Quality of life predicts outcome of deep brain stimulation in early Parkinson disease

W. M.Michael Schuepbach; Lisa Tonder; Alfons Schnitzler; Paul Krack; Joern Rau; Andreas Hartmann; Thomas D. Hälbig; Fanny Pineau; Andrea Falk; Laura Paschen; Stephen Paschen; Jens Volkmann; Haidar S. Dafsari; Michael T. Barbe; Gereon R. Fink; Andrea Kühn; Andreas Kupsch; Gerd H. Schneider; Eric Seigneuret; Valerie Fraix; Andrea Kistner; P. Patrick Chaynes; Fabienne Ory-Magne; Christine Brefel-Courbon; Jan Vesper; Lars Wojtecki; Stéphane Derrey; David Maltête; Philippe Damier; Pascal Derkinderen; Friederike Sixel-Döring; Claudia Trenkwalder; Alireza Gharabaghi; Tobias Wächter; Daniel Weiss; Marcus O. Pinsker; Jean Marie Regis; Tatiana Witjas; Stephane Thobois; Patrick Mertens; Karina Knudsen; Carmen Schade-Brittinger; Jean Luc Houeto; Yves Agid; Marie Vidailhet; Lars Timmermann; Gunther Deuschl

doi:10.1212/WNL.0000000000007037

Quality of life predicts outcome of deep brain stimulation in early Parkinson disease

W. M.Michael Schuepbach, Lisa Tonder, Alfons Schnitzler, Paul Krack, Joern Rau, Andreas Hartmann, Thomas D. Hälbig, Fanny Pineau, Andrea Falk, Laura Paschen, Stephen Paschen, Jens Volkmann, Haidar S. Dafsari, Michael T. Barbe, Gereon R. Fink, Andrea Kühn, Andreas Kupsch, Gerd H. Schneider, Eric Seigneuret, Valerie FraixAndrea Kistner, P. Patrick Chaynes, Fabienne Ory-Magne, Christine Brefel-Courbon, Jan Vesper, Lars Wojtecki, Stéphane Derrey, David Maltête, Philippe Damier, Pascal Derkinderen, Friederike Sixel-Döring, Claudia Trenkwalder, Alireza Gharabaghi, Tobias Wächter, Daniel Weiss, Marcus O. Pinsker, Jean Marie Regis, Tatiana Witjas, Stephane Thobois, Patrick Mertens, Karina Knudsen, Carmen Schade-Brittinger, Jean Luc Houeto, Yves Agid, Marie Vidailhet, Lars Timmermann, Gunther Deuschl

Research output: Contribution to journal › Article › peer-review

48 Scopus citations

Abstract

To investigate predictors for improvement of disease-specific quality of life (QOL) after deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson disease (PD) with early motor complications.MethodsWe performed a secondary analysis of data from the previously published EARLYSTIM study, a prospective randomized trial comparing STN-DBS (n = 124) to best medical treatment (n = 127) after 2 years follow-up with disease-specific QOL (39-item Parkinson's Disease Questionnaire summary index [PDQ-39-SI]) as the primary endpoint. Linear regression analyses of the baseline characteristics age, disease duration, duration of motor complications, and disease severity measured at baseline with the Unified Parkinson's Disease Rating Scale (UPDRS) (UPDRS-III "off" and "on" medications, UPDRS-IV) were conducted to determine predictors of change in PDQ-39-SI.ResultsPDQ-39-SI at baseline was correlated to the change in PDQ-39-SI after 24 months in both treatment groups (p < 0.05). The higher the baseline score (worse QOL) the larger the improvement in QOL after 24 months. No correlation was found for any of the other baseline characteristics analyzed in either treatment group.ConclusionImpaired QOL as subjectively evaluated by the patient is the most important predictor of benefit in patients with PD and early motor complications, fulfilling objective gold standard inclusion criteria for STN-DBS. Our results prompt systematically including evaluation of disease-specific QOL when selecting patients with PD for STN-DBS.Clinicaltrials.gov identifierNCT00354133.

Original language	English
Pages (from-to)	E1109-E1120
Journal	Neurology
Volume	92
Issue number	10
DOIs	https://doi.org/10.1212/WNL.0000000000007037
State	Published - 5 Mar 2019
Externally published	Yes

Access to Document

10.1212/WNL.0000000000007037

Cite this

Schuepbach, W. M. M., Tonder, L., Schnitzler, A., Krack, P., Rau, J., Hartmann, A., Hälbig, T. D., Pineau, F., Falk, A., Paschen, L., Paschen, S., Volkmann, J., Dafsari, H. S., Barbe, M. T., Fink, G. R., Kühn, A., Kupsch, A., Schneider, G. H., Seigneuret, E., ... Deuschl, G. (2019). Quality of life predicts outcome of deep brain stimulation in early Parkinson disease. Neurology, 92(10), E1109-E1120. https://doi.org/10.1212/WNL.0000000000007037

@article{94c38cadeb914cc9b25de0de8bd247f6,

title = "Quality of life predicts outcome of deep brain stimulation in early Parkinson disease",

abstract = "To investigate predictors for improvement of disease-specific quality of life (QOL) after deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson disease (PD) with early motor complications.MethodsWe performed a secondary analysis of data from the previously published EARLYSTIM study, a prospective randomized trial comparing STN-DBS (n = 124) to best medical treatment (n = 127) after 2 years follow-up with disease-specific QOL (39-item Parkinson's Disease Questionnaire summary index [PDQ-39-SI]) as the primary endpoint. Linear regression analyses of the baseline characteristics age, disease duration, duration of motor complications, and disease severity measured at baseline with the Unified Parkinson's Disease Rating Scale (UPDRS) (UPDRS-III {"}off{"} and {"}on{"} medications, UPDRS-IV) were conducted to determine predictors of change in PDQ-39-SI.ResultsPDQ-39-SI at baseline was correlated to the change in PDQ-39-SI after 24 months in both treatment groups (p < 0.05). The higher the baseline score (worse QOL) the larger the improvement in QOL after 24 months. No correlation was found for any of the other baseline characteristics analyzed in either treatment group.ConclusionImpaired QOL as subjectively evaluated by the patient is the most important predictor of benefit in patients with PD and early motor complications, fulfilling objective gold standard inclusion criteria for STN-DBS. Our results prompt systematically including evaluation of disease-specific QOL when selecting patients with PD for STN-DBS.Clinicaltrials.gov identifierNCT00354133.",

author = "Schuepbach, {W. M.Michael} and Lisa Tonder and Alfons Schnitzler and Paul Krack and Joern Rau and Andreas Hartmann and H{\"a}lbig, {Thomas D.} and Fanny Pineau and Andrea Falk and Laura Paschen and Stephen Paschen and Jens Volkmann and Dafsari, {Haidar S.} and Barbe, {Michael T.} and Fink, {Gereon R.} and Andrea K{\"u}hn and Andreas Kupsch and Schneider, {Gerd H.} and Eric Seigneuret and Valerie Fraix and Andrea Kistner and Chaynes, {P. Patrick} and Fabienne Ory-Magne and Christine Brefel-Courbon and Jan Vesper and Lars Wojtecki and St{\'e}phane Derrey and David Malt{\^e}te and Philippe Damier and Pascal Derkinderen and Friederike Sixel-D{\"o}ring and Claudia Trenkwalder and Alireza Gharabaghi and Tobias W{\"a}chter and Daniel Weiss and Pinsker, {Marcus O.} and Regis, {Jean Marie} and Tatiana Witjas and Stephane Thobois and Patrick Mertens and Karina Knudsen and Carmen Schade-Brittinger and Houeto, {Jean Luc} and Yves Agid and Marie Vidailhet and Lars Timmermann and Gunther Deuschl",

note = "Funding Information: Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article. The Article Processing Charge was funded by Medtronic. Funding Information: This study was funded by grants from the German Ministry of Research (Klinische Studien 01KG0502) and the French Programme Hospitalier de Recherche Clinique National (P050909) and by Medtronic. Publisher Copyright: {\textcopyright} 2019 American Academy of Neurology.",

year = "2019",

month = mar,

day = "5",

doi = "10.1212/WNL.0000000000007037",

language = "English",

volume = "92",

pages = "E1109--E1120",

journal = "Neurology",

issn = "0028-3878",

publisher = "Lippincott Williams and Wilkins Ltd.",

number = "10",

}

Schuepbach, WMM, Tonder, L, Schnitzler, A, Krack, P, Rau, J, Hartmann, A, Hälbig, TD, Pineau, F, Falk, A, Paschen, L, Paschen, S, Volkmann, J, Dafsari, HS, Barbe, MT, Fink, GR, Kühn, A, Kupsch, A, Schneider, GH, Seigneuret, E, Fraix, V, Kistner, A, Chaynes, PP, Ory-Magne, F, Brefel-Courbon, C, Vesper, J, Wojtecki, L, Derrey, S, Maltête, D, Damier, P, Derkinderen, P, Sixel-Döring, F, Trenkwalder, C, Gharabaghi, A, Wächter, T, Weiss, D, Pinsker, MO, Regis, JM, Witjas, T, Thobois, S, Mertens, P, Knudsen, K, Schade-Brittinger, C, Houeto, JL, Agid, Y, Vidailhet, M, Timmermann, L & Deuschl, G 2019, 'Quality of life predicts outcome of deep brain stimulation in early Parkinson disease', Neurology, vol. 92, no. 10, pp. E1109-E1120. https://doi.org/10.1212/WNL.0000000000007037

TY - JOUR

T1 - Quality of life predicts outcome of deep brain stimulation in early Parkinson disease

AU - Schuepbach, W. M.Michael

AU - Tonder, Lisa

AU - Schnitzler, Alfons

AU - Krack, Paul

AU - Rau, Joern

AU - Hartmann, Andreas

AU - Hälbig, Thomas D.

AU - Pineau, Fanny

AU - Falk, Andrea

AU - Paschen, Laura

AU - Paschen, Stephen

AU - Volkmann, Jens

AU - Dafsari, Haidar S.

AU - Barbe, Michael T.

AU - Fink, Gereon R.

AU - Kühn, Andrea

AU - Kupsch, Andreas

AU - Schneider, Gerd H.

AU - Seigneuret, Eric

AU - Fraix, Valerie

AU - Kistner, Andrea

AU - Chaynes, P. Patrick

AU - Ory-Magne, Fabienne

AU - Brefel-Courbon, Christine

AU - Vesper, Jan

AU - Wojtecki, Lars

AU - Derrey, Stéphane

AU - Maltête, David

AU - Damier, Philippe

AU - Derkinderen, Pascal

AU - Sixel-Döring, Friederike

AU - Trenkwalder, Claudia

AU - Gharabaghi, Alireza

AU - Wächter, Tobias

AU - Weiss, Daniel

AU - Pinsker, Marcus O.

AU - Regis, Jean Marie

AU - Witjas, Tatiana

AU - Thobois, Stephane

AU - Mertens, Patrick

AU - Knudsen, Karina

AU - Schade-Brittinger, Carmen

AU - Houeto, Jean Luc

AU - Agid, Yves

AU - Vidailhet, Marie

AU - Timmermann, Lars

AU - Deuschl, Gunther

N1 - Funding Information: Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article. The Article Processing Charge was funded by Medtronic. Funding Information: This study was funded by grants from the German Ministry of Research (Klinische Studien 01KG0502) and the French Programme Hospitalier de Recherche Clinique National (P050909) and by Medtronic. Publisher Copyright: © 2019 American Academy of Neurology.

PY - 2019/3/5

Y1 - 2019/3/5

N2 - To investigate predictors for improvement of disease-specific quality of life (QOL) after deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson disease (PD) with early motor complications.MethodsWe performed a secondary analysis of data from the previously published EARLYSTIM study, a prospective randomized trial comparing STN-DBS (n = 124) to best medical treatment (n = 127) after 2 years follow-up with disease-specific QOL (39-item Parkinson's Disease Questionnaire summary index [PDQ-39-SI]) as the primary endpoint. Linear regression analyses of the baseline characteristics age, disease duration, duration of motor complications, and disease severity measured at baseline with the Unified Parkinson's Disease Rating Scale (UPDRS) (UPDRS-III "off" and "on" medications, UPDRS-IV) were conducted to determine predictors of change in PDQ-39-SI.ResultsPDQ-39-SI at baseline was correlated to the change in PDQ-39-SI after 24 months in both treatment groups (p < 0.05). The higher the baseline score (worse QOL) the larger the improvement in QOL after 24 months. No correlation was found for any of the other baseline characteristics analyzed in either treatment group.ConclusionImpaired QOL as subjectively evaluated by the patient is the most important predictor of benefit in patients with PD and early motor complications, fulfilling objective gold standard inclusion criteria for STN-DBS. Our results prompt systematically including evaluation of disease-specific QOL when selecting patients with PD for STN-DBS.Clinicaltrials.gov identifierNCT00354133.

AB - To investigate predictors for improvement of disease-specific quality of life (QOL) after deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson disease (PD) with early motor complications.MethodsWe performed a secondary analysis of data from the previously published EARLYSTIM study, a prospective randomized trial comparing STN-DBS (n = 124) to best medical treatment (n = 127) after 2 years follow-up with disease-specific QOL (39-item Parkinson's Disease Questionnaire summary index [PDQ-39-SI]) as the primary endpoint. Linear regression analyses of the baseline characteristics age, disease duration, duration of motor complications, and disease severity measured at baseline with the Unified Parkinson's Disease Rating Scale (UPDRS) (UPDRS-III "off" and "on" medications, UPDRS-IV) were conducted to determine predictors of change in PDQ-39-SI.ResultsPDQ-39-SI at baseline was correlated to the change in PDQ-39-SI after 24 months in both treatment groups (p < 0.05). The higher the baseline score (worse QOL) the larger the improvement in QOL after 24 months. No correlation was found for any of the other baseline characteristics analyzed in either treatment group.ConclusionImpaired QOL as subjectively evaluated by the patient is the most important predictor of benefit in patients with PD and early motor complications, fulfilling objective gold standard inclusion criteria for STN-DBS. Our results prompt systematically including evaluation of disease-specific QOL when selecting patients with PD for STN-DBS.Clinicaltrials.gov identifierNCT00354133.

UR - http://www.scopus.com/inward/record.url?scp=85062422885&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000007037

DO - 10.1212/WNL.0000000000007037

M3 - Article

C2 - 30737338

AN - SCOPUS:85062422885

VL - 92

SP - E1109-E1120

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 10

ER -

Quality of life predicts outcome of deep brain stimulation in early Parkinson disease

Abstract

Access to Document

Fingerprint

Cite this