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@ARTICLE{Jost:1023535,
author = {Jost, Stefanie T. and Aloui, Salima and Evans, Julian and
Ashkan, Keyoumars and Sauerbier, Anna and Rizos, Alexandra
and Petry-Schmelzer, Jan Niklas and Gronostay, Alexandra and
Fink, Gereon R. and Visser-Vandewalle, Veerle and Antonini,
Angelo and Silverdale, Monty and Timmermann, Lars and
Martinez-Martin, Pablo and Chaudhuri, K. Ray and Dafsari,
Haidar S. and Martinez-Martin, Pablo and Rodriguez-Blazquez
, Carmen and Chaudhuri, Ray and Rizos, Alexandra and
Sauerbier, Anna and Parry, Miriam and Trivedi, Dhaval and
Martino, Davide and Odin, Per and Antonini, Angelo and
Stocchi, Fabrizio and van Hilten, Jacobus J and van Laar,
Teus and Falup-Pecurariu, Cristian and Dietrichs, Espen and
Lyons, Kelly E. and Weintraub, Dan and Kurtis, Monica and
Serrano-Dueñas, Marcos and Borges, Vanderci and Behari,
Madhuri and Bhattacharya, Kalyan and Kumar, Hrishikesh and
Singhal, Bhim and Bhidayasiri, Roongroj and Shen-Yang, Lim
and Gallardo, Marisol and Abe, Kazuo and Bostantjopoulou,
Sevasti and Martin Rabey, Jose and Micheli, Federico and
Rodriguez-Violante, Mayela and Riboldazzi, Giulio and
Catalan, Maria Jose and Ellis, Cathy and Bean, Lorna and
Kessel, Belinda and Worth, Paul and Shearing, Gemma and
Sophia, Rani and Sharma, Jagdish and Silverdale, Monty and
Pal, Suvankar and Ashkan, Keyoumars and Adler, Charles and
Barone, Paolo and Brooks, David J. and Brown, Richard and
Cantillon, Marc and Carroll, Camille and Coelho, Miguel and
Dafsari, Haidar S. and Henriksen, Tove and Hu, Michele and
Jenner, Peter and Kramberger, Milica and Kumar, Padma and
Kurtis, Mónica and Lewis, Simon and Litvan, Irene and
Lyons, Kelly and Masellis, Mario and Mochizuki, Hideki and
Morley, James F. and Nirenberg, Melissa and Pagonabarraga,
Javier and Panicker, Jalesh and Pavese, Nicola and Pekkonen,
Eero and Postuma, Ron and Rosales, Raymond and Schapira,
Anthony and Simuni, Tanya and Subramanian, Indu and
Tagliati, Michele and Timmermann, Lars and Tinazzi, Michele
and Toledo, Jon and Tsuboi, Yoshio and Walker, Richard},
title = {{N}eurostimulation for {A}dvanced {P}arkinson {D}isease and
{Q}uality of {L}ife at 5 {Y}ears},
journal = {JAMA network open},
volume = {7},
number = {1},
issn = {2574-3805},
address = {Chicago, Ill.},
publisher = {American Medical Association},
reportid = {FZJ-2024-01741},
pages = {e2352177 -},
year = {2024},
abstract = {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.},
cin = {INM-3},
ddc = {610},
cid = {I:(DE-Juel1)INM-3-20090406},
pnm = {5252 - Brain Dysfunction and Plasticity (POF4-525)},
pid = {G:(DE-HGF)POF4-5252},
typ = {PUB:(DE-HGF)16},
pubmed = {38236600},
UT = {WOS:001145711600006},
doi = {10.1001/jamanetworkopen.2023.52177},
url = {https://juser.fz-juelich.de/record/1023535},
}