• Stefanie T Jost, Ray ChaudhuriKKParkinson Foundation International Centre of Excellence, King's College Hospital, London, UK.Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK., Keyoumars Ashkan, Philipp A Loehrer, Monty Silverdale, Alexandra Rizos, Julian Evans, Jan Niklas Petry-Schmelzer, Michael T Barbe, Anna Sauerbier, Gereon R Fink, Veerle Visser-Vandewalle, Angelo Antonini, Pablo Martinez-Martin, Lars Timmermann, Haidar S Dafsari, and EUROPAR and the International Parkinson and Movement Disorders Society Non-Motor Parkinson’s Disease Study Group.
• Department of Neurology, University Hospital of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
• J Parkinsons Dis. 2021 Jan 1; 11 (1): 323-335.

BackgroundSleep 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.ObjectiveTo 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.MethodsIn 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.ResultsPropensity 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.ConclusionsWe 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.

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