Büttner Charlotte, Maack Marike, Janitzky Kathrin, Witt Karsten
Department of Neurology and Research Center of Neurosensory Sciences Carl von Ossietzky University Oldenburg Oldenburg Germany.
Mov Disord Clin Pract. 2019 Aug 16;6(7):521-530. doi: 10.1002/mdc3.12819. eCollection 2019 Sep.
Several studies examined the influence of subthalamic nucleus-deep brain stimulation (STN-DBS) on quality of life (QoL) in patients with Parkinson's disease (PD). However, it is unclear whether this effect differs between age groups and disease durations and whether it stays consistent over time.
We assessed the influence of stimulation duration, disease duration, and age at surgery on QoL after STN-DBS.
We systematically searched for studies reporting the results of the Parkinson's Disease Questionnaire 39 or 8. Studies were included if they investigated the time passed since STN-DBS or if their study cohort fell into the range of one of the following age groups: younger than 60 years or between 60 and 70 years. For each condition, a standardized mean difference meta-analysis was performed. Furthermore, all studies were categorized into short or long disease duration at surgery using a median split.
A total of 23 studies reporting the cumulative outcome of 76 to 802 PD patients were included in this analysis. The results demonstrate a substantial improvement of QoL after DBS that remains stable over 36 months. QoL falls to preoperative scores 60 months after surgery. However, only 3 studies could be included in this analysis. Both younger and older PD patients profit in QoL from STN-DBS, independent of the disease duration.
The results of this analysis show an impressive improvement in QoL after STN-DBS, with a loss of QoL 60 months after DBS surgery. This highlights the need to explore the factors influencing QoL after STN-DBS to prevent or delay a decline in QoL.
多项研究探讨了丘脑底核深部脑刺激（STN-DBS）对帕金森病（PD）患者生活质量（QoL）的影响。然而，目前尚不清楚这种影响在不同年龄组和病程之间是否存在差异，以及随着时间的推移是否保持一致。
我们评估了刺激持续时间、病程和手术年龄对STN-DBS术后生活质量的影响。
我们系统检索了报告帕金森病问卷39或8结果的研究。如果研究调查了自STN-DBS以来的时间，或者其研究队列属于以下年龄组之一：60岁以下或60至70岁，则纳入研究。对于每种情况，进行标准化平均差荟萃分析。此外，所有研究根据手术时病程的中位数分为病程短或长两类。
本分析共纳入23项报告76至802例PD患者累积结果的研究。结果表明，DBS术后生活质量有显著改善，并在36个月内保持稳定。术后60个月，生活质量降至术前水平。然而，本分析仅纳入了3项研究。无论病程长短，年轻和老年PD患者均可从STN-DBS中受益于生活质量的改善。
本分析结果显示，STN-DBS术后生活质量有显著改善，但术后60个月生活质量有所下降。这突出表明需要探索影响STN-DBS术后生活质量的因素，以预防或延缓生活质量的下降。
