• Haidar S Dafsari, K Ray-Chaudhuri, Keyoumars Ashkan, Lena Sachse, Picabo Mahlstedt, Monty Silverdale, Alexandra Rizos, Marian Strack, Stefanie T Jost, Paul Reker, Michael Samuel, Veerle Visser-Vandewalle, Julian Evans, Angelo Antonini, Pablo Martinez-Martin, Lars Timmermann, and EUROPAR, the IPMDS Non Motor P.D. Study Group.
• Department of Neurology, University Hospital Cologne, Kerpenerstr. 62, 50937, Cologne, Germany. haidar.dafsari@uk-koeln.de.
• J. Neurol. 2020 Jun 1; 267 (6): 1830-1841.

BackgroundSubthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and sleep symptoms in Parkinson's disease (PD). However, the long-term effects of STN-DBS on sleep and its relationship with QoL outcome are unclear.MethodsIn this prospective, observational, multicenter study including 73 PD patients undergoing bilateral STN-DBS, we examined PDSleep Scale (PDSS), PDQuestionnaire-8 (PDQ-8), Scales for Outcomes in PD-motor examination, -activities of daily living, and -complications (SCOPA-A, -B, -C), and levodopa-equivalent daily dose (LEDD) preoperatively, at 5 and 24 months follow-up. Longitudinal changes were analyzed with Friedman-tests or repeated-measures ANOVA, when parametric tests were applicable, and Bonferroni-correction for multiple comparisons. Post-hoc, visits were compared with Wilcoxon signed-rank/t-tests. The magnitude of clinical responses was investigated using effect size.ResultsSignificant beneficial effects of STN-DBS were observed for PDSS, PDQ-8, SCOPA-A, -B, and -C. All outcomes improved significantly at 5 months with subsequent decrements in gains at 24 months follow-up which were significant for PDSS, PDQ-8, and SCOPA-B. Comparing baseline and 24 months follow-up, we observed significant improvements of PDSS (small effect), SCOPA-A (moderate effect), -C, and LEDD (large effects). PDSS and PDQ-8 improvements correlated significantly at 5 and 24 months follow-up.ConclusionsIn this multicenter study with a 24 months follow-up, we report significant sustained improvements after bilateral STN-DBS using a PD-specific sleep scale and a significant relationship between sleep and QoL improvements. This highlights the importance of sleep in holistic assessments of DBS outcomes.

20 keywords...

hide…