Is improvement in the quality of life after subthalamic nucleus stimulation in Parkinson's disease predictable?
Identifieur interne : 000934 ( Main/Corpus ); précédent : 000933; suivant : 000935Is improvement in the quality of life after subthalamic nucleus stimulation in Parkinson's disease predictable?
Auteurs : Christine Daniels ; Paul Krack ; Jens Volkmann ; Jan Raethjen ; Markus O. Pinsker ; Manja Kloss ; Volker Tronnier ; Alfons Schnitzler ; Lars Wojtecki ; Kai Bötzel ; Adrian Danek ; Rüdiger Hilker ; Volker Sturm ; Andreas Kupsch ; Elfriede Karner ; Günther Deuschl ; Karsten WittSource :
- Movement Disorders [ 0885-3185 ] ; 2011-12.
English descriptors
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) significantly improves quality of life (QoL) in PD. However, QoL fails to improve in a relevant proportion of patients. We studied clinical baseline and progression parameters associated with improvement in QoL after DBS. Data from a German randomized, controlled study comparing DBS (60 patients) with best medical treatment (59 patients) were analyzed. Changes in patients' QoL were assessed using the Parkinson's Disease Questionnaire (PDQ‐39) at baseline and at the 6‐month follow‐up. For the STN‐DBS patients, the changes in PDQ‐39 were correlated with predefined clinical preoperative and progression parameters. Scores for QoL improved after STN‐DBS for 57% of the patients, and for 43% patients, they did not improve. Patients with improvement in QoL showed significantly higher cumulative daily “off” time. Changes in the PDQ‐39 showed a significant positive correlation with the cumulative daily off time at baseline. Logistic regression analysis revealed that 1 additional hour off time at baseline increases the odds for improvement on PDQ‐39 by a factor of 1.33 (odds ratio). In the postoperative course, changes in the PDQ‐39 significantly correlated with the reduction of cumulative daily off time, an improvement on the UPDRS (UPDRS III off), and positive mood changes. Among the baseline parameters, the cumulative daily off time is the strongest predictor for improvement in disease‐related QoL after DBS. Improvement in QoL after STN‐DBS is also correlated with changes in motor functions and changes in depression and anxiety. © 2011 Movement Disorder Society
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DOI: 10.1002/mds.23907
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xml:lang="en">Is improvement in the quality of life after subthalamic nucleus stimulation in Parkinson's disease predictable?</title><author><name sortKey="Daniels, Christine" sort="Daniels, Christine" uniqKey="Daniels C" first="Christine" last="Daniels">Christine Daniels</name><affiliation><mods:affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</mods:affiliation></affiliation></author><author><name sortKey="Krack, Paul" sort="Krack, Paul" uniqKey="Krack P" first="Paul" last="Krack">Paul Krack</name><affiliation><mods:affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</mods:affiliation></affiliation></author><author><name sortKey="Volkmann, Jens" sort="Volkmann, Jens" uniqKey="Volkmann J" first="Jens" last="Volkmann">Jens Volkmann</name><affiliation><mods:affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</mods:affiliation></affiliation></author><author><name sortKey="Raethjen, Jan" sort="Raethjen, Jan" uniqKey="Raethjen J" first="Jan" last="Raethjen">Jan Raethjen</name><affiliation><mods:affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</mods:affiliation></affiliation></author><author><name sortKey="Pinsker, Markus O" sort="Pinsker, Markus O" uniqKey="Pinsker M" first="Markus O." last="Pinsker">Markus O. Pinsker</name><affiliation><mods:affiliation>Department of Neurosurgery, Christian‐Albrechts‐University, Kiel, Germany</mods:affiliation></affiliation></author><author><name sortKey="Kloss, Manja" sort="Kloss, Manja" uniqKey="Kloss M" first="Manja" last="Kloss">Manja Kloss</name><affiliation><mods:affiliation>Department of Neurology, Heidelberg University, Heidelberg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Tronnier, Volker" sort="Tronnier, Volker" uniqKey="Tronnier V" first="Volker" last="Tronnier">Volker Tronnier</name><affiliation><mods:affiliation>Department of Neurosurgery, Heidelberg University, Heidelberg, Germany</mods:affiliation></affiliation></author><author><name sortKey="Schnitzler, Alfons" sort="Schnitzler, Alfons" uniqKey="Schnitzler A" first="Alfons" last="Schnitzler">Alfons Schnitzler</name><affiliation><mods:affiliation>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</mods:affiliation></affiliation></author><author><name sortKey="Wojtecki, Lars" sort="Wojtecki, Lars" uniqKey="Wojtecki L" first="Lars" last="Wojtecki">Lars Wojtecki</name><affiliation><mods:affiliation>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</mods:affiliation></affiliation></author><author><name sortKey="Botzel, Kai" sort="Botzel, Kai" uniqKey="Botzel K" first="Kai" last="Bötzel">Kai Bötzel</name><affiliation><mods:affiliation>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</mods:affiliation></affiliation></author><author><name sortKey="Danek, Adrian" sort="Danek, Adrian" uniqKey="Danek A" first="Adrian" last="Danek">Adrian Danek</name><affiliation><mods:affiliation>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</mods:affiliation></affiliation></author><author><name sortKey="Hilker, Rudiger" sort="Hilker, Rudiger" uniqKey="Hilker R" first="Rüdiger" last="Hilker">Rüdiger Hilker</name><affiliation><mods:affiliation>Department of Neurology, Cologne University, Cologne, Germany</mods:affiliation></affiliation></author><author><name sortKey="Sturm, Volker" sort="Sturm, Volker" uniqKey="Sturm V" first="Volker" last="Sturm">Volker Sturm</name><affiliation><mods:affiliation>Department of Neurosurgery, Cologne University, Cologne, Germany</mods:affiliation></affiliation></author><author><name sortKey="Kupsch, Andreas" sort="Kupsch, Andreas" uniqKey="Kupsch A" first="Andreas" last="Kupsch">Andreas Kupsch</name><affiliation><mods:affiliation>Department of Neurology, Charité Hospital, Humboldt University, Berlin, Germany</mods:affiliation></affiliation></author><author><name sortKey="Karner, Elfriede" sort="Karner, Elfriede" uniqKey="Karner E" first="Elfriede" last="Karner">Elfriede Karner</name><affiliation><mods:affiliation>Department of Neurology, Innsbruck Medical University, Innsbruck, Austria</mods:affiliation></affiliation></author><author><name sortKey="Deuschl, Gunther" sort="Deuschl, Gunther" uniqKey="Deuschl G" first="Günther" last="Deuschl">Günther Deuschl</name><affiliation><mods:affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</mods:affiliation></affiliation></author><author><name sortKey="Witt, Karsten" sort="Witt, Karsten" uniqKey="Witt K" first="Karsten" last="Witt">Karsten Witt</name><affiliation><mods:affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-12">2011-12</date><biblScope unit="volume">26</biblScope><biblScope unit="issue">14</biblScope><biblScope unit="page" from="2516">2516</biblScope><biblScope unit="page" to="2521">2521</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">A5E7E464341E6A4CAE24AA74AABD71E1210FB514</idno><idno type="DOI">10.1002/mds.23907</idno><idno type="ArticleID">MDS23907</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>deep brain stimulation</term><term>quality of life</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Deep brain stimulation (DBS) of the subthalamic nucleus (STN) significantly improves quality of life (QoL) in PD. However, QoL fails to improve in a relevant proportion of patients. We studied clinical baseline and progression parameters associated with improvement in QoL after DBS. Data from a German randomized, controlled study comparing DBS (60 patients) with best medical treatment (59 patients) were analyzed. Changes in patients' QoL were assessed using the Parkinson's Disease Questionnaire (PDQ‐39) at baseline and at the 6‐month follow‐up. For the STN‐DBS patients, the changes in PDQ‐39 were correlated with predefined clinical preoperative and progression parameters. Scores for QoL improved after STN‐DBS for 57% of the patients, and for 43% patients, they did not improve. Patients with improvement in QoL showed significantly higher cumulative daily “off” time. Changes in the PDQ‐39 showed a significant positive correlation with the cumulative daily off time at baseline. Logistic regression analysis revealed that 1 additional hour off time at baseline increases the odds for improvement on PDQ‐39 by a factor of 1.33 (odds ratio). In the postoperative course, changes in the PDQ‐39 significantly correlated with the reduction of cumulative daily off time, an improvement on the UPDRS (UPDRS III off), and positive mood changes. Among the baseline parameters, the cumulative daily off time is the strongest predictor for improvement in disease‐related QoL after DBS. Improvement in QoL after STN‐DBS is also correlated with changes in motor functions and changes in depression and anxiety. © 2011 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Christine Daniels MD</name><affiliations><json:string>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</json:string></affiliations></json:item><json:item><name>Paul Krack MD, PhD</name><affiliations><json:string>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</json:string></affiliations></json:item><json:item><name>Jens Volkmann MD, PhD</name><affiliations><json:string>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</json:string></affiliations></json:item><json:item><name>Jan Raethjen MD, PhD</name><affiliations><json:string>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</json:string></affiliations></json:item><json:item><name>Markus O. Pinsker MD, PhD</name><affiliations><json:string>Department of Neurosurgery, Christian‐Albrechts‐University, Kiel, Germany</json:string></affiliations></json:item><json:item><name>Manja Kloss MD</name><affiliations><json:string>Department of Neurology, Heidelberg University, Heidelberg, Germany</json:string></affiliations></json:item><json:item><name>Volker Tronnier MD, PhD</name><affiliations><json:string>Department of Neurosurgery, Heidelberg University, Heidelberg, Germany</json:string></affiliations></json:item><json:item><name>Alfons Schnitzler MD, PhD</name><affiliations><json:string>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</json:string></affiliations></json:item><json:item><name>Lars Wojtecki MD</name><affiliations><json:string>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</json:string></affiliations></json:item><json:item><name>Kai Bötzel MD, PhD</name><affiliations><json:string>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</json:string></affiliations></json:item><json:item><name>Adrian Danek MD, PhD</name><affiliations><json:string>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</json:string></affiliations></json:item><json:item><name>Rüdiger Hilker MD, PhD</name><affiliations><json:string>Department of Neurology, Cologne University, Cologne, Germany</json:string></affiliations></json:item><json:item><name>Volker Sturm MD, PhD</name><affiliations><json:string>Department of Neurosurgery, Cologne University, Cologne, Germany</json:string></affiliations></json:item><json:item><name>Andreas Kupsch MD, PhD</name><affiliations><json:string>Department of Neurology, Charité Hospital, Humboldt University, Berlin, Germany</json:string></affiliations></json:item><json:item><name>Elfriede Karner MPsych</name><affiliations><json:string>Department of Neurology, Innsbruck Medical University, Innsbruck, Austria</json:string></affiliations></json:item><json:item><name>Günther Deuschl MD, PhD</name><affiliations><json:string>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</json:string></affiliations></json:item><json:item><name>Karsten Witt MD, PhD</name><affiliations><json:string>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>deep brain stimulation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>quality of life</value></json:item></subject><articleId><json:string>MDS23907</json:string></articleId><language><json:string>eng</json:string></language><abstract>Deep brain stimulation (DBS) of the subthalamic nucleus (STN) significantly improves quality of life (QoL) in PD. However, QoL fails to improve in a relevant proportion of patients. We studied clinical baseline and progression parameters associated with improvement in QoL after DBS. Data from a German randomized, controlled study comparing DBS (60 patients) with best medical treatment (59 patients) were analyzed. Changes in patients' QoL were assessed using the Parkinson's Disease Questionnaire (PDQ‐39) at baseline and at the 6‐month follow‐up. For the STN‐DBS patients, the changes in PDQ‐39 were correlated with predefined clinical preoperative and progression parameters. Scores for QoL improved after STN‐DBS for 57% of the patients, and for 43% patients, they did not improve. Patients with improvement in QoL showed significantly higher cumulative daily “off” time. Changes in the PDQ‐39 showed a significant positive correlation with the cumulative daily off time at baseline. Logistic regression analysis revealed that 1 additional hour off time at baseline increases the odds for improvement on PDQ‐39 by a factor of 1.33 (odds ratio). In the postoperative course, changes in the PDQ‐39 significantly correlated with the reduction of cumulative daily off time, an improvement on the UPDRS (UPDRS III off), and positive mood changes. Among the baseline parameters, the cumulative daily off time is the strongest predictor for improvement in disease‐related QoL after DBS. Improvement in QoL after STN‐DBS is also correlated with changes in motor functions and changes in depression and anxiety. © 2011 Movement Disorder Society</abstract><qualityIndicators><score>6.477</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 810 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>3</keywordCount><abstractCharCount>1641</abstractCharCount><pdfWordCount>3537</pdfWordCount><pdfCharCount>21959</pdfCharCount><pdfPageCount>6</pdfPageCount><abstractWordCount>245</abstractWordCount></qualityIndicators><title>Is improvement in the quality of life after subthalamic nucleus stimulation in Parkinson's disease predictable?</title><genre><json:string>article</json:string></genre><host><volume>26</volume><publisherId><json:string>MDS</json:string></publisherId><pages><total>6</total><last>2521</last><first>2516</first></pages><issn><json:string>0885-3185</json:string></issn><issue>14</issue><subject><json:item><value>Research Article</value></json:item></subject><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1531-8257</json:string></eissn><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2011</publicationDate><copyrightDate>2011</copyrightDate><doi><json:string>10.1002/mds.23907</json:string></doi><id>A5E7E464341E6A4CAE24AA74AABD71E1210FB514</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/A5E7E464341E6A4CAE24AA74AABD71E1210FB514/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/A5E7E464341E6A4CAE24AA74AABD71E1210FB514/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/A5E7E464341E6A4CAE24AA74AABD71E1210FB514/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Is improvement in the quality of life after subthalamic nucleus stimulation in Parkinson's disease predictable?</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2011</date></publicationStmt><notesStmt><note type="content">*Funding agencies: This study was supported by the Parkinson Foundation Europe and the German Ministry of Research and Technology (01GI0201) Kompetenznetz Parkinson, TP3.</note><note type="content">*Relevant conflicts of interest/financial disclosures: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</note><note type="content">*Full financial disclosures and author roles may be found in the online version of this article.</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Is improvement in the quality of life after subthalamic nucleus stimulation in Parkinson's disease predictable?</title><author><persName><forename type="first">Christine</forename><surname>Daniels</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation></author><author><persName><forename type="first">Paul</forename><surname>Krack</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation></author><author><persName><forename type="first">Jens</forename><surname>Volkmann</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation></author><author><persName><forename type="first">Jan</forename><surname>Raethjen</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation></author><author><persName><forename type="first">Markus O.</forename><surname>Pinsker</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neurosurgery, Christian‐Albrechts‐University, Kiel, Germany</affiliation></author><author><persName><forename type="first">Manja</forename><surname>Kloss</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, Heidelberg University, Heidelberg, Germany</affiliation></author><author><persName><forename type="first">Volker</forename><surname>Tronnier</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neurosurgery, Heidelberg University, Heidelberg, Germany</affiliation></author><author><persName><forename type="first">Alfons</forename><surname>Schnitzler</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</affiliation></author><author><persName><forename type="first">Lars</forename><surname>Wojtecki</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</affiliation></author><author><persName><forename type="first">Kai</forename><surname>Bötzel</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</affiliation></author><author><persName><forename type="first">Adrian</forename><surname>Danek</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</affiliation></author><author><persName><forename type="first">Rüdiger</forename><surname>Hilker</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neurology, Cologne University, Cologne, Germany</affiliation></author><author><persName><forename type="first">Volker</forename><surname>Sturm</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neurosurgery, Cologne University, Cologne, Germany</affiliation></author><author><persName><forename type="first">Andreas</forename><surname>Kupsch</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neurology, Charité Hospital, Humboldt University, Berlin, Germany</affiliation></author><author><persName><forename type="first">Elfriede</forename><surname>Karner</surname></persName><roleName type="degree">MPsych</roleName><affiliation>Department of Neurology, Innsbruck Medical University, Innsbruck, Austria</affiliation></author><author><persName><forename type="first">Günther</forename><surname>Deuschl</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation></author><author><persName><forename type="first">Karsten</forename><surname>Witt</surname></persName><roleName type="degree">MD, PhD</roleName><note type="correspondence"><p>Correspondence: Department of Neurology, University of Schleswig‐Holstein, Campus Kiel, Schittenhelmstrasse 10, D‐24105 Kiel, Germany</p></note><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-12"></date><biblScope unit="volume">26</biblScope><biblScope unit="issue">14</biblScope><biblScope unit="page" from="2516">2516</biblScope><biblScope unit="page" to="2521">2521</biblScope></imprint></monogr><idno type="istex">A5E7E464341E6A4CAE24AA74AABD71E1210FB514</idno><idno type="DOI">10.1002/mds.23907</idno><idno type="ArticleID">MDS23907</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2011</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Deep brain stimulation (DBS) of the subthalamic nucleus (STN) significantly improves quality of life (QoL) in PD. However, QoL fails to improve in a relevant proportion of patients. We studied clinical baseline and progression parameters associated with improvement in QoL after DBS. Data from a German randomized, controlled study comparing DBS (60 patients) with best medical treatment (59 patients) were analyzed. Changes in patients' QoL were assessed using the Parkinson's Disease Questionnaire (PDQ‐39) at baseline and at the 6‐month follow‐up. For the STN‐DBS patients, the changes in PDQ‐39 were correlated with predefined clinical preoperative and progression parameters. Scores for QoL improved after STN‐DBS for 57% of the patients, and for 43% patients, they did not improve. Patients with improvement in QoL showed significantly higher cumulative daily “off” time. Changes in the PDQ‐39 showed a significant positive correlation with the cumulative daily off time at baseline. Logistic regression analysis revealed that 1 additional hour off time at baseline increases the odds for improvement on PDQ‐39 by a factor of 1.33 (odds ratio). In the postoperative course, changes in the PDQ‐39 significantly correlated with the reduction of cumulative daily off time, an improvement on the UPDRS (UPDRS III off), and positive mood changes. Among the baseline parameters, the cumulative daily off time is the strongest predictor for improvement in disease‐related QoL after DBS. Improvement in QoL after STN‐DBS is also correlated with changes in motor functions and changes in depression and anxiety. © 2011 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>deep brain stimulation</term></item><item><term>quality of life</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-02-26">Received</change><change when="2011-07-15">Registration</change><change when="2011-12">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/A5E7E464341E6A4CAE24AA74AABD71E1210FB514/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. 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href="file:MDS.MDS23907.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="3"></count><count type="referenceTotal" number="15"></count><count type="wordTotal" number="5154"></count></countGroup><titleGroup><title type="main" xml:lang="en">Is improvement in the quality of life after subthalamic nucleus stimulation in Parkinson's disease predictable?<link href="#fn5"></link><link href="#fn6"></link><link href="#fn7"></link></title><title type="short" xml:lang="en">Quality of Life After DBS in PD</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Christine</givenNames><familyName>Daniels</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Paul</givenNames><familyName>Krack</familyName><degrees>MD, 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Neurology, Heinrich Heine University, Dusseldorf, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af7" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurology, Cologne University, Cologne, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af8" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurosurgery, Cologne University, Cologne, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af9" countryCode="DE" type="organization"><unparsedAffiliation>Department of Neurology, Charité Hospital, Humboldt University, Berlin, Germany</unparsedAffiliation></affiliation><affiliation xml:id="af10" countryCode="AT" type="organization"><unparsedAffiliation>Department of Neurology, Innsbruck Medical University, Innsbruck, Austria</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword><keyword xml:id="kwd2">deep brain stimulation</keyword><keyword xml:id="kwd3">quality of life</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Deep brain stimulation (DBS) of the subthalamic nucleus (STN) significantly improves quality of life (QoL) in PD. However, QoL fails to improve in a relevant proportion of patients. We studied clinical baseline and progression parameters associated with improvement in QoL after DBS. Data from a German randomized, controlled study comparing DBS (60 patients) with best medical treatment (59 patients) were analyzed. Changes in patients' QoL were assessed using the Parkinson's Disease Questionnaire (PDQ‐39) at baseline and at the 6‐month follow‐up. For the STN‐DBS patients, the changes in PDQ‐39 were correlated with predefined clinical preoperative and progression parameters. Scores for QoL improved after STN‐DBS for 57% of the patients, and for 43% patients, they did not improve. Patients with improvement in QoL showed significantly higher cumulative daily “off” time. Changes in the PDQ‐39 showed a significant positive correlation with the cumulative daily off time at baseline. Logistic regression analysis revealed that 1 additional hour off time at baseline increases the odds for improvement on PDQ‐39 by a factor of 1.33 (odds ratio). In the postoperative course, changes in the PDQ‐39 significantly correlated with the reduction of cumulative daily off time, an improvement on the UPDRS (UPDRS III off), and positive mood changes. Among the baseline parameters, the cumulative daily off time is the strongest predictor for improvement in disease‐related QoL after DBS. Improvement in QoL after STN‐DBS is also correlated with changes in motor functions and changes in depression and anxiety. © 2011 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn5"><p><b>Funding agencies:</b> This study was supported by the Parkinson Foundation Europe and the German Ministry of Research and Technology (01GI0201) Kompetenznetz Parkinson, TP3.</p></note><note xml:id="fn6"><p><b>Relevant conflicts of interest/financial disclosures:</b> Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</p></note><note xml:id="fn7"><p>Full financial disclosures and author roles may be found in the online version of this article.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Is improvement in the quality of life after subthalamic nucleus stimulation in Parkinson's disease predictable?</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Quality of Life After DBS in PD</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Is improvement in the quality of life after subthalamic nucleus stimulation in Parkinson's disease predictable?</title></titleInfo><name type="personal"><namePart type="given">Christine</namePart><namePart type="family">Daniels</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, 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type="given">Alfons</namePart><namePart type="family">Schnitzler</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lars</namePart><namePart type="family">Wojtecki</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Heinrich Heine University, Dusseldorf, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kai</namePart><namePart type="family">Bötzel</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Adrian</namePart><namePart type="family">Danek</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Ludwig‐Maximilians‐University, Munich, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Rüdiger</namePart><namePart type="family">Hilker</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Cologne University, Cologne, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Volker</namePart><namePart type="family">Sturm</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurosurgery, Cologne University, Cologne, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Andreas</namePart><namePart type="family">Kupsch</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Charité Hospital, Humboldt University, Berlin, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Elfriede</namePart><namePart type="family">Karner</namePart><namePart type="termsOfAddress">MPsych</namePart><affiliation>Department of Neurology, Innsbruck Medical University, Innsbruck, Austria</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Günther</namePart><namePart type="family">Deuschl</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Karsten</namePart><namePart type="family">Witt</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurology, Christian‐Albrechts‐University, Kiel, Germany</affiliation><description>Correspondence: Department of Neurology, University of Schleswig‐Holstein, Campus Kiel, Schittenhelmstrasse 10, D‐24105 Kiel, Germany</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2011-12</dateIssued><dateCaptured encoding="w3cdtf">2010-02-26</dateCaptured><dateValid encoding="w3cdtf">2011-07-15</dateValid><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">3</extent><extent unit="references">15</extent><extent unit="words">5154</extent></physicalDescription><abstract lang="en">Deep brain stimulation (DBS) of the subthalamic nucleus (STN) significantly improves quality of life (QoL) in PD. However, QoL fails to improve in a relevant proportion of patients. We studied clinical baseline and progression parameters associated with improvement in QoL after DBS. Data from a German randomized, controlled study comparing DBS (60 patients) with best medical treatment (59 patients) were analyzed. Changes in patients' QoL were assessed using the Parkinson's Disease Questionnaire (PDQ‐39) at baseline and at the 6‐month follow‐up. For the STN‐DBS patients, the changes in PDQ‐39 were correlated with predefined clinical preoperative and progression parameters. Scores for QoL improved after STN‐DBS for 57% of the patients, and for 43% patients, they did not improve. Patients with improvement in QoL showed significantly higher cumulative daily “off” time. Changes in the PDQ‐39 showed a significant positive correlation with the cumulative daily off time at baseline. Logistic regression analysis revealed that 1 additional hour off time at baseline increases the odds for improvement on PDQ‐39 by a factor of 1.33 (odds ratio). In the postoperative course, changes in the PDQ‐39 significantly correlated with the reduction of cumulative daily off time, an improvement on the UPDRS (UPDRS III off), and positive mood changes. Among the baseline parameters, the cumulative daily off time is the strongest predictor for improvement in disease‐related QoL after DBS. Improvement in QoL after STN‐DBS is also correlated with changes in motor functions and changes in depression and anxiety. © 2011 Movement Disorder Society</abstract><note type="content">*Funding agencies: This study was supported by the Parkinson Foundation Europe and the German Ministry of Research and Technology (01GI0201) Kompetenznetz Parkinson, TP3.</note><note type="content">*Relevant conflicts of interest/financial disclosures: Drs. Bötzel, Deuschl, Krack, Krause, Kupsch, Pinsker, Schnitzler, Sturm, Tronnier, Volkmann, and Wojtecki report having received speaking fees from Medtronic; Drs. Deuschl, Tronnier, Volkmann, and Wojtecki report having received consulting fees from Medtronic; Drs. Deuschl, Kupsch, Krause, Krack, and Volkmann report having received research grants from Medtronic; and Dr. Sturm reports owning stock options from Medtronic. No other potential conflict of interest relevant to this article was reported.</note><note type="content">*Full financial disclosures and author roles may be found in the online version of this article.</note><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>deep brain stimulation</topic><topic>quality of life</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2011</date><detail type="volume"><caption>vol.</caption><number>26</number></detail><detail type="issue"><caption>no.</caption><number>14</number></detail><extent unit="pages"><start>2516</start><end>2521</end><total>6</total></extent></part></relatedItem><identifier type="istex">A5E7E464341E6A4CAE24AA74AABD71E1210FB514</identifier><identifier type="DOI">10.1002/mds.23907</identifier><identifier type="ArticleID">MDS23907</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2011 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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