Subthalamic stimulation improves quality of sleep in Parkinson disease: A 36-month controlled study

On behalf of EUROPAR and the International Parkinson and Movement Disorders Society Non-Motor Parkinson's Disease Study Group

doi:10.3233/JPD-202278

Subthalamic stimulation improves quality of sleep in Parkinson disease: A 36-month controlled study

On behalf of EUROPAR and the International Parkinson and Movement Disorders Society Non-Motor Parkinson's Disease Study Group

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

23 Citations (Scopus)

Abstract

Background: Sleep disturbances and neuropsychiatric symptoms are some of the most common nonmotor symptoms in Parkinson's disease (PD). The effect of subthalamic stimulation (STN-DBS) on these symptoms beyond a short-term follow-up is unclear. Objective: To examine 36-month effects of bilateral STN-DBS on quality of sleep, depression, anxiety, and quality of life (QoL) compared to standard-of-care medical therapy (MED) in PD. Methods: In this prospective, controlled, observational, propensity score matched, international multicenter study, we assessed sleep disturbances using the PDSleep Scale-1 (PDSS), QoL employing the PDQuestionnaire-8 (PDQ-8), motor disorder with the Scales for Outcomes in PD (SCOPA), anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and dopaminergic medication requirements (LEDD). Within-group longitudinal outcome changes were tested using Wilcoxon signed-rank and between-group longitudinal differences of change scores with Mann-Whitney U tests. Spearman correlations analyzed the relationships of outcome parameter changes at follow-up. Results: Propensity score matching applied on 159 patients (STN-DBS n = 75, MED n = 84) resulted in 40 patients in each treatment group. At 36-month follow-up, STN-DBS led to significantly better PDSS and PDQ-8 change scores, which were significantly correlated. We observed no significant effects for HADS and no significant correlations between change scores in PDSS, HADS, and LEDD. Conclusions: We report Class IIb evidence of beneficial effects of STN-DBS on quality of sleep at 36-month follow-up, which were associated with QoL improvement independent of depression and dopaminergic medication. Our study highlights the importance of sleep for assessments of DBS outcomes.

Original language	English
Pages (from-to)	323-335
Number of pages	13
Journal	Journal of Parkinson's Disease
Volume	11
Issue number	1
DOIs	https://doi.org/10.3233/JPD-202278
Publication status	Published - 2021

Keywords

Deep brain stimulation
Nonmotor symptoms
Quality of life
Sleep dysfunction
Subthalamic nucleus

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10.3233/JPD-202278

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@article{f94cb4932e204046a61544808e3695d9,

title = "Subthalamic stimulation improves quality of sleep in Parkinson disease: A 36-month controlled study",

abstract = "Background: Sleep disturbances and neuropsychiatric symptoms are some of the most common nonmotor symptoms in Parkinson's disease (PD). The effect of subthalamic stimulation (STN-DBS) on these symptoms beyond a short-term follow-up is unclear. Objective: To examine 36-month effects of bilateral STN-DBS on quality of sleep, depression, anxiety, and quality of life (QoL) compared to standard-of-care medical therapy (MED) in PD. Methods: In this prospective, controlled, observational, propensity score matched, international multicenter study, we assessed sleep disturbances using the PDSleep Scale-1 (PDSS), QoL employing the PDQuestionnaire-8 (PDQ-8), motor disorder with the Scales for Outcomes in PD (SCOPA), anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and dopaminergic medication requirements (LEDD). Within-group longitudinal outcome changes were tested using Wilcoxon signed-rank and between-group longitudinal differences of change scores with Mann-Whitney U tests. Spearman correlations analyzed the relationships of outcome parameter changes at follow-up. Results: Propensity score matching applied on 159 patients (STN-DBS n = 75, MED n = 84) resulted in 40 patients in each treatment group. At 36-month follow-up, STN-DBS led to significantly better PDSS and PDQ-8 change scores, which were significantly correlated. We observed no significant effects for HADS and no significant correlations between change scores in PDSS, HADS, and LEDD. Conclusions: We report Class IIb evidence of beneficial effects of STN-DBS on quality of sleep at 36-month follow-up, which were associated with QoL improvement independent of depression and dopaminergic medication. Our study highlights the importance of sleep for assessments of DBS outcomes.",

keywords = "Deep brain stimulation, Nonmotor symptoms, Quality of life, Sleep dysfunction, Subthalamic nucleus",

author = "{On behalf of EUROPAR and the International Parkinson and Movement Disorders Society Non-Motor Parkinson's Disease Study Group} and Jost, {Stefanie T.} and {Ray Chaudhuri}, K. and Keyoumars Ashkan and Loehrer, {Philipp A.} and Monty Silverdale and Alexandra Rizos and Julian Evans and Petry-Schmelzer, {Jan Niklas} and Barbe, {Michael T.} and Anna Sauerbier and Fink, {Gereon R.} and Veerle Visser-Vandewalle and Angelo Antonini and Pablo Martinez-Martin and Lars Timmermann and Dafsari, {Haidar S.}",

note = "Funding Information: Philipp A. Loehrer was funded by the SUCCESS-Program of the University of Marburg, the Parkinson{\textquoteright}s Foundation, and the Stiftung zur F{\"o}rderung junger Neurowissenschaftler. Funding Information: 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. Funding Information: Lars Timmermann reports grants, personal fees and non-financial support from SAPIENS Steering Brain Stimulation, Medtronic, Boston Scientific and St. Jude Medical. Funding Information: Haidar S. Dafsari{\textquoteright}s work was funded by the Prof. Klaus Thiemann Foundation and the Felgenhauer Foundation and has received honoraria by Boston Scientific and Medtronic. Funding Information: Michael T. Barbe. received speaker{\textquoteright}s honoraria from Medtronic, Boston Scientific, Abbott (formerly St. Jude), GE Medical, UCB, Apothekerverband K{\"o}ln 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. Funding Information: K. Ray Chaudhuri has received funding from Parkinson{\textquoteright}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. Funding Information: Angelo Antonini reports personal consultancy fees from Zambon, AbbVie, Boehringer Ingel-heim, 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, Cariparo Foundation, owns Patent WO2015110261-A1, owns shares from PD Neurotechnology Limited. Funding Information: Alexandra Rizos has received honorarium from UCB and was supported by a grant from Medtronic. Publisher Copyright: {\textcopyright} 2021 - IOS Press. All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

doi = "10.3233/JPD-202278",

language = "English",

volume = "11",

pages = "323--335",

journal = "Journal of Parkinson's Disease",

issn = "1877-7171",

publisher = "IOS Press",

number = "1",

}

TY - JOUR

T1 - Subthalamic stimulation improves quality of sleep in Parkinson disease

T2 - A 36-month controlled study

AU - On behalf of EUROPAR and the International Parkinson and Movement Disorders Society Non-Motor Parkinson's Disease Study Group

AU - Jost, Stefanie T.

AU - Ray Chaudhuri, K.

AU - Ashkan, Keyoumars

AU - Loehrer, Philipp A.

AU - Silverdale, Monty

AU - Rizos, Alexandra

AU - Evans, Julian

AU - Petry-Schmelzer, Jan Niklas

AU - Barbe, Michael T.

AU - Sauerbier, Anna

AU - Fink, Gereon R.

AU - Visser-Vandewalle, Veerle

AU - Antonini, Angelo

AU - Martinez-Martin, Pablo

AU - Timmermann, Lars

AU - Dafsari, Haidar S.

N1 - Funding Information: Philipp A. Loehrer was funded by the SUCCESS-Program of the University of Marburg, the Parkinson’s Foundation, and the Stiftung zur Förderung junger Neurowissenschaftler. Funding Information: 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. Funding Information: Lars Timmermann reports grants, personal fees and non-financial support from SAPIENS Steering Brain Stimulation, Medtronic, Boston Scientific and St. Jude Medical. Funding Information: Haidar S. Dafsari’s work was funded by the Prof. Klaus Thiemann Foundation and the Felgenhauer Foundation and has received honoraria by Boston Scientific and Medtronic. Funding Information: Michael T. Barbe. 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. Funding Information: K. Ray Chaudhuri 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. Funding Information: Angelo Antonini reports personal consultancy fees from Zambon, AbbVie, Boehringer Ingel-heim, 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, Cariparo Foundation, owns Patent WO2015110261-A1, owns shares from PD Neurotechnology Limited. Funding Information: Alexandra Rizos has received honorarium from UCB and was supported by a grant from Medtronic. Publisher Copyright: © 2021 - IOS Press. All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021

Y1 - 2021

N2 - Background: Sleep disturbances and neuropsychiatric symptoms are some of the most common nonmotor symptoms in Parkinson's disease (PD). The effect of subthalamic stimulation (STN-DBS) on these symptoms beyond a short-term follow-up is unclear. Objective: To examine 36-month effects of bilateral STN-DBS on quality of sleep, depression, anxiety, and quality of life (QoL) compared to standard-of-care medical therapy (MED) in PD. Methods: In this prospective, controlled, observational, propensity score matched, international multicenter study, we assessed sleep disturbances using the PDSleep Scale-1 (PDSS), QoL employing the PDQuestionnaire-8 (PDQ-8), motor disorder with the Scales for Outcomes in PD (SCOPA), anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and dopaminergic medication requirements (LEDD). Within-group longitudinal outcome changes were tested using Wilcoxon signed-rank and between-group longitudinal differences of change scores with Mann-Whitney U tests. Spearman correlations analyzed the relationships of outcome parameter changes at follow-up. Results: Propensity score matching applied on 159 patients (STN-DBS n = 75, MED n = 84) resulted in 40 patients in each treatment group. At 36-month follow-up, STN-DBS led to significantly better PDSS and PDQ-8 change scores, which were significantly correlated. We observed no significant effects for HADS and no significant correlations between change scores in PDSS, HADS, and LEDD. Conclusions: We report Class IIb evidence of beneficial effects of STN-DBS on quality of sleep at 36-month follow-up, which were associated with QoL improvement independent of depression and dopaminergic medication. Our study highlights the importance of sleep for assessments of DBS outcomes.

AB - Background: Sleep disturbances and neuropsychiatric symptoms are some of the most common nonmotor symptoms in Parkinson's disease (PD). The effect of subthalamic stimulation (STN-DBS) on these symptoms beyond a short-term follow-up is unclear. Objective: To examine 36-month effects of bilateral STN-DBS on quality of sleep, depression, anxiety, and quality of life (QoL) compared to standard-of-care medical therapy (MED) in PD. Methods: In this prospective, controlled, observational, propensity score matched, international multicenter study, we assessed sleep disturbances using the PDSleep Scale-1 (PDSS), QoL employing the PDQuestionnaire-8 (PDQ-8), motor disorder with the Scales for Outcomes in PD (SCOPA), anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and dopaminergic medication requirements (LEDD). Within-group longitudinal outcome changes were tested using Wilcoxon signed-rank and between-group longitudinal differences of change scores with Mann-Whitney U tests. Spearman correlations analyzed the relationships of outcome parameter changes at follow-up. Results: Propensity score matching applied on 159 patients (STN-DBS n = 75, MED n = 84) resulted in 40 patients in each treatment group. At 36-month follow-up, STN-DBS led to significantly better PDSS and PDQ-8 change scores, which were significantly correlated. We observed no significant effects for HADS and no significant correlations between change scores in PDSS, HADS, and LEDD. Conclusions: We report Class IIb evidence of beneficial effects of STN-DBS on quality of sleep at 36-month follow-up, which were associated with QoL improvement independent of depression and dopaminergic medication. Our study highlights the importance of sleep for assessments of DBS outcomes.

KW - Deep brain stimulation

KW - Nonmotor symptoms

KW - Quality of life

KW - Sleep dysfunction

KW - Subthalamic nucleus

UR - http://www.scopus.com/inward/record.url?scp=85100553843&partnerID=8YFLogxK

U2 - 10.3233/JPD-202278

DO - 10.3233/JPD-202278

M3 - Article

C2 - 33074192

AN - SCOPUS:85100553843

SN - 1877-7171

VL - 11

SP - 323

EP - 335

JO - Journal of Parkinson's Disease

JF - Journal of Parkinson's Disease

IS - 1

ER -

Subthalamic stimulation improves quality of sleep in Parkinson disease: A 36-month controlled study

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Keywords

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