TY  - JOUR
AU  - Jost, Stefanie T.
AU  - Aloui, Salima
AU  - Evans, Julian
AU  - Ashkan, Keyoumars
AU  - Sauerbier, Anna
AU  - Rizos, Alexandra
AU  - Petry-Schmelzer, Jan Niklas
AU  - Gronostay, Alexandra
AU  - Fink, Gereon R.
AU  - Visser-Vandewalle, Veerle
AU  - Antonini, Angelo
AU  - Silverdale, Monty
AU  - Timmermann, Lars
AU  - Martinez-Martin, Pablo
AU  - Chaudhuri, K. Ray
AU  - Dafsari, Haidar S.
AU  - Martinez-Martin, Pablo
AU  - Rodriguez-Blazquez , Carmen
AU  - Chaudhuri, Ray
AU  - Rizos, Alexandra
AU  - Sauerbier, Anna
AU  - Parry, Miriam
AU  - Trivedi, Dhaval
AU  - Martino, Davide
AU  - Odin, Per
AU  - Antonini, Angelo
AU  - Stocchi, Fabrizio
AU  - van Hilten, Jacobus J
AU  - van Laar, Teus
AU  - Falup-Pecurariu, Cristian
AU  - Dietrichs, Espen
AU  - Lyons, Kelly E.
AU  - Weintraub, Dan
AU  - Kurtis, Monica
AU  - Serrano-Dueñas, Marcos
AU  - Borges, Vanderci
AU  - Behari, Madhuri
AU  - Bhattacharya, Kalyan
AU  - Kumar, Hrishikesh
AU  - Singhal, Bhim
AU  - Bhidayasiri, Roongroj
AU  - Shen-Yang, Lim
AU  - Gallardo, Marisol
AU  - Abe, Kazuo
AU  - Bostantjopoulou, Sevasti
AU  - Martin Rabey, Jose
AU  - Micheli, Federico
AU  - Rodriguez-Violante, Mayela
AU  - Riboldazzi, Giulio
AU  - Catalan, Maria Jose
AU  - Ellis, Cathy
AU  - Bean, Lorna
AU  - Kessel, Belinda
AU  - Worth, Paul
AU  - Shearing, Gemma
AU  - Sophia, Rani
AU  - Sharma, Jagdish
AU  - Silverdale, Monty
AU  - Pal, Suvankar
AU  - Ashkan, Keyoumars
AU  - Adler, Charles
AU  - Barone, Paolo
AU  - Brooks, David J.
AU  - Brown, Richard
AU  - Cantillon, Marc
AU  - Carroll, Camille
AU  - Coelho, Miguel
AU  - Dafsari, Haidar S.
AU  - Henriksen, Tove
AU  - Hu, Michele
AU  - Jenner, Peter
AU  - Kramberger, Milica
AU  - Kumar, Padma
AU  - Kurtis, Mónica
AU  - Lewis, Simon
AU  - Litvan, Irene
AU  - Lyons, Kelly
AU  - Masellis, Mario
AU  - Mochizuki, Hideki
AU  - Morley, James F.
AU  - Nirenberg, Melissa
AU  - Pagonabarraga, Javier
AU  - Panicker, Jalesh
AU  - Pavese, Nicola
AU  - Pekkonen, Eero
AU  - Postuma, Ron
AU  - Rosales, Raymond
AU  - Schapira, Anthony
AU  - Simuni, Tanya
AU  - Subramanian, Indu
AU  - Tagliati, Michele
AU  - Timmermann, Lars
AU  - Tinazzi, Michele
AU  - Toledo, Jon
AU  - Tsuboi, Yoshio
AU  - Walker, Richard
TI  - Neurostimulation for Advanced Parkinson Disease and Quality of Life at 5 Years
JO  - JAMA network open
VL  - 7
IS  - 1
SN  - 2574-3805
CY  - Chicago, Ill.
PB  - American Medical Association
M1  - FZJ-2024-01741
SP  - e2352177 -
PY  - 2024
AB  - 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.
LB  - PUB:(DE-HGF)16
C6  - 38236600
UR  - <Go to ISI:>//WOS:001145711600006
DO  - DOI:10.1001/jamanetworkopen.2023.52177
UR  - https://juser.fz-juelich.de/record/1023535
ER  -