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@ARTICLE{Gronostay:1024588,
      author       = {Gronostay, Alexandra and Jost, Stefanie Theresa and
                      Silverdale, Monty and Rizos, Alexandra and Loehrer, Philipp
                      Alexander and Evans, Julian and Sauerbier, Anna and Indi,
                      Donya and Leta, Valentina and Reker, Paul and Fink, Gereon
                      Rudolf and Ashkan, Keyoumars and Antonini, Angelo and
                      Nimsky, Christopher and Visser-Vandewalle, Veerle and
                      Martinez-Martin, Pablo and Ray Chaudhuri, K. and Timmermann,
                      Lars and Dafsari, Haidar S},
      title        = {{S}tratifying quality of life outcome in subthalamic
                      stimulation for {P}arkinson’s disease},
      journal      = {Journal of neurology, neurosurgery, and psychiatry},
      volume       = {95},
      number       = {7},
      issn         = {0022-3050},
      address      = {London},
      publisher    = {BMJ Publishing Group},
      reportid     = {FZJ-2024-02262},
      pages        = {jnnp-2023-332272 -},
      year         = {2024},
      note         = {Paper is funded by the German Research Foundation (Grant
                      KFO 219)},
      abstract     = {ABSTRACTBackground Subthalamic nucleus deep
                      brainstimulation (STN-DBS)for Parkinson’s disease
                      (PD)improves quality of life (QoL), motor and
                      non-motorsymptoms (NMS). However, in previous studies,
                      $43\%–49\%$ of patients did not experience clinically
                      relevantpostoperative QoL improvement. To inform
                      individualisedprediction of postoperative QoL improvement,
                      wedeveloped a stratification analysis of QoL outcomesbased
                      on preoperative non-motortotal burden, severityof motor
                      progression and motor response in levodopachallenge
                      tests.Methods This was a prospective,
                      open-label,multicentre, international study with a
                      6-monthfollow-up.A distribution-basedthreshold
                      identified’QoL responders’ in the
                      PDQuestionnaire-8SummaryIndex (PDQ-8SI). After baseline
                      stratification based onthe NMS Scale, Hoehn and Yahr Scale
                      and levodoparesponse assessed with the Unified PD Rating
                      Scale-III,we compared postoperative QoL response between
                      thesestrata. To assess the clinical usefulness and
                      statisticalfeasibility of stratifications, we compared
                      cumulativedistribution function curves, respectively
                      PDQ-8within-stratumvariation.Results All main outcomes
                      improved postoperatively.Based on the 8.1 points threshold
                      for clinicallymeaningful PDQ-8SI improvement, only 80/161
                      patientswere classified as ’QoL responders’. The
                      absolute riskreductions for QoL non-responseamong respective
                      non-motor,motor progression and levodopa response stratawere
                      $23\%,$ $8\%$ and $3\%,$ respectively. Only
                      non-motorstratification reduced
                      PDQ-8within-stratumvariationcompared with the overall
                      cohort.Conclusions Non-motorstratification, but not
                      motorprogression or levodopa response stratification,
                      isclinically useful and statistically feasible for
                      personalisedpreoperative prediction of postoperative QoL
                      outcome ofSTN-DBSfor PD. Our findings highlight that
                      non-motorassessments are necessary components of a
                      case-based,holistic approach of DBS indication evaluations
                      gearedtowards optimising postoperative QoL outcomes.},
      cin          = {INM-3},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-3-20090406},
      pnm          = {5251 - Multilevel Brain Organization and Variability
                      (POF4-525)},
      pid          = {G:(DE-HGF)POF4-5251},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {38124227},
      UT           = {WOS:001143623900001},
      doi          = {10.1136/jnnp-2023-332272},
      url          = {https://juser.fz-juelich.de/record/1024588},
}