Newly published data from a nonrandomized controlled trial of patients with advanced Parkinson’s disease (PD) showed that the quality of life (QOL) remained stable after 5 years of subthalamic deep brain stimulation (STN-DBS). The study, led by Stefanie Jost, PhD, a doctor of psychology at the University of Cologne, assessed 108 PD patients, with 62 receiving STN-DBS and 46 receiving standard-of-care medication (MED). The results revealed that the favorable effects of STN-DBS on mobility accounted for the differences in QOL outcomes compared to MED.
Patients were evaluated on various outcomes, including the Parkinson’s Disease Questionnaire 8 (PDQ-8), Unified PD Rating Scale (UPDRS)-motor examination, Scales for Outcomes in PD (SCOPA)-activities of daily living (ADL) and motor complications (M), and levodopa-equivalent daily dose (LEDD). At the 5-year follow-up, the MED group experienced a significant decline in QOL, as indicated by changes on the PDQ-8. Conversely, the STN-DBS group demonstrated stable QOL. The difference in mean change from baseline was 6.6 points between the two groups.
Compared to the MED group, patients who received STN-DBS exhibited positive outcomes in the PDQ mobility domain at the 5-year follow-up. Additionally, the SCOPA-M total score showed a significant worsening of motor complications in the MED group, while the STN-DBS group showed a non-significant improvement. Notably, the improvement in motor complications for the STN-DBS group was primarily driven by a 47.1% improvement in SCOPA-M motor complications.
Furthermore, the study revealed a substantial decrease in the levodopa-equivalent daily dose (LEDD) for the STN-DBS group, while the MED group experienced an increase. The difference in LEDD change between the two groups was significant.
The authors highlighted that this study provided valuable class IIb evidence of the long-term benefits of STN-DBS on motor complications and medication requirements for PD patients. The results emphasized the importance of assessing activities of daily living (ADL) outcomes when evaluating the efficacy of STN-DBS for PD.
In terms of safety, the investigators reported 39 serious adverse events (AEs) in 17 patients who underwent STN-DBS. However, all of these events were resolved without major consequences, except for one patient who underwent surgical colostomy for ileus. The majority of serious AEs were categorized as surgical, device-related, neurologic, psychiatric, or other reasons.
With the publication of these findings, patients with advanced PD and their healthcare providers can gain insight into the long-term benefits of STN-DBS in maintaining quality of life. The study’s results may help guide patient counseling and postoperative monitoring, offering hope for improved outcomes and enhanced long-term well-being.
