Neurostimulation Produces a Stable Quality of Life Up to 5 Years in Patients With Parkinson Disease, Study Finds

Deep brain stimulation of the subthalamic nucleus (STN-DBS) results in a stable quality of life (QOL) over 5 years in patients with advanced Parkinson disease, according to a study published in JAMA Network Open.

To investigate the long-term effects of STN-DBS on QOL compared with standard-of-care medication (MED), researchers performed a prospective, observational, quasi-experimental, longitudinal nonrandomized controlled trial from March 1, 2011, to May 31, 2017.

“...we tested the hypotheses that in advanced [Parkinson disease] at 5-year follow-up, QOL remains stable in patients undergoing STN-DBS and worsens in patients treated with MED and that this difference results in favorable outcomes of QOL and motor aspects as well as medication requirements in STN-DBS,” explained Stefanie Jost, PhD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology in Cologne, Germany, and coauthors.

The researchers also investigated the relationship between changes in QOL and various clinical outcomes.

When outcomes between MED and STN-DBS groups in patients with Parkinson disease were compared, QOL, as measured by the PDQ-8 Summary Index (SI), worsened significantly in the MED group by 49.4% over five years (change of −10.9 points, 95% CI: −19.0 to −2.7, P=.01), while remaining stable in the STN-DBS group. Motor function, assessed through the SCOPA-M total score, also deteriorated in the MED group by 19.5% (change of −4.5, 95% CI: −7.4 to −1.6, P=.008) but showed a non-significant improvement in the STN-DBS group.

A significant reduction in medication dosage in the STN-DBS group compared with an increase in the MED group was observed, along with a moderate correlation between changes in quality of life and activities of daily living.

“This trial found that patients who received STN-DBS had stable QOL at 5-year follow-up, primarily because of improved mobility, and highlights the importance of long-term improvement in outcomes related to activities of daily living,” concluded the study authors.

Reference

Jost ST, Aloui S, Evans J, et al. Neurostimulation for advanced Parkinson disease and quality of life at 5 years: A nonrandomized controlled trial. JAMA Netw Open. 2024;7(1):e2352177. doi:10.1001/jamanetworkopen.2023.52177