% IMPORTANT: The following is UTF-8 encoded. This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.
@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},
}