%0 Journal Article
%A Jost, Stefanie T.
%A Aloui, Salima
%A Evans, Julian
%A Ashkan, Keyoumars
%A Sauerbier, Anna
%A Rizos, Alexandra
%A Petry-Schmelzer, Jan Niklas
%A Gronostay, Alexandra
%A Fink, Gereon R.
%A Visser-Vandewalle, Veerle
%A Antonini, Angelo
%A Silverdale, Monty
%A Timmermann, Lars
%A Martinez-Martin, Pablo
%A Chaudhuri, K. Ray
%A Dafsari, Haidar S.
%A Martinez-Martin, Pablo
%A Rodriguez-Blazquez , Carmen
%A Chaudhuri, Ray
%A Rizos, Alexandra
%A Sauerbier, Anna
%A Parry, Miriam
%A Trivedi, Dhaval
%A Martino, Davide
%A Odin, Per
%A Antonini, Angelo
%A Stocchi, Fabrizio
%A van Hilten, Jacobus J
%A van Laar, Teus
%A Falup-Pecurariu, Cristian
%A Dietrichs, Espen
%A Lyons, Kelly E.
%A Weintraub, Dan
%A Kurtis, Monica
%A Serrano-Dueñas, Marcos
%A Borges, Vanderci
%A Behari, Madhuri
%A Bhattacharya, Kalyan
%A Kumar, Hrishikesh
%A Singhal, Bhim
%A Bhidayasiri, Roongroj
%A Shen-Yang, Lim
%A Gallardo, Marisol
%A Abe, Kazuo
%A Bostantjopoulou, Sevasti
%A Martin Rabey, Jose
%A Micheli, Federico
%A Rodriguez-Violante, Mayela
%A Riboldazzi, Giulio
%A Catalan, Maria Jose
%A Ellis, Cathy
%A Bean, Lorna
%A Kessel, Belinda
%A Worth, Paul
%A Shearing, Gemma
%A Sophia, Rani
%A Sharma, Jagdish
%A Silverdale, Monty
%A Pal, Suvankar
%A Ashkan, Keyoumars
%A Adler, Charles
%A Barone, Paolo
%A Brooks, David J.
%A Brown, Richard
%A Cantillon, Marc
%A Carroll, Camille
%A Coelho, Miguel
%A Dafsari, Haidar S.
%A Henriksen, Tove
%A Hu, Michele
%A Jenner, Peter
%A Kramberger, Milica
%A Kumar, Padma
%A Kurtis, Mónica
%A Lewis, Simon
%A Litvan, Irene
%A Lyons, Kelly
%A Masellis, Mario
%A Mochizuki, Hideki
%A Morley, James F.
%A Nirenberg, Melissa
%A Pagonabarraga, Javier
%A Panicker, Jalesh
%A Pavese, Nicola
%A Pekkonen, Eero
%A Postuma, Ron
%A Rosales, Raymond
%A Schapira, Anthony
%A Simuni, Tanya
%A Subramanian, Indu
%A Tagliati, Michele
%A Timmermann, Lars
%A Tinazzi, Michele
%A Toledo, Jon
%A Tsuboi, Yoshio
%A Walker, Richard
%T Neurostimulation for Advanced Parkinson Disease and Quality of Life at 5 Years
%J JAMA network open
%V 7
%N 1
%@ 2574-3805
%C Chicago, Ill.
%I American Medical Association
%M FZJ-2024-01741
%P e2352177 -
%D 2024
%X Importance: Deep brain stimulation of the subthalamic nucleus (STN-DBS) improves quality of life (QOL) in patients with advanced Parkinson disease (PD). However, controlled studies with more than 3 years of follow-up are lacking.Objective: To investigate the long-term effects of STN-DBS on QOL compared with standard-of-care medication (MED).Design, setting, and participants: In this prospective, observational, quasi-experimental, longitudinal nonrandomized controlled trial, 183 patients were screened for eligibility and 167 were enrolled from March 1, 2011, to May 31, 2017, at 3 European university centers. Propensity score matching for demographic and clinical characteristics was applied to 108 patients with PD (62 in the STN-DBS group and 46 in the MED group), resulting in a well-balanced, matched subcohort of 25 patients per group. Data analysis was performed from September 2022 to January 2023.Exposure: Treatment for PD of STN-DBS or MED.Main outcomes and measures: Assessments included Parkinson's Disease Questionnaire 8 (PDQ-8), Unified PD Rating Scale-motor examination, Scales for Outcomes in PD-activities of daily living (ADL) and motor complications, and levodopa-equivalent daily dose. Within-group longitudinal outcome changes, between-group differences, and correlations of change scores were analyzed.Results: The study population in the analysis included 108 patients (mean [SD] age, 63.7 [8.3] years; 66 [61.1%] male). At 5-year follow-up, PDQ-8 and ADL worsened only in the MED group (PDQ-8 change, -10.9; 95% CI, -19.0 to -2.7; P = .01; ADL change: -2.0; 95% CI, -3.1 to -0.8; P = .002), whereas both outcomes remained stable in the STN-DBS group (PDQ-8 change, -4.3; 95% CI, -13.2 to 4.7; P = .34; ADL change, -0.8; 95% CI, -2.5 to 1.0; P = .38). Changes in PDQ-8 and ADL correlated moderately (rs = .40, P = .008). Furthermore, STN-DBS outcomes were favorable for motor complications (median difference in change scores between STN-DBS and MED, -2.0; 95% CI, -4.0 to -1.0; P = .003), mobility (-1.0; 95% CI, -2.0 to 0; P = .03), and levodopa-equivalent daily dose reduction (-821.4; 95% CI, -1111.9 to -530.8; P < .001).Conclusions and relevance: This study provides evidence of differences in QOL outcomes at 5-year follow-up between STN-DBS (stable) and MED (worsened), mainly driven by the favorable effect of STN-DBS on mobility (class IIb evidence). The association between changes in QOL and ADL, but not motor impairment or complications, highlights the relative importance of ADL outcomes for long-term DBS assessments.Trial registration: German ClinicalTrials Registry: DRKS00006735.
%F PUB:(DE-HGF)16
%9 Journal Article
%$ 38236600
%U <Go to ISI:>//WOS:001145711600006
%R 10.1001/jamanetworkopen.2023.52177
%U https://juser.fz-juelich.de/record/1023535