Category: Surgical Therapy: Parkinson's Disease
Objective: To assess differences in quality of life between Globus Pallidus internus (Gpi) or Subthalamic (STN) nucleus deep brain stimulation (DBS) in Parkinson’s Disease (PD) patients participating in the Parkinson’s Outcomes Project (POP) longitudinal study.
Background: STN or Gpi DBS are safe and effective treatments for management of PD motor complications, fluctuations and refractory tremor. Although DBS has been shown to improve quality of life (QoL), data comparing targets (STN vs GPi) or type of implantations (i.e., unilateral vs bilateral surgery) are limited. We aimed to analyze real world clinical practice data as part of the Parkinson’s Foundation Centers of Excellence longitudinal study to investigate potential differences between DBS targets.
Method: We analyzed available QoL data using the PD Quality of life questionnaires (PDQ-39) in 425 patients enrolled in the study who underwent DBS. We compared PDQ-39 scores preoperatively to last follow up available after surgery. The main outcomes were the absolute and percentage change in QoL from baseline. T-test, Chi-squared test or exact fisher test were used to compare patients’ characteristics across groups. Linear mixed effect models were used to adjust for age, disease duration, H&Y stage, number of comorbidities at baseline visit.
Results: The average number of years since diagnosis before surgery was 9 in both targets (9.07±8.76). After controlling for baseline age, disease duration, H&Y stage and number of comorbidities, no significant differences were seen between bilateral (28.41±14.75) and unilateral (25.41±15.68) procedures pre-op vs follow-up total PDQ39 scores (P value =0.0904). Similarly, no statistical differences in QoL were detected between the two targets on PDQ-39 total scores (P value= 0.1737); Gpi (30.10±14.71) and STN (27.48±15.45). Patients managed with STN DBS tended to have lower baseline PDQ-39 pain subscale scores than those in the Gpi group (p = 0.03).
Conclusion: No significant differences in QoL were seen between Gpi and STN or unilateral versus bilateral DBS surgery in our cohort.
To cite this abstract in AMA style:
A. Ramirez-Zamora, M. Rafferty, N. Dahodwala, M. Neault, A. Naito, J. Beck, R. de Leon, S. Wu, C. Marras, T. Thomas. Quality of life after Globus Pallidus vs Subthalamic nucleus DBS; insights from the Parkinson’s Outcomes Project registry. [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/quality-of-life-after-globus-pallidus-vs-subthalamic-nucleus-dbs-insights-from-the-parkinsons-outcomes-project-registry/. Accessed November 22, 2024.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/quality-of-life-after-globus-pallidus-vs-subthalamic-nucleus-dbs-insights-from-the-parkinsons-outcomes-project-registry/