Objective: To study the long-term effects of bilateral subthalamic deep brain stimulation (STN-DBS) on Quality of Life (QoL), motor, non-motor symptoms (NMS) in patients with Parkinson’s disease (PD) using validated composite measures.

Background: Class I evidence shows that STN-DBS improves motor symptoms and QoL in patients with PD ¹. However, only few studies have investigated non-motor effects of DBS ², in particular its long-term effects. We hypothesized that STN-DBS is associated with a reduction of a range of NMS in patients with PD.

Methods: In this ongoing, multicenter, open, prospective, international study (London, Cologne, Manchester) we investigated non-motor effects of STN-DBS in real-life use in patients with PD. We surveyed PD Quality of Life Questionnaire (PDQ-8), Non-motor Symptoms Scale (NMSS), Non-motor Symptoms Questionnaire (NMSQ), and Scales (ADL, motor examination, and complications) at preoperative baseline, at 6 months follow-up (6MFU) and 24 months FU (24MFU).

Results: Thus far 42 consecutive patients with advanced PD (28 male, mean age: 63.3±7.2 yrs, mean duration of disease: 10.6±4.7 yrs, median Hoehn &Yahr stage: 2.5) have completed 24 MFU. STN-DBS significantly improved all scores (repeated measures ANOVA, all p≤0.035). Post-hoc analyses showed a significant improvement from baseline to 6MFU (Wilcoxon signed rank-test, respectively paired t-test when criteria were fulfilled; all p≤0.015) followed by a deterioration from 6MFU to 24MFU (motor examination n.s., all other p≤0.041). Long-term outcomes comparing baseline to 24 MFU improved significantly for Scopa-motor examination and complications (all p≤0.025), but not for PDQ-8, NMSQ and SCOPA-ADL.

Conclusions: This study provides evidence that bilateral STN-DBS has beneficial effects on QoL, non-motor and motor symptoms in patients with PD. The deterioration of all scales from 6MFU to 24MFU may have a variety of causes, e.g. disease progression. This effect was more pronounced on QoL, NMS and ADL which at 24MFU reached levels comparable to preoperative baseline while a significant improvement of motor symptoms was sustained over two years. Long-term effects of DBS on specific NMS domains such as mood, sleep, and autonomic symptoms are now being studied.

References: 1. Deuschl G, Schade-Brittinger C, Krack P, et al. A randomized trial of deep-brain stimulation for Parkinson’s disease. N Engl J Med 2006;355:896-908.

2. Dafsari HS, Reddy P, Herchenbach C, et al. Beneficial effects of bilateral subthalamic stimulation on Non-motor symptoms in Parkinson’s disease. Brain Stimul 2016;9(1):78-85.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/long-term-effects-of-subthalamic-nucleus-deep-brain-stimulation-on-quality-of-life-non-motor-and-motor-symptoms/