Is improvement in the quality of life after subthalamic nucleus stimulation in Parkinson's disease predictable?

被引：81

作者：

Daniels, Christine ^{[1
]}

Krack, Paul ^{[1
]}

Volkmann, Jens ^{[1
]}

Raethjen, Jan ^{[1
]}

Pinsker, Markus O. ^{[2
]}

Kloss, Manja ^{[3
]}

Tronnier, Volker ^{[4
]}

Schnitzler, Alfons ^{[5
]}

Wojtecki, Lars ^{[5
]}

Boetzel, Kai ^{[6
]}

Danek, Adrian ^{[6
]}

Hilker, Ruediger ^{[7
]}

Sturm, Volker ^{[8
]}

Kupsch, Andreas ^{[9
]}

Karner, Elfriede ^{[10
]}

Deuschl, Guenther ^{[1
]}

Witt, Karsten ^{[1
]}

机构：

[1] Univ Kiel, Dept Neurol, D-2300 Kiel, Germany

[2] Univ Kiel, Dept Neurosurg, D-2300 Kiel, Germany

[3] Univ Heidelberg, Dept Neurol, Heidelberg, Germany

[4] Univ Heidelberg, Dept Neurosurg, Heidelberg, Germany

[5] Univ Dusseldorf, Dept Neurol, Dusseldorf, Germany

[6] Univ Munich, Dept Neurol, D-8000 Munich, Germany

[7] Univ Cologne, Dept Neurol, D-50931 Cologne, Germany

[8] Univ Cologne, Dept Neurosurg, D-50931 Cologne, Germany

[9] Humboldt Univ, Dept Neurol, Charite Hosp, D-10099 Berlin, Germany

[10] Innsbruck Med Univ, Dept Neurol, Innsbruck, Austria

来源：

MOVEMENT DISORDERS | 2011年 / 26卷 / 14期

关键词：

Parkinson's disease; deep brain stimulation; quality of life; DEEP-BRAIN-STIMULATION; TRIAL;

D O I：

10.1002/mds.23907

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

100204 [神经病学];

摘要：

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) significantly improves quality of life (QoL) in PD. However, QoL fails to improve in a relevant proportion of patients. We studied clinical baseline and progression parameters associated with improvement in QoL after DBS. Data from a German randomized, controlled study comparing DBS (60 patients) with best medical treatment (59 patients) were analyzed. Changes in patients' QoL were assessed using the Parkinson's Disease Questionnaire (PDQ-39) at baseline and at the 6-month follow-up. For the STN-DBS patients, the changes in PDQ-39 were correlated with predefined clinical preoperative and progression parameters. Scores for QoL improved after STN-DBS for 57% of the patients, and for 43% patients, they did not improve. Patients with improvement in QoL showed significantly higher cumulative daily off time. Changes in the PDQ-39 showed a significant positive correlation with the cumulative daily off time at baseline. Logistic regression analysis revealed that 1 additional hour off time at baseline increases the odds for improvement on PDQ-39 by a factor of 1.33 (odds ratio). In the postoperative course, changes in the PDQ-39 significantly correlated with the reduction of cumulative daily off time, an improvement on the UPDRS (UPDRS III off), and positive mood changes. Among the baseline parameters, the cumulative daily off time is the strongest predictor for improvement in disease-related QoL after DBS. Improvement in QoL after STN-DBS is also correlated with changes in motor functions and changes in depression and anxiety. (c) 2011 Movement Disorder Society

引用

页码：2516 / 2521

页数：6

共 15 条

[1]

Reliability analysis of the PDQ-39 (German version) [J].