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Long-term effects of pallidal or subthalamic deep brain stimulation on quality of life in Parkinson's disease
Movement Disorders, 05/06/09

Volkmann J et al. – In pts with advanced Parkinson's disease (PD), despite sustained motor improvements many of initial benefits from deep brain stimulation (DBS) are lost after 3 yrs, which may reflect either disease progression or adaptive changes in the subjective perception of health-related wellbeing over time.

• Study of effects of DBS of the subthalamic nucleus (STN-DBS) or internal pallidum (GPi-DBS) on health-related quality of life (HrQoL) in pts with advanced PD in a previously reported multicenter trial
• Sickness Impact Profile (SIP) questionnaires for analysis in subgroup of 20/20 pts with GPi-DBS and 45/49 pts with STN-DBS at baseline, 6 mo, and 36 mo
• SIP for physical dimension and psychosocial dimension sum score and 12 category scores
• Category scores: alertness/intellectual behavior (AIB), ambulation (A), body care and movement (BCM), communication (C), eating (E), emotional behavior (EB), home management (HM), mobility (M), recreation and pastimes (RP), sleep and rest (SR), social interaction (SI), and work (W)
• Assessment of motor functioning by Unified Parkinson's Disease Rating Scale and diaries

• At 6 mo, significant improvements in off-period motor symptoms and activities of daily living paralleled by significant reductions in total, physical, and psychosocial SIP score in both treatment groups
• At 3 yrs, sustained improvements in physical dimension score, BCM, E, M, RP after STN-DBS and M, SI after GPi-DBS
• All other SIP subscores approached baseline values, but were still the same or better (except C) whereas motor functioning remained stable after 36 mo
• STN-DBS and GPi-DBS led to significant early improvements in HrQoL

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