The Deep Brain Stimulation Impairment Scale: A useful complement in assessment of well-being and functioning in DBS-patients - Results from a large multicentre survey in patients with Parkinson's disease.

Deep brain stimulation Deep brain stimulation impairment scale (DBS-IS) Parkinson's disease Parkinson's disease questionnaire (PDQ-39) Patient outcome Quality of life

Journal

Parkinsonism & related disorders
ISSN: 1873-5126
Titre abrégé: Parkinsonism Relat Disord
Pays: England
ID NLM: 9513583

Informations de publication

Date de publication:
06 2022
Historique:
received: 27 12 2021
revised: 11 04 2022
accepted: 16 04 2022
pubmed: 14 5 2022
medline: 29 6 2022
entrez: 13 5 2022
Statut: ppublish

Résumé

Deep Brain Stimulation (DBS) has been proven to alleviate motor symptoms in Parkinson's Disease (PD). Regarding non-motor symptoms, however, inconsistencies have been reported, on whether DBS causes reductions in well-being and functioning. To assess motor and non-motor impairment in DBS-patients, the Deep Brain Stimulation Impairment Scale (DBS-IS) has been developed. Yet, the extent to which the DBS-IS detects impairment in DBS-patients and thus could serve as a useful tool that complements the PDQ-39 (gold standard) in assessment of well-being and functioning in PD-patients has not been shown. By comparing DBS and non-DBS-patients we aimed to identify DBS-specific symptoms. We thereby aimed to show in how far the DBS-IS complements the PDQ-39 in assessing well-being and functioning in PD patients under DBS. In a cross-sectional study, 186 DBS-patients were matched (for age, disease duration and sex) to 186 non-DBS-patients (N = 372) and the two groups were compared regarding well-being and functioning: Impairment was assessed via DBS-IS and overall Quality of Life (QoL) was assessed via PDQ-39. Additionally, we analyzed differences in impairment between age and disease duration clusters. DBS-patients showed significantly higher total impairment (DBS-IS) and significantly higher impairment on the subscales Postural Instability and Gait difficulties and speaking difficulties than non-DBS-patients. Impairment increased with age and disease duration and, overall, differences in impairment rose by age. Overall QoL (PDQ-39) was non-significantly lower in DBS-patients. Since there is evidence that the PDQ-39 misses some DBS-specific symptoms, the DBS-IS is recommended to complement the PDQ-39 when assessing DBS-patients.

Sections du résumé

BACKGROUND
Deep Brain Stimulation (DBS) has been proven to alleviate motor symptoms in Parkinson's Disease (PD). Regarding non-motor symptoms, however, inconsistencies have been reported, on whether DBS causes reductions in well-being and functioning. To assess motor and non-motor impairment in DBS-patients, the Deep Brain Stimulation Impairment Scale (DBS-IS) has been developed. Yet, the extent to which the DBS-IS detects impairment in DBS-patients and thus could serve as a useful tool that complements the PDQ-39 (gold standard) in assessment of well-being and functioning in PD-patients has not been shown.
OBJECTIVES
By comparing DBS and non-DBS-patients we aimed to identify DBS-specific symptoms. We thereby aimed to show in how far the DBS-IS complements the PDQ-39 in assessing well-being and functioning in PD patients under DBS.
METHODS
In a cross-sectional study, 186 DBS-patients were matched (for age, disease duration and sex) to 186 non-DBS-patients (N = 372) and the two groups were compared regarding well-being and functioning: Impairment was assessed via DBS-IS and overall Quality of Life (QoL) was assessed via PDQ-39. Additionally, we analyzed differences in impairment between age and disease duration clusters.
RESULTS
DBS-patients showed significantly higher total impairment (DBS-IS) and significantly higher impairment on the subscales Postural Instability and Gait difficulties and speaking difficulties than non-DBS-patients. Impairment increased with age and disease duration and, overall, differences in impairment rose by age. Overall QoL (PDQ-39) was non-significantly lower in DBS-patients.
CONCLUSION
Since there is evidence that the PDQ-39 misses some DBS-specific symptoms, the DBS-IS is recommended to complement the PDQ-39 when assessing DBS-patients.

Identifiants

pubmed: 35561498
pii: S1353-8020(22)00104-3
doi: 10.1016/j.parkreldis.2022.04.008
pii:
doi:

Types de publication

Journal Article Multicenter Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

8-15

Informations de copyright

Copyright © 2022 Elsevier Ltd. All rights reserved.

Auteurs

Lena Haarmann (L)

Department of Medical Psychology ǀ Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. Electronic address: lena.haarmann@uk-koeln.de.

Elke Kalbe (E)

Department of Medical Psychology ǀ Neuropsychology and Gender Studies & Center for Neuropsychological Diagnostics and Intervention (CeNDI), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.

Catharine J Lewis (CJ)

Department of Neurology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.

Carsten Eggers (C)

Department of Neurology, University of Marburg, Marburg, Germany.

Andrea A Kühn (AA)

Department of Neurology, Movement Disorders Unit, Charité - University Medicine, Berlin, Germany.

Henriette Krug (H)

Department Pedagogy, Nursing and Health, University of Applied Sciences, Medical School Hamburg, Hamburg, Germany.

Jens Volkmann (J)

Department of Neurology, University of Wuerzburg, Wuerzburg, Germany.

Anna D Kirsch (AD)

Department of Neurology, University of Wuerzburg, Wuerzburg, Germany.

Lars Wojtecki (L)

Department of Neurology, Movement Disorders and Neuromodulation, University Clinic Duesseldorf, Duesseldorf, Germany.

Alfons Schnitzler (A)

Department of Neurology, Movement Disorders and Neuromodulation, University Clinic Duesseldorf, Duesseldorf, Germany.

Günther Deuschl (G)

Department of Neurology, Christian-Albrecht-University, Kiel, Germany.

Joachim K Krauss (JK)

Department of Neurosurgery, Medical School Hannover, Hannover, Germany.

Christiane Woopen (C)

Heinrich-Hertz-Chair, Center for Life Ethics, University of Bonn, Bonn, Germany.

Lars Timmermann (L)

Department of Neurology, University of Marburg, Marburg, Germany.

Franziska Maier (F)

Department of Psychiatry, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. Electronic address: franziska.maier@uk-koeln.de.

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