Long term improvement in quality of life in Parkinson's disease after deep brain stimulation of the subthalamic nucleus: an observational cohort.
Parkinson's medication doses stayed about 50% lower for nearly 20 years after subthalamic deep brain stimulation.
Long term improvement in quality of life in Parkinson's disease after deep brain stimulation of the subthalamic nucleus: an observational cohort.
Long-term quality of life (quality of life) outcomes following subthalamic nucleus (subthalamic nucleus) deep brain stimulation (deep brain stimulation) in Parkinson's disease (PD) remain incompletely characterized beyond 10-15 years.
To evaluate long term quality of life and clinical outcomes in PD patients undergoing bilateral STN-DBS with follow up extending up to 25 years.
Single center, prospective observational cohort study at a tertiary academic medical center.
medication needs stayed cut nearly in half for close to 20 years
Among 387 patients (baseline PDQ-39, 35.34 ± 14.79), quality of life improved significantly at year 1 (24.38 ± 14.39; p < 0.001) and year 3 (29.84 ± 15.70; p < 0.001), followed by stabilization at or near baseline through 25 years without sustained worsening.
Motor function (UPDRS Part III, OFF state) improved significantly through year 12 ( p < 0.001), with sustained reductions in OFF time and dyskinesia through year 20 ( p < 0.001).
Cognitive scores declined over time, with significant worsening beginning at year 2 ( p < 0.03), and depression scores worsened gradually after year 3 ( p = 0.04).
Bilateral subthalamic nucleus deep brain stimulation is associated with significant early improvements in quality of life followed by long-term stabilization without deterioration below baseline for up to 25 years.
These findings suggest that subthalamic nucleus deep brain stimulation provides durable symptomatic benefit and relative preservation of quality of life compared with the expected progressive decline in PD.
Long-term management should prioritize non-motor symptoms, particularly cognition and communication.