Only physical aspects of quality of life are significantly improved by bilateral subthalamic stimulation in Parkinson's disease
Identifieur interne : 000B08 ( PascalFrancis/Checkpoint ); précédent : 000B07; suivant : 000B09Only physical aspects of quality of life are significantly improved by bilateral subthalamic stimulation in Parkinson's disease
Auteurs : Sophie Drapier [France] ; Sylvie Raoul [France] ; Dominique Drapier [France] ; Emmanuelle Leray [France] ; Francois Lallement [France] ; Isabelle Rivier [France] ; Paul Sauleau [France] ; Youen Lajat [France] ; Gilles Edan [France] ; Marc Verin [France]Source :
- Journal of neurology [ 0340-5354 ] ; 2005.
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Abstract
Background The well known global improvement of quality of life (QoL) after bilateral high frequency chronic deep brain stimulation of the subthalamic nucleus (STN DBS) in Parkinson's disease (PD) is in contrast to behavioral disturbances as observed after surgery. Indeed the impact of DBS on physical versus mental aspects of QoL in PD remains unknown. Objective To assess the influence of bilateral STN DBS on physical versus mental aspects of QoL in Parkinson's disease. Methods The results of 27 patients for the Unified Parkinson's disease Rating Scale (UPDRS), Parkinson's Disease Questionnaire 39 (PDQ39) and Short Form 36 health survey questionnaire (SF36) were compared before surgery and after 12 months of bilateral STN DBS. Results Comparing off-dopa conditions before versus 12 months after surgery, both UPDRS part II and part III significantly improved: 32.6 % and 52%, respectively. UPDRS part I scores did not change significantly at 12 months. As for PDQ39, the global score significantly improved after surgery (21.1 %) as did four subscores: mobility (25.6 %), activity of daily living (34.5 %), stigma (40.1 %) and bodily discomfort (30%). Three PDQ39 subscores, however, showed no significant changes: emotional well-being (10.7%), social support (3.2%) and cognition (8.5%) and one item even worsened: communication (-7.7%). In SF36, only physical items significantly improved. Conclusion Using clinician's based rating scale, bilateral STN DBS showed significant improvement in PD patients at 12 month follow up. However, using patient's self-assessment scales, the clinical benefit of STN DBS was more subtle: physical items of QoL significantly improved, whereas mental items such as emotional well-being, social support, cognition and communication showed no improvement. Our results are suggestive of a dissociation of motor and non-motor symptoms control after bilateral STN DBS in PD patients.
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type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Rivier, Isabelle" sort="Rivier, Isabelle" uniqKey="Rivier I" first="Isabelle" last="Rivier">Isabelle Rivier</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology Medical University</s1><s2>Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Région Bretagne</region><region type="old region">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Sauleau, Paul" sort="Sauleau, Paul" uniqKey="Sauleau P" first="Paul" last="Sauleau">Paul Sauleau</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology Medical University</s1><s2>Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 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type="wicri:source">INIST</idno><idno type="inist">05-0239560</idno><date when="2005">2005</date><idno type="stanalyst">PASCAL 05-0239560 INIST</idno><idno type="RBID">Pascal:05-0239560</idno><idno type="wicri:Area/PascalFrancis/Corpus">000C94</idno><idno type="wicri:Area/PascalFrancis/Curation">000740</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000B08</idno><idno type="wicri:explorRef" wicri:stream="PascalFrancis" wicri:step="Checkpoint">000B08</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Only physical aspects of quality of life are significantly improved by bilateral subthalamic stimulation in Parkinson's disease</title><author><name sortKey="Drapier, Sophie" sort="Drapier, Sophie" uniqKey="Drapier S" first="Sophie" last="Drapier">Sophie Drapier</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology Medical University</s1><s2>Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Région Bretagne</region><region type="old region">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Raoul, Sylvie" sort="Raoul, Sylvie" uniqKey="Raoul S" first="Sylvie" last="Raoul">Sylvie Raoul</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Neurosurgery Medical University</s1><s2>Nantes</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Pays de la Loire</region><region type="old region">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation></author><author><name sortKey="Drapier, Dominique" sort="Drapier, Dominique" uniqKey="Drapier D" first="Dominique" last="Drapier">Dominique Drapier</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Department of Psychiatry Medical University</s1><s2>Rennes</s2><s3>FRA</s3><sZ>3 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Région Bretagne</region><region type="old region">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Leray, Emmanuelle" sort="Leray, Emmanuelle" uniqKey="Leray E" first="Emmanuelle" last="Leray">Emmanuelle Leray</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology Medical University</s1><s2>Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Région Bretagne</region><region type="old region">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Lallement, Francois" sort="Lallement, Francois" uniqKey="Lallement F" first="Francois" last="Lallement">Francois Lallement</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology Medical University</s1><s2>Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Région Bretagne</region><region type="old region">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Rivier, Isabelle" sort="Rivier, Isabelle" uniqKey="Rivier I" first="Isabelle" last="Rivier">Isabelle Rivier</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology Medical University</s1><s2>Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Région Bretagne</region><region type="old region">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Sauleau, Paul" sort="Sauleau, Paul" uniqKey="Sauleau P" first="Paul" last="Sauleau">Paul Sauleau</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology Medical University</s1><s2>Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Région Bretagne</region><region type="old region">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Lajat, Youen" sort="Lajat, Youen" uniqKey="Lajat Y" first="Youen" last="Lajat">Youen Lajat</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Neurosurgery Medical University</s1><s2>Nantes</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Pays de la Loire</region><region type="old region">Pays de la Loire</region><settlement type="city">Nantes</settlement></placeName></affiliation></author><author><name sortKey="Edan, Gilles" sort="Edan, Gilles" uniqKey="Edan G" first="Gilles" last="Edan">Gilles Edan</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology Medical University</s1><s2>Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Région Bretagne</region><region type="old region">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author><author><name sortKey="Verin, Marc" sort="Verin, Marc" uniqKey="Verin M" first="Marc" last="Verin">Marc Verin</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology Medical University</s1><s2>Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Région Bretagne</region><region type="old region">Région Bretagne</region><settlement type="city">Rennes</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">Journal of neurology</title><title level="j" type="abbreviated">J. neurol.</title><idno type="ISSN">0340-5354</idno><imprint><date when="2005">2005</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of neurology</title><title level="j" type="abbreviated">J. neurol.</title><idno type="ISSN">0340-5354</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Deep brain stimulation</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Quality of life</term><term>Subthalamic nucleus</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term><term>Qualité vie</term><term>Noyau sousthalamique</term><term>Parkinson maladie</term><term>Stimulation cérébrale profonde</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background The well known global improvement of quality of life (QoL) after bilateral high frequency chronic deep brain stimulation of the subthalamic nucleus (STN DBS) in Parkinson's disease (PD) is in contrast to behavioral disturbances as observed after surgery. Indeed the impact of DBS on physical versus mental aspects of QoL in PD remains unknown. Objective To assess the influence of bilateral STN DBS on physical versus mental aspects of QoL in Parkinson's disease. Methods The results of 27 patients for the Unified Parkinson's disease Rating Scale (UPDRS), Parkinson's Disease Questionnaire 39 (PDQ39) and Short Form 36 health survey questionnaire (SF36) were compared before surgery and after 12 months of bilateral STN DBS. Results Comparing off-dopa conditions before versus 12 months after surgery, both UPDRS part II and part III significantly improved: 32.6 % and 52%, respectively. UPDRS part I scores did not change significantly at 12 months. As for PDQ39, the global score significantly improved after surgery (21.1 %) as did four subscores: mobility (25.6 %), activity of daily living (34.5 %), stigma (40.1 %) and bodily discomfort (30%). Three PDQ39 subscores, however, showed no significant changes: emotional well-being (10.7%), social support (3.2%) and cognition (8.5%) and one item even worsened: communication (-7.7%). In SF36, only physical items significantly improved. Conclusion Using clinician's based rating scale, bilateral STN DBS showed significant improvement in PD patients at 12 month follow up. However, using patient's self-assessment scales, the clinical benefit of STN DBS was more subtle: physical items of QoL significantly improved, whereas mental items such as emotional well-being, social support, cognition and communication showed no improvement. Our results are suggestive of a dissociation of motor and non-motor symptoms control after bilateral STN DBS in PD patients.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0340-5354</s0></fA01><fA02 i1="01"><s0>JNRYA9</s0></fA02><fA03 i2="1"><s0>J. neurol.</s0></fA03><fA05><s2>252</s2></fA05><fA06><s2>5</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Only physical aspects of quality of life are significantly improved by bilateral subthalamic stimulation in Parkinson's disease</s1></fA08><fA11 i1="01" i2="1"><s1>DRAPIER (Sophie)</s1></fA11><fA11 i1="02" i2="1"><s1>RAOUL (Sylvie)</s1></fA11><fA11 i1="03" i2="1"><s1>DRAPIER (Dominique)</s1></fA11><fA11 i1="04" i2="1"><s1>LERAY (Emmanuelle)</s1></fA11><fA11 i1="05" i2="1"><s1>LALLEMENT (Francois)</s1></fA11><fA11 i1="06" i2="1"><s1>RIVIER (Isabelle)</s1></fA11><fA11 i1="07" i2="1"><s1>SAULEAU (Paul)</s1></fA11><fA11 i1="08" i2="1"><s1>LAJAT (Youen)</s1></fA11><fA11 i1="09" i2="1"><s1>EDAN (Gilles)</s1></fA11><fA11 i1="10" i2="1"><s1>VERIN (Marc)</s1></fA11><fA14 i1="01"><s1>Department of Neurology Medical University</s1><s2>Rennes</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>9 aut.</sZ><sZ>10 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Neurosurgery Medical University</s1><s2>Nantes</s2><s3>FRA</s3><sZ>2 aut.</sZ><sZ>8 aut.</sZ></fA14><fA14 i1="03"><s1>Department of Psychiatry Medical University</s1><s2>Rennes</s2><s3>FRA</s3><sZ>3 aut.</sZ></fA14><fA20><s1>583-588</s1></fA20><fA21><s1>2005</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>4826</s2><s5>354000125399880110</s5></fA43><fA44><s0>0000</s0><s1>© 2005 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>31 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>05-0239560</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Journal of neurology</s0></fA64><fA66 i1="01"><s0>DEU</s0></fA66><fC01 i1="01" l="ENG"><s0>Background The well known global improvement of quality of life (QoL) after bilateral high frequency chronic deep brain stimulation of the subthalamic nucleus (STN DBS) in Parkinson's disease (PD) is in contrast to behavioral disturbances as observed after surgery. Indeed the impact of DBS on physical versus mental aspects of QoL in PD remains unknown. Objective To assess the influence of bilateral STN DBS on physical versus mental aspects of QoL in Parkinson's disease. Methods The results of 27 patients for the Unified Parkinson's disease Rating Scale (UPDRS), Parkinson's Disease Questionnaire 39 (PDQ39) and Short Form 36 health survey questionnaire (SF36) were compared before surgery and after 12 months of bilateral STN DBS. Results Comparing off-dopa conditions before versus 12 months after surgery, both UPDRS part II and part III significantly improved: 32.6 % and 52%, respectively. UPDRS part I scores did not change significantly at 12 months. As for PDQ39, the global score significantly improved after surgery (21.1 %) as did four subscores: mobility (25.6 %), activity of daily living (34.5 %), stigma (40.1 %) and bodily discomfort (30%). Three PDQ39 subscores, however, showed no significant changes: emotional well-being (10.7%), social support (3.2%) and cognition (8.5%) and one item even worsened: communication (-7.7%). In SF36, only physical items significantly improved. Conclusion Using clinician's based rating scale, bilateral STN DBS showed significant improvement in PD patients at 12 month follow up. However, using patient's self-assessment scales, the clinical benefit of STN DBS was more subtle: physical items of QoL significantly improved, whereas mental items such as emotional well-being, social support, cognition and communication showed no improvement. Our results are suggestive of a dissociation of motor and non-motor symptoms control after bilateral STN DBS in PD patients.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17G</s0></fC02><fC02 i1="03" i2="X"><s0>002B17F</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Système nerveux pathologie</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Qualité vie</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Quality of life</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Calidad vida</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Noyau sousthalamique</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Subthalamic nucleus</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Núcleo subtalámico</s0><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Parkinson maladie</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Parkinson disease</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s5>04</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Stimulation cérébrale profonde</s0><s4>CD</s4><s5>96</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Deep brain stimulation</s0><s4>CD</s4><s5>96</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Encéphale pathologie</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Extrapyramidal syndrome</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Système nerveux central pathologie</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Système nerveux central</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Central nervous system</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Sistema nervioso central</s0><s5>41</s5></fC07><fN21><s1>164</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>France</li></country><region><li>Pays de la Loire</li><li>Région Bretagne</li></region><settlement><li>Nantes</li><li>Rennes</li></settlement></list><tree><country name="France"><region name="Région Bretagne"><name sortKey="Drapier, Sophie" sort="Drapier, Sophie" uniqKey="Drapier S" first="Sophie" last="Drapier">Sophie Drapier</name></region><name sortKey="Drapier, Dominique" sort="Drapier, Dominique" uniqKey="Drapier D" first="Dominique" last="Drapier">Dominique Drapier</name><name sortKey="Edan, Gilles" sort="Edan, Gilles" uniqKey="Edan G" first="Gilles" last="Edan">Gilles Edan</name><name sortKey="Lajat, Youen" sort="Lajat, Youen" uniqKey="Lajat Y" first="Youen" last="Lajat">Youen Lajat</name><name sortKey="Lallement, Francois" sort="Lallement, Francois" uniqKey="Lallement F" first="Francois" last="Lallement">Francois Lallement</name><name sortKey="Leray, Emmanuelle" sort="Leray, Emmanuelle" uniqKey="Leray E" first="Emmanuelle" last="Leray">Emmanuelle Leray</name><name sortKey="Raoul, Sylvie" sort="Raoul, Sylvie" uniqKey="Raoul S" first="Sylvie" last="Raoul">Sylvie Raoul</name><name sortKey="Rivier, Isabelle" sort="Rivier, Isabelle" uniqKey="Rivier I" first="Isabelle" last="Rivier">Isabelle Rivier</name><name sortKey="Sauleau, Paul" sort="Sauleau, Paul" uniqKey="Sauleau P" first="Paul" last="Sauleau">Paul Sauleau</name><name sortKey="Verin, Marc" sort="Verin, Marc" uniqKey="Verin M" first="Marc" last="Verin">Marc Verin</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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