Department of Pathophysiology, Jagiellonian University Medical College, Cracow, Poland; Department of Neurosurgery, Jagiellonian University Medical College, Cracow, Poland.
Department of Pathophysiology, Jagiellonian University Medical College, Cracow, Poland.
World Neurosurg. 2019 May;125:e552-e562. doi: 10.1016/j.wneu.2019.01.132. Epub 2019 Feb 1.
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) can reduce motor symptoms in patients with Parkinson disease (PD) and improve their health-related quality of life (HRQoL). The effect of STN DBS on activities of daily living (ADL), an important component of quality of life, is poorly understood. We aimed to investigate effects of STN DBS on HRQoL and ADL in patients with PD.
HRQoL and ADL were assessed using the following disease-specific and generic questionnaires at baseline and 3, 6, and 12 months after surgery: the Parkinson's Disease Questionnaire 39 (PDQ-39), the Short-Form 36 health survey questionnaire, the World Health Organization Quality of Life Scale-Brief version, the Unified Parkinson's Disease Rating Scale part II, the ADL scale, and the Instrumental Activities of Daily Living scale.
We reported significant early improvements (3 months) in the HRQoL and ADL, and these benefits increased over time (6 months); however, further improvement between 6 and 12 months was nonsignificant. Two PDQ-39 subdomains (social support and communications) and a Short-Form 36 health survey questionnaire subdomain (social functioning) showed declines after surgery. Changes in the Instrumental Activities of Daily Living scale were significantly correlated with changes in the PDQ-39 summary index and other PDQ-39 subdomains, including mobility, emotional well-being, social support, and cognition, at all follow-up points.
STN DBS caused a marked improvement in HRQoL at 3 and 6 months; however, HRQoL remained stable at the 12-month postoperative follow-up. Moreover, we have shown a significant correlation between ADL performance and HRQoL after STN DBS.
深部脑刺激（DBS）于丘脑底核（STN）可减轻帕金森病（PD）患者的运动症状，并改善其健康相关生活质量（HRQoL）。STN DBS 对日常生活活动（ADL）的影响，即生活质量的重要组成部分，知之甚少。我们旨在研究 STN DBS 对 PD 患者 HRQoL 和 ADL 的影响。
在手术前和手术后 3、6 和 12 个月，使用以下特定疾病和通用问卷评估 HRQoL 和 ADL：帕金森病问卷 39 项（PDQ-39）、36 项简短健康调查问卷、世界卫生组织生活质量量表-简短版、统一帕金森病评定量表第二部分、ADL 量表和工具性日常生活活动量表。
我们报告了 HRQoL 和 ADL 的早期显著改善（3 个月），这些益处随时间增加（6 个月）；然而，6 至 12 个月之间的进一步改善不显著。PDQ-39 的两个亚域（社会支持和沟通）和 36 项简短健康调查问卷的一个亚域（社会功能）在手术后下降。工具性日常生活活动量表的变化与 PDQ-39 综合指数和其他 PDQ-39 亚域的变化显著相关，包括移动性、情绪健康、社会支持和认知，在所有随访点均如此。
STN DBS 在 3 个月和 6 个月时引起 HRQoL 的显著改善；然而，HRQoL 在术后 12 个月的随访中保持稳定。此外，我们还显示了 STN DBS 后 ADL 表现与 HRQoL 之间存在显著相关性。
