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DOI: 10.1590/0004-282X-ANP-2021-0048
Quality of life of patients with Parkinson's disease: a comparison between preoperative and postoperative states among those who were treated with deep brain stimulation
Qualidade de vida de pacientes com doença de Parkinson: uma comparação dos estados pré-operatório e pós-operatório daqueles tratados com estimulação cerebral profundaABSTRACT
Background: Deep brain stimulation (DBS) is a well-established procedure for treating Parkinson's disease (PD). Although its mechanisms of action are still unclear, improvements in motor symptoms and reductions in medication side effects can be achieved for a significant proportion of patients, with consequent enhancement of quality of life. Objective: To investigate the impact of DBS on the quality of life of PD patients. Methods: This was a retrospective longitudinal study with collection of historical data in a neurosurgery center, from June 2019 to December 2020. The sample was obtained according to convenience, and the Parkinson's Disease Questionnaire (PDQ-39), Unified Parkinson's Disease Rating Scale (UPDRS) III and IV, Trail-Making Test and Verbal Fluency Test were used. Results: Data were collected from 17 patients (13 with subthalamic nucleus DBS and 4 with globus pallidus pars interna DBS). Significant improvement (p=0.008) on the UPDRS III was observed in comparing the preoperative without DBS with the postoperative with DBS. About 47.0% of the patients showed post-surgical improvement in QoL (p=0.29). Thirteen patients were able to complete part A of the Trail-Making Test and four of these also completed part B. Almost 60% of the patients scored sufficiently on the semantic test, whereas only 11.8% scored sufficiently on the orthographic evaluation. No association between implant site and test performance could be traced. Conclusions: Improvements in quality of life and motor function were observed in the majority of the patients enrolled. Despite the limitations of this study, DBS strongly benefits a significant proportion of PD patients when well indicated.
RESUMO
Antecedentes: A estimulação cerebral profunda (ECP) é um procedimento bem estabelecido para o tratamento da doença de Parkinson (DP). Embora seus mecanismos de ação não sejam claros, a melhora dos sintomas motores e a redução dos efeitos colaterais dos medicamentos são contempladas em uma proporção significativa de pacientes, com melhora da qualidade de vida. Objetivo: Investigar o impacto da ECP na qualidade de vida de pacientes em DP. Métodos: Trata-se de um estudo longitudinal retrospectivo, com coleta de dados históricos em um centro de neurocirurgia, de junho de 2019 a dezembro de 2020. A amostra foi feita por conveniência, e os questionários Parkinson's Disease Questionnare (PDQ-39), Unified Parkinson's Disease Rating Scale (UPDRS) III e IV, Trail Making Test e Teste de Fluência Verbal foram utilizados. Resultados: Dos dados coletados de 17 pacientes (13 ECP em núcleo subtalâmico e ECP em globo pálido interno) notou-se melhora significativa (p=0,008) no UPDRS III ao se comparar o pré-operatório sem ECP com pós-operatório com ECP, e cerca de 47,0% deles apresentaram melhora pós-cirúrgica na qualidade de vida (p=0,29). Treze pacientes conseguiram completar a parte A do Trail Making Test e quatro também completaram a parte B. Quase 60,0% dos pacientes obtiveram pontuação suficiente no teste semântico, enquanto apenas 11,8% obtiveram pontuação suficiente na avaliação ortográfica. Não foi possível rastrear a associação entre local do implante e desempenho. Conclusões: Melhora na qualidade de vida e na função motora foi observada na maioria dos pacientes. Apesar das limitações do estudo, a ECP beneficia fortemente uma proporção significativa de pacientes em DP quando bem indicada.
Authors’ contributions:
The authors contributed equally to all stages of the work, and all authors approved the version submitted for publication.
Publication History
Received: 29 January 2021
Accepted: 16 April 2021
Article published online:
31 January 2023
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