Stefanie T Jost1, K Ray Chaudhuri2,3, Keyoumars Ashkan2, Philipp A Loehrer4, Monty Silverdale5, Alexandra Rizos2, Julian Evans5, Jan Niklas Petry-Schmelzer1, Michael T Barbe1, Anna Sauerbier1,3, Gereon R Fink1,6, Veerle Visser-Vandewalle7, Angelo Antonini8, Pablo Martinez-Martin9, Lars Timmermann4, Haidar S Dafsari1. 1. Department of Neurology, University Hospital of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. 2. Parkinson Foundation International Centre of Excellence, King's College Hospital, London, UK. 3. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 4. Department of Neurology, University Hospital Giessen and Marburg, Campus Marburg, Marburg, Germany. 5. Department of Neurology and Neurosurgery, Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, University of Manchester, Greater Manchester, UK. 6. Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Centre Jülich, Jülich, Germany. 7. Department of Stereotaxy and Functional Neurosurgery, University Hospital of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. 8. Department of Neurosciences (DNS), Padova University, Padova, Italy. 9. Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain.
Abstract
BACKGROUND: Sleep disturbances and neuropsychiatric symptoms are some of the most common nonmotor symptoms in Parkinson's disease (PD). The effect of subthalamic stimulation (STN-DBS) on these symptoms beyond a short-term follow-up is unclear. OBJECTIVE: To examine 36-month effects of bilateral STN-DBS on quality of sleep, depression, anxiety, and quality of life (QoL) compared to standard-of-care medical therapy (MED) in PD. METHODS: In this prospective, controlled, observational, propensity score matched, international multicenter study, we assessed sleep disturbances using the PDSleep Scale-1 (PDSS), QoL employing the PDQuestionnaire-8 (PDQ-8), motor disorder with the Scales for Outcomes in PD (SCOPA), anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and dopaminergic medication requirements (LEDD). Within-group longitudinal outcome changes were tested using Wilcoxon signed-rank and between-group longitudinal differences of change scores with Mann-Whitney U tests. Spearman correlations analyzed the relationships of outcome parameter changes at follow-up. RESULTS: Propensity score matching applied on 159 patients (STN-DBS n = 75, MED n = 84) resulted in 40 patients in each treatment group. At 36-month follow-up, STN-DBS led to significantly better PDSS and PDQ-8 change scores, which were significantly correlated. We observed no significant effects for HADS and no significant correlations between change scores in PDSS, HADS, and LEDD. CONCLUSIONS: We report Class IIb evidence of beneficial effects of STN-DBS on quality of sleep at 36-month follow-up, which were associated with QoL improvement independent of depression and dopaminergic medication. Our study highlights the importance of sleep for assessments of DBS outcomes.
BACKGROUND: Sleep disturbances and neuropsychiatric symptoms are some of the most common nonmotor symptoms in Parkinson's disease (PD). The effect of subthalamic stimulation (STN-DBS) on these symptoms beyond a short-term follow-up is unclear. OBJECTIVE: To examine 36-month effects of bilateral STN-DBS on quality of sleep, depression, anxiety, and quality of life (QoL) compared to standard-of-care medical therapy (MED) in PD. METHODS: In this prospective, controlled, observational, propensity score matched, international multicenter study, we assessed sleep disturbances using the PDSleep Scale-1 (PDSS), QoL employing the PDQuestionnaire-8 (PDQ-8), motor disorder with the Scales for Outcomes in PD (SCOPA), anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and dopaminergic medication requirements (LEDD). Within-group longitudinal outcome changes were tested using Wilcoxon signed-rank and between-group longitudinal differences of change scores with Mann-Whitney U tests. Spearman correlations analyzed the relationships of outcome parameter changes at follow-up. RESULTS: Propensity score matching applied on 159 patients (STN-DBS n = 75, MED n = 84) resulted in 40 patients in each treatment group. At 36-month follow-up, STN-DBS led to significantly better PDSS and PDQ-8 change scores, which were significantly correlated. We observed no significant effects for HADS and no significant correlations between change scores in PDSS, HADS, and LEDD. CONCLUSIONS: We report Class IIb evidence of beneficial effects of STN-DBS on quality of sleep at 36-month follow-up, which were associated with QoL improvement independent of depression and dopaminergic medication. Our study highlights the importance of sleep for assessments of DBS outcomes.
Entities:
Keywords:
Deep brain stimulation; nonmotor symptoms; quality of life; sleep dysfunction; subthalamic nucleus
Authors: Stefanie T Jost; Veerle Visser-Vandewalle; Alexandra Rizos; Philipp A Loehrer; Monty Silverdale; Julian Evans; Michael Samuel; Jan Niklas Petry-Schmelzer; Anna Sauerbier; Alexandra Gronostay; Michael T Barbe; Gereon R Fink; Keyoumars Ashkan; Angelo Antonini; Pablo Martinez-Martin; K Ray Chaudhuri; Lars Timmermann; Haidar S Dafsari Journal: NPJ Parkinsons Dis Date: 2021-06-08
Authors: Stefanie T Jost; Lena Strobel; Alexandra Rizos; Philipp A Loehrer; Keyoumars Ashkan; Julian Evans; Franz Rosenkranz; Michael T Barbe; Gereon R Fink; Jeremy Franklin; Anna Sauerbier; Christopher Nimsky; Afsar Sattari; K Ray Chaudhuri; Angelo Antonini; Lars Timmermann; Pablo Martinez-Martin; Monty Silverdale; Elke Kalbe; Veerle Visser-Vandewalle; Haidar S Dafsari Journal: NPJ Parkinsons Dis Date: 2022-04-20
Authors: Anna Sauerbier; Philipp Loehrer; Stefanie T Jost; Shania Heil; Jan N Petry-Schmelzer; Johanna Herberg; Pia Bachon; Salima Aloui; Alexandra Gronostay; Lisa Klingelhoefer; J Carlos Baldermann; Daniel Huys; Christopher Nimsky; Michael T Barbe; Gereon R Fink; Pablo Martinez-Martin; K Ray Chaudhuri; Veerle Visser-Vandewalle; Lars Timmermann; Daniel Weintraub; Haidar S Dafsari Journal: J Neurol Neurosurg Psychiatry Date: 2021-09-11 Impact factor: 10.154