Abstract
Objective: To determine whether Parkinson’s disease (PD) patients eligible to subthalamic deep brain stimulation (STN-DBS) with probable REM sleep behavior disorder (RBD) pre-operatively could be more at risk of poorer motor, non-motor and quality of life outcomes 12 months after surgery, compared to those without RBD.
Methods: We analyzed the preoperative clinical profile of 448 PD from a French multicentric prospective study (PREDISTIM), according to the presence or absence of probable RBD, based on the RBD Single Question and RBD Screening Questionnaire. Among the 215 PD patients with 12 months follow-up after STN-DBS, we compared motor, cognitive, psycho-behavioral profile and quality of life outcomes in patients with (preopRBD+) or without probable RBD preoperatively (preopRBD-).
Results: At preoperative evaluation, preopRBD+ were older (61±7.2 vs. 59.5±7.7 years; p=0.02), had less motor impairment (MDS-UPDRS III Off: 38.7±16.2 vs. 43.4±7.1; p=0.03) but more non-motor symptoms on daily living activities (MDS-UPDRS I: 12.6±5.5 vs. 10.7±5.3; p<0.001), more psycho-behavioral manifestations (ASBPD total: 7.7±5.1 vs. 5.1±0.4; p=0.003) and worse quality of life (PDQ39: 33±12 vs. 29±12; p=0.03), as compared to preopRBD-. Both preopRBD+ and preopRBD- had significant MDS-UPDRS IV score decrease (-37% and -33% respectively), MDS-UPDRS III “MedOff/StimOn” score decrease (-52% and -54%), and dopaminergic treatment decrease (-52% and -49%) after surgery, with no between group difference. There was no between group difference for cognitive and global quality of life outcomes.
Conclusions: In PD patients eligible to STN-DBS, the presence of probable RBD preoperatively is not associated with a different clinical outcome 1 year after neurosurgery.
Registration number: ClinicalTrials.gov: NCT02360683.
Classification of evidence: This study provides Class II evidence that, in PD patients eligible for STN-DBS, the presence of probable RBD preoperatively is not associated with poorer outcomes one year post surgery.
- Received January 19, 2021.
- Accepted in final form September 20, 2021.
- © 2021 American Academy of Neurology
AAN Members
We have changed the login procedure to improve access between AAN.com and the Neurology journals. If you are experiencing issues, please log out of AAN.com and clear history and cookies. (For instructions by browser, please click the instruction pages below). After clearing, choose preferred Journal and select login for AAN Members. You will be redirected to a login page where you can log in with your AAN ID number and password. When you are returned to the Journal, your name should appear at the top right of the page.
AAN Non-Member Subscribers
Purchase access
Disputes & Debates: Rapid online correspondence
REQUIREMENTS
If you are uploading a letter concerning an article:
You must have updated your disclosures within six months: http://submit.neurology.org
Your co-authors must send a completed Publishing Agreement Form to Neurology Staff (not necessary for the lead/corresponding author as the form below will suffice) before you upload your comment.
If you are responding to a comment that was written about an article you originally authored:
You (and co-authors) do not need to fill out forms or check disclosures as author forms are still valid
and apply to letter.
Submission specifications:
- Submissions must be < 200 words with < 5 references. Reference 1 must be the article on which you are commenting.
- Submissions should not have more than 5 authors. (Exception: original author replies can include all original authors of the article)
- Submit only on articles published within 6 months of issue date.
- Do not be redundant. Read any comments already posted on the article prior to submission.
- Submitted comments are subject to editing and editor review prior to posting.