissenschaftler. M.S. has received honoraria from Bial, Britannia and Medtronic as well as grants from Parkinson’s UK, Michael J Fox Foundation, NIHR, BBSRC, Dystonia society and Innovate UK. Julian Evans reports no financial disclosures. M.S. has received honoraria for educational meetings/travel/accommodation from Medtronic, Abbott, and UCB, grants from Parkinson’s UK and Ipsen, and has acted as a consultant for Medtronic and Abbott. J.N.P.-S. has received travel grants from Boston Scientific. Anna Sauerbier reports no financial disclosures. Alexandra Gronostay reports no financial disclosures. M.T.B. received speaker’s honoraria from Medtronic, Boston Scientific, Abbott (formerly St. Jude), GE Medical, UCB, Apothekerverband Köln e.V. and Bial as well as research funding from the Felgenhauer-Stiftung, Forschungspool Klinische Studien (University of Cologne), Horizon 2020 (Gondola), Medtronic (ODIS), and Boston Scientific and advisory honoraria for the IQWIG. G.R.F. reports no financial disclosures. K.A. has received honoraria for educational meetings, travel and consultancy from Medtronic, St Jude Medical and Boston Scientific. A.A. reports personal consultancy fees from Zambon, AbbVie, Boehringer Ingelheim, GE, Neuroderm, Biogen, Bial, EVER Neuro Pharma, Therevance, Vectura grants from Chiesi Pharmaceuticals, Lundbeck, Horizon 2020 - PD_Pal Grant 825785, Ministry of Education University and Research (MIUR) Grant ARS01_01081, owns Patent WO2015110261-A1, owns shares from PD Neurotechnology Limited. P.M.-M. has received honoraria from Editorial Viguera and Movement Disorder Society for lecturing in courses; from AbbVie for speaking in experts’ meetings and from AbbVie and Zambon for participating in the Advisory Board of epidemiological studies. License fee payments for the King’s Parkinson’s Disease Pain Scale, and grants from the International Parkinson and Movement Disorder Society for development and validation of the MDS-Non-Motor Symptoms Scale. K.R.C. has received funding from Parkinson’s UK, NIHR, UCB, and the European Union; he received honoraria from UCB, Abbott, Britannia, US Worldmeds, and Otsuka Pharmaceuticals; and acted as a consultant for AbbVie, UCB, and Britannia. L.T. reports grants, personal fees and non-financial support from SAPIENS Steering Brain Stimulation, Medtronic, Boston Scientific and St. Jude Medical. H.S.D.’s work was funded by the Prof. Klaus Thiemann Foundation and the Felgenhauer Foundation and has received honoraria by Boston Scientific and Medtronic. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


To identify predictors of 36-month follow-up quality of life (QoL) outcome after bilateral subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson’s disease (PD). In this ongoing, prospective, multicenter international study (Cologne, Manchester, London) including 73 patients undergoing STN-DBS, we assessed the following scales preoperatively and at 6-month and 36-month follow-up: PD Questionnaire-8 (PDQ-8), NMSScale (NMSS), Scales for Outcomes in PD (SCOPA)-motor examination, -activities of daily living, and -complications, and levodopa equivalent daily dose (LEDD). We analyzed factors associated with QoL improvement at 36-month follow-up based on (1) correlations between baseline test scores and QoL improvement, (2) step-wise linear regressions with baseline test scores as independent and QoL improvement as dependent variables, (3) logistic regressions and receiver operating characteristic curves using a dichotomized variable “QoL responders”/“non-responders”. At both follow-ups, NMSS total score, SCOPA-motor examination, and -complications improved and LEDD was reduced significantly. PDQ-8 improved at 6-month follow-up with subsequent decrements in gains at 36-month follow-up when 61.6% of patients were categorized as “QoL non-responders”. Correlations, linear, and logistic regression analyses found greater PDQ-8 improvements in patients with younger age, worse PDQ-8, and worse specific NMS at baseline, such as ‘difficulties experiencing pleasure’ and ‘problems sustaining concentration’. Baseline SCOPA scores were not associated with PDQ-8 changes. Our results provide evidence that 36-month QoL changes depend on baseline neuropsychological and neuropsychiatric non-motor symptoms burden. These findings highlight the need for an assessment of a wide range of non-motor and motor symptoms when advising and selecting individuals for DBS therapy.

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