Beneficial nonmotor effects of subthalamic and pallidal neurostimulation in Parkinson's disease
Background: Subthalamic (STN) and pallidal (GPi) deep brain stimulation (DBS) improve quality of life, motor, and nonmotor symptoms (NMS) in advanced Parkinson’s disease (PD). However, few studies have compared their nonmotor effects. Objective: To compare nonmotor effects of STN-DBS and GPi-DBS. Me...
| Autores: | , , , , , , , , , , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Fecha de publicación: | 2020 |
| País: | España |
| Institución: | Instituto de Salud Carlos III (ISCIII) |
| Repositorio: | Repisalud |
| Idioma: | inglés |
| OAI Identifier: | oai:repisalud.isciii.es:20.500.12105/14926 |
| Acceso en línea: | http://hdl.handle.net/20.500.12105/14926 |
| Access Level: | acceso abierto |
| Palabra clave: | Activities of Daily Living Aged Deep Brain Stimulation Fatigue Female Follow-Up Studies Globus Pallidus Humans Levodopa Male Middle Aged Parkinson Disease Prospective Studies Quality of Life Sleep Subthalamic Nucleus Treatment Outcome |
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Beneficial nonmotor effects of subthalamic and pallidal neurostimulation in Parkinson's diseaseDafsari, Haidar SDos Santos Ghilardi, Maria GabrielaVisser-Vandewalle, VeerleRizos, AlexandraAshkan, KeyoumarsSilverdale, MontyEvans, JulianMartinez, Raquel C RCury, Rubens GJost, Stefanie TBarbe, Michael TFink, Gereon RAntonini, AngeloChaudhuri, Kallol RayMartínez-Martín, PabloFonoff, Erich TalamoniTimmermann, LarsEUROPAR Study GroupIPMDS Non Motor PD Study GroupActivities of Daily LivingAgedDeep Brain StimulationFatigueFemaleFollow-Up StudiesGlobus PallidusHumansLevodopaMaleMiddle AgedParkinson DiseaseProspective StudiesQuality of LifeSleepSubthalamic NucleusTreatment OutcomeBackground: Subthalamic (STN) and pallidal (GPi) deep brain stimulation (DBS) improve quality of life, motor, and nonmotor symptoms (NMS) in advanced Parkinson’s disease (PD). However, few studies have compared their nonmotor effects. Objective: To compare nonmotor effects of STN-DBS and GPi-DBS. Methods: In this prospective, observational, multicenter study including 60 PD patients undergoing bilateral STN-DBS (n = 40) or GPi-DBS (n = 20), we examined PDQuestionnaire (PDQ), NMSScale (NMSS), Unified PD Rating Scale-activities of daily living, -motor impairment, -complications (UPDRS-II, –III, -IV), Hoehn&Yahr, Schwab&England Scale, and levodopa-equivalent daily dose (LEDD) preoperatively and at 6-month follow-up. Intra-group changes at follow-up were analyzed with Wilcoxon signed-rank or paired t-test, if parametric tests were applicable, and corrected for multiple comparisons. Inter-group differences were explored with Mann-Whitney-U/unpaired t-tests. Analyses were performed before and after propensity score matching which balanced out demographic and preoperative clinical characteristics. Strength of clinical changes was assessed with effect size. Results: In both groups, PDQ, UPDRS-II, -IV, Schwab&England Scale, and NMSS improved significantly at follow-up. STN-DBS was significantly better for LEDD reduction, GPi-DBS for UPDRS-IV. While NMSS total score outcomes were similar, explorative NMSS domain analyses revealed distinct profiles: Both targets improved sleep/fatigue and mood/cognition, but only STN-DBS the miscellaneous (pain/olfaction) and attention/memory and only GPi-DBS cardiovascular and sexual function domains. Conclusions: To our knowledge, this is the first study to report distinct patterns of beneficial nonmotor effects of STN-DBS and GPi-DBS in PD. This study highlights the importance of NMS assessments to tailor DBS target choices to patients’ individual motor and nonmotor profiles.ElsevierThiemann StiftungFelgenhauer Foundation20222022-09-0220202020-12-0120202020-12-01research articlehttp://purl.org/coar/resource_type/c_2df8fbb1VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/20.500.12105/14926reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/149262026-06-12T12:43:37Z |
| dc.title.none.fl_str_mv |
Beneficial nonmotor effects of subthalamic and pallidal neurostimulation in Parkinson's disease |
| title |
Beneficial nonmotor effects of subthalamic and pallidal neurostimulation in Parkinson's disease |
| spellingShingle |
Beneficial nonmotor effects of subthalamic and pallidal neurostimulation in Parkinson's disease Dafsari, Haidar S Activities of Daily Living Aged Deep Brain Stimulation Fatigue Female Follow-Up Studies Globus Pallidus Humans Levodopa Male Middle Aged Parkinson Disease Prospective Studies Quality of Life Sleep Subthalamic Nucleus Treatment Outcome |
| title_short |
Beneficial nonmotor effects of subthalamic and pallidal neurostimulation in Parkinson's disease |
| title_full |
Beneficial nonmotor effects of subthalamic and pallidal neurostimulation in Parkinson's disease |
| title_fullStr |
Beneficial nonmotor effects of subthalamic and pallidal neurostimulation in Parkinson's disease |
| title_full_unstemmed |
Beneficial nonmotor effects of subthalamic and pallidal neurostimulation in Parkinson's disease |
| title_sort |
Beneficial nonmotor effects of subthalamic and pallidal neurostimulation in Parkinson's disease |
| dc.creator.none.fl_str_mv |
Dafsari, Haidar S Dos Santos Ghilardi, Maria Gabriela Visser-Vandewalle, Veerle Rizos, Alexandra Ashkan, Keyoumars Silverdale, Monty Evans, Julian Martinez, Raquel C R Cury, Rubens G Jost, Stefanie T Barbe, Michael T Fink, Gereon R Antonini, Angelo Chaudhuri, Kallol Ray Martínez-Martín, Pablo Fonoff, Erich Talamoni Timmermann, Lars EUROPAR Study Group IPMDS Non Motor PD Study Group |
| author |
Dafsari, Haidar S |
| author_facet |
Dafsari, Haidar S Dos Santos Ghilardi, Maria Gabriela Visser-Vandewalle, Veerle Rizos, Alexandra Ashkan, Keyoumars Silverdale, Monty Evans, Julian Martinez, Raquel C R Cury, Rubens G Jost, Stefanie T Barbe, Michael T Fink, Gereon R Antonini, Angelo Chaudhuri, Kallol Ray Martínez-Martín, Pablo Fonoff, Erich Talamoni Timmermann, Lars EUROPAR Study Group IPMDS Non Motor PD Study Group |
| author_role |
author |
| author2 |
Dos Santos Ghilardi, Maria Gabriela Visser-Vandewalle, Veerle Rizos, Alexandra Ashkan, Keyoumars Silverdale, Monty Evans, Julian Martinez, Raquel C R Cury, Rubens G Jost, Stefanie T Barbe, Michael T Fink, Gereon R Antonini, Angelo Chaudhuri, Kallol Ray Martínez-Martín, Pablo Fonoff, Erich Talamoni Timmermann, Lars EUROPAR Study Group IPMDS Non Motor PD Study Group |
| author2_role |
author author author author author author author author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Thiemann Stiftung Felgenhauer Foundation |
| dc.subject.none.fl_str_mv |
Activities of Daily Living Aged Deep Brain Stimulation Fatigue Female Follow-Up Studies Globus Pallidus Humans Levodopa Male Middle Aged Parkinson Disease Prospective Studies Quality of Life Sleep Subthalamic Nucleus Treatment Outcome |
| topic |
Activities of Daily Living Aged Deep Brain Stimulation Fatigue Female Follow-Up Studies Globus Pallidus Humans Levodopa Male Middle Aged Parkinson Disease Prospective Studies Quality of Life Sleep Subthalamic Nucleus Treatment Outcome |
| description |
Background: Subthalamic (STN) and pallidal (GPi) deep brain stimulation (DBS) improve quality of life, motor, and nonmotor symptoms (NMS) in advanced Parkinson’s disease (PD). However, few studies have compared their nonmotor effects. Objective: To compare nonmotor effects of STN-DBS and GPi-DBS. Methods: In this prospective, observational, multicenter study including 60 PD patients undergoing bilateral STN-DBS (n = 40) or GPi-DBS (n = 20), we examined PDQuestionnaire (PDQ), NMSScale (NMSS), Unified PD Rating Scale-activities of daily living, -motor impairment, -complications (UPDRS-II, –III, -IV), Hoehn&Yahr, Schwab&England Scale, and levodopa-equivalent daily dose (LEDD) preoperatively and at 6-month follow-up. Intra-group changes at follow-up were analyzed with Wilcoxon signed-rank or paired t-test, if parametric tests were applicable, and corrected for multiple comparisons. Inter-group differences were explored with Mann-Whitney-U/unpaired t-tests. Analyses were performed before and after propensity score matching which balanced out demographic and preoperative clinical characteristics. Strength of clinical changes was assessed with effect size. Results: In both groups, PDQ, UPDRS-II, -IV, Schwab&England Scale, and NMSS improved significantly at follow-up. STN-DBS was significantly better for LEDD reduction, GPi-DBS for UPDRS-IV. While NMSS total score outcomes were similar, explorative NMSS domain analyses revealed distinct profiles: Both targets improved sleep/fatigue and mood/cognition, but only STN-DBS the miscellaneous (pain/olfaction) and attention/memory and only GPi-DBS cardiovascular and sexual function domains. Conclusions: To our knowledge, this is the first study to report distinct patterns of beneficial nonmotor effects of STN-DBS and GPi-DBS in PD. This study highlights the importance of NMS assessments to tailor DBS target choices to patients’ individual motor and nonmotor profiles. |
| publishDate |
2020 |
| dc.date.none.fl_str_mv |
2020 2020-12-01 2020 2020-12-01 2022 2022-09-02 |
| dc.type.none.fl_str_mv |
research article http://purl.org/coar/resource_type/c_2df8fbb1 VoR http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| dc.type.openaire.fl_str_mv |
info:eu-repo/semantics/article |
| format |
article |
| dc.identifier.none.fl_str_mv |
http://hdl.handle.net/20.500.12105/14926 |
| url |
http://hdl.handle.net/20.500.12105/14926 |
| dc.language.none.fl_str_mv |
Inglés eng |
| language_invalid_str_mv |
Inglés |
| language |
eng |
| dc.rights.none.fl_str_mv |
open access http://purl.org/coar/access_right/c_abf2 Attribution-NonCommercial-NoDerivatives 4.0 Internacional http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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info:eu-repo/semantics/openAccess |
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open access http://purl.org/coar/access_right/c_abf2 Attribution-NonCommercial-NoDerivatives 4.0 Internacional http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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openAccess |
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application/pdf application/pdf application/pdf application/pdf application/pdf application/pdf |
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Elsevier |
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Elsevier |
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reponame:Repisalud instname:Instituto de Salud Carlos III (ISCIII) |
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Instituto de Salud Carlos III (ISCIII) |
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Repisalud |
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