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Parkinson’s Disease
Volume 2017 (2017), Article ID 5609163, 8 pages
https://doi.org/10.1155/2017/5609163
Research Article

Predictors of Functional and Quality of Life Outcomes following Deep Brain Stimulation Surgery in Parkinson’s Disease Patients: Disease, Patient, and Surgical Factors

1Center for Neurological Restoration, Cleveland Clinic, 9500 Euclid Avenue, Mail Code U2, Cleveland, OH 44195, USA
2Case Western Reserve University, University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH 44106, USA
3Department of Neurology, Alexandria University, El Hadara University Hospital, El Hadara Kebly, Alexandria, Egypt
4Department of Quantitative Health Sciences, Cleveland Clinic, 9500 Euclid Avenue, Mail Code JJN3-01, Cleveland, OH 44195, USA
5Neurological Institute, Center for Outcomes Research and Evaluation, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
6Department of Neurology, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Fl 3, Weston, FL 33331, USA

Correspondence should be addressed to Hesham Abboud

Received 19 February 2017; Revised 19 May 2017; Accepted 9 July 2017; Published 9 August 2017

Academic Editor: Jan Aasly

Copyright © 2017 Hesham Abboud et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. The primary objective was to evaluate predictors of quality of life (QOL) and functional outcomes following deep brain stimulation (DBS) in Parkinson’s disease (PD) patients. The secondary objective was to identify predictors of global improvement. Methods. PD patients who underwent DBS at our Center from 2006 to 2011 were evaluated by chart review and email/phone survey. Postoperative UPDRS II and EQ-5D were analyzed using simple linear regression adjusting for preoperative score. For global outcomes, we utilized the Patient Global Impression of Change Scale (PGIS) and the Clinician Global Impression of Change Scale (CGIS). Results. There were 130 patients in the dataset. Preoperative and postoperative UPDRS II and EQ-5D were available for 45 patients, PGIS for 67 patients, and CGIS for 116 patients. Patients with falls/postural instability had 6-month functional scores and 1-year QOL scores that were significantly worse than patients without falls/postural instability. For every 1-point increase in preoperative UPDRS III and for every 1-unit increase in body mass index (BMI), the 6-month functional scores significantly worsened. Patients with tremors, without dyskinesia, and without gait-freezing were more likely to have “much” or “very much” improved CGIS. Conclusions. Presence of postural instability, high BMI, and worse baseline motor scores were the greatest predictors of poorer functional and QOL outcomes after DBS.