Health-related quality of life in patients with advanced Parkinson's disease treated with deep brain stimulation of the subthalamic nuclei.

Parkinson's disease (PD) is a progressive neurodegenerative disorder for which there is as yet no cure. It affects many aspects of patients' lives, only some of which can be monitored by available clinical rating scales. In the past decade, there has been a new emphasis on the use of health-related quality of life (HRQOL) measures to describe patient response to treatment. We describe patient-reported HRQOL in subjects who underwent bilateral deep brain stimulation (DBS) of the subthalamic nuclei (STN) for the treatment of PD, compared with a similar group of subjects who did not receive surgical treatment. A consecutive series of patients (n = 11) with advanced idiopathic PD were treated with DBS of the STN. This surgically treated group was compared prospectively with a similar group of patients (n =13) awaiting surgery. Self-reported HRQOL, measured by the Parkinson's Disease Questionnaire (PDQ-39) was evaluated at three time periods T(0), T(3), and T(6). The surgery group was evaluated according to the Unified Parkinson's Disease Rating Sale (UPDRS) before (T(0)), 3 (T(3)), and 6 months (T(6)) after surgery. HRQOL, UPDRS part II and III, duration of off periods, and dyskinesias improved significantly from T(0) to T(3) and from T(0) to T(6) for the surgery group but not for the nonsurgery group. Ten of the 11 patients treated with DBS of the STN reported a lower summary score (indicating better HRQOL) 6 months after surgery. The results of this prospective controlled study suggest that patients with advanced idiopathic PD treated with DBS of the STN obtain significant improvements in patient reported HRQOL and in clinical outcomes 3 and 6 months after surgery.