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 journalArticlepeer-review

64 Scopus citations


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 languageEnglish
Pages (from-to)E1109-E1120
Issue number10
StatePublished - 5 Mar 2019
Externally publishedYes


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