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| 001 | 1024588 | ||
| 005 | 20250204113823.0 | ||
| 024 | 7 | _ | |a 10.1136/jnnp-2023-332272 |2 doi |
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| 037 | _ | _ | |a FZJ-2024-02262 |
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| 100 | 1 | _ | |a Gronostay, Alexandra |0 P:(DE-HGF)0 |b 0 |
| 245 | _ | _ | |a Stratifying quality of life outcome in subthalamic stimulation for Parkinson’s disease |
| 260 | _ | _ | |a London |c 2024 |b BMJ Publishing Group |
| 336 | 7 | _ | |a article |2 DRIVER |
| 336 | 7 | _ | |a Output Types/Journal article |2 DataCite |
| 336 | 7 | _ | |a Journal Article |b journal |m journal |0 PUB:(DE-HGF)16 |s 1719553199_18134 |2 PUB:(DE-HGF) |
| 336 | 7 | _ | |a ARTICLE |2 BibTeX |
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| 336 | 7 | _ | |a Journal Article |0 0 |2 EndNote |
| 500 | _ | _ | |a Paper is funded by the German Research Foundation (Grant KFO 219) |
| 520 | _ | _ | |a 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. |
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| 700 | 1 | _ | |a Jost, Stefanie Theresa |0 0000-0003-0477-2289 |b 1 |
| 700 | 1 | _ | |a Silverdale, Monty |0 P:(DE-HGF)0 |b 2 |
| 700 | 1 | _ | |a Rizos, Alexandra |0 P:(DE-HGF)0 |b 3 |
| 700 | 1 | _ | |a Loehrer, Philipp Alexander |0 0000-0002-5279-2156 |b 4 |
| 700 | 1 | _ | |a Evans, Julian |0 P:(DE-HGF)0 |b 5 |
| 700 | 1 | _ | |a Sauerbier, Anna |0 P:(DE-HGF)0 |b 6 |
| 700 | 1 | _ | |a Indi, Donya |0 P:(DE-HGF)0 |b 7 |
| 700 | 1 | _ | |a Leta, Valentina |0 0000-0002-5794-7540 |b 8 |
| 700 | 1 | _ | |a Reker, Paul |0 P:(DE-HGF)0 |b 9 |
| 700 | 1 | _ | |a Fink, Gereon Rudolf |0 P:(DE-Juel1)131720 |b 10 |
| 700 | 1 | _ | |a Ashkan, Keyoumars |0 P:(DE-HGF)0 |b 11 |
| 700 | 1 | _ | |a Antonini, Angelo |0 0000-0003-1040-2807 |b 12 |
| 700 | 1 | _ | |a Nimsky, Christopher |0 P:(DE-HGF)0 |b 13 |
| 700 | 1 | _ | |a Visser-Vandewalle, Veerle |0 P:(DE-HGF)0 |b 14 |
| 700 | 1 | _ | |a Martinez-Martin, Pablo |0 P:(DE-HGF)0 |b 15 |
| 700 | 1 | _ | |a Ray Chaudhuri, K. |0 P:(DE-HGF)0 |b 16 |
| 700 | 1 | _ | |a Timmermann, Lars |0 P:(DE-HGF)0 |b 17 |
| 700 | 1 | _ | |a Dafsari, Haidar S |0 0000-0001-8849-4233 |b 18 |e Corresponding author |
| 773 | _ | _ | |a 10.1136/jnnp-2023-332272 |g p. jnnp-2023-332272 - |0 PERI:(DE-600)1480429-3 |n 7 |p jnnp-2023-332272 - |t Journal of neurology, neurosurgery, and psychiatry |v 95 |y 2024 |x 0022-3050 |
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