Please use this identifier to cite or link to this item:http://hdl.handle.net/20.500.12105/12288
Beneficial effect of 24-month bilateral subthalamic stimulation on quality of sleep in Parkinson's disease.
Dafsari, Haidar S | Ray-Chaudhuri, K | Ashkan, Keyoumars | Sachse, Lena | Mahlstedt, Picabo | Silverdale, Monty | Rizos, Alexandra | Strack, Marian | Jost, Stefanie T | Reker, Paul | Samuel, Michael | Visser-Vandewalle, Veerle | Evans, Julian | Antonini, Angelo | Martinez-Martin, Pablo ISCIII | Timmermann, Lars
J Neurol . 2020 Jun;267(6):1830-1841
Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and sleep symptoms in Parkinson's disease (PD). However, the long-term effects of STN-DBS on sleep and its relationship with QoL outcome are unclear. In this prospective, observational, multicenter study including 73 PD patients undergoing bilateral STN-DBS, we examined PDSleep Scale (PDSS), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD-motor examination, -activities of daily living, and -complications (SCOPA-A, -B, -C), and levodopa-equivalent daily dose (LEDD) preoperatively, at 5 and 24 months follow-up. Longitudinal changes were analyzed with Friedman-tests or repeated-measures ANOVA, when parametric tests were applicable, and Bonferroni-correction for multiple comparisons. Post-hoc, visits were compared with Wilcoxon signed-rank/t-tests. The magnitude of clinical responses was investigated using effect size. Significant beneficial effects of STN-DBS were observed for PDSS, PDQ-8, SCOPA-A, -B, and -C. All outcomes improved significantly at 5 months with subsequent decrements in gains at 24 months follow-up which were significant for PDSS, PDQ-8, and SCOPA-B. Comparing baseline and 24 months follow-up, we observed significant improvements of PDSS (small effect), SCOPA-A (moderate effect), -C, and LEDD (large effects). PDSS and PDQ-8 improvements correlated significantly at 5 and 24 months follow-up. In this multicenter study with a 24 months follow-up, we report significant sustained improvements after bilateral STN-DBS using a PD-specific sleep scale and a significant relationship between sleep and QoL improvements. This highlights the importance of sleep in holistic assessments of DBS outcomes.
Deep brain stimulation | Non-motor symptoms | Parkinson’s disease sleep scale | Quality of life | Subthalamic nucleus
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