Objective: To compare the 60-months quality of life (QoL) effects of subthalamic stimulation (STN-DBS) to standard-of-care oral/transdermal medical therapy (MED) in Parkinson’s disease (PD).

Background: Little is known about long-term outcomes of STN-DBS on QoL in PD.

Method: Here, we report the 60-month follow-up of a prospective, observational, controlled, international multicenter study. Assessments included PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD (SCOPA)‑motor examination, ‑activities of daily living (ADL), and ‑complications, and levodopa-equivalent daily dose (LEDD). Propensity score matching identified a sub-cohort with balanced baseline characteristics between the STN-DBS and MED groups. We analyzed within-group longitudinal outcome changes using Wilcoxon signed-rank and between-group differences of change scores using Mann-Whitney U tests.

Results: Propensity score matching applied on 106 patients (STN-DBS n=60, MED n=46) resulted in a well-balanced sub-cohort including 25 patients per group. STN-DBS outcomes were favorable for motor complications and LEDD reduction. PDQ-8 and ADL worsened in the MED group only. Changes of PDQ-8 and ADL correlated.

Conclusion: This study provides Class IIb evidence that long-term STN-DBS resulted in stable QoL outcome. In the MED group, QoL worsened and this impairment was associated with worsened ADL outcomes at 60-month follow-up. This study highlights the importance of ADL for long-term QoL outcomes of surgical and conventional medical therapy of PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-prospective-controlled-study-of-subthalamic-stimulation-in-parkinsons-disease-quality-of-life-outcome-at-the-5-year-follow-up/