Luis Otávio Nogueira, Angela Maria Sandini Corso, Louise Dalla Corte Dallé, Vanio L J Antunes, Matheus de M Fernandes, Isabella S M Rabelo, Marcus V Della Coletta, Carolina Candeias da Silva, Lorena Broseghini Barcelos, Henrique Ballalai Ferraz, Robson Luis Oliveira de Amorim, Dayany Leonel Boone
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However, the long-term trajectory of Quality of Life (QoL) following STN-DBS remains underexplored.</p><p><strong>Objectives: </strong>We aimed to conduct a systematic review and meta-analysis to assess QoL trends up to five years after STN-DBS.</p><p><strong>Methods: </strong>We systematically searched PubMed, Embase, and Cochrane databases from inception to August 2024 for studies involving PD patients treated with bilateral STN-DBS, evaluating QoL using the Parkinson's Disease Questionnaire (PDQ), with a minimum follow-up of 12 months post-surgery. Continuous outcomes were pooled using standardized mean differences (SMD), and statistical analyses were conducted using R version 4.3.2.</p><p><strong>Results: </strong>Out of 4106 screened articles, 42 studies with a total of 2767 patients were included in the meta-analysis. 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引用次数: 0
摘要
背景：丘脑底核深部脑刺激（STN-DBS）是帕金森病（PD）的一种公认的治疗方法。然而，STN-DBS后生活质量（QoL）的长期轨迹仍未得到充分探讨。目的：我们旨在进行系统回顾和荟萃分析，以评估STN-DBS后长达五年的生活质量趋势。方法：我们系统地检索PubMed、Embase和Cochrane数据库，从开始到2024年8月，检索涉及双侧STN-DBS治疗的PD患者的研究，使用帕金森病问卷（PDQ）评估生活质量，术后至少随访12个月。采用标准化平均差异（SMD）对连续结果进行汇总，采用R 4.3.2版本进行统计分析。结果：在筛选的4106篇文章中，42项研究共2767名患者被纳入meta分析。术后36个月，生活质量均有改善(SMD 0.83；95% CI 0.29至1.37)，随后在60个月时下降到术前水平(SMD -0.06；95% CI -0.26 ~ 0.15)。60个月时的子域分析显示认知功能和沟通明显恶化。meta回归显示，生活质量的改善与临床和社会人口学因素（如年龄、性别和病程）无关；但与平均基线PDQ有相关性（P = 0.01）。结论：本荟萃分析提供了STN-DBS后的长期生活质量趋势，强调需要进一步探索导致生活质量下降的因素，并制定缓解这种恶化的策略。
Long-Term Quality of Life Trend after Subthalamic Stimulation for Parkinson's Disease: An Updated Systematic Review and Meta-Analysis.
Background: Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a well-established treatment for Parkinson's Disease (PD). However, the long-term trajectory of Quality of Life (QoL) following STN-DBS remains underexplored.
Objectives: We aimed to conduct a systematic review and meta-analysis to assess QoL trends up to five years after STN-DBS.
Methods: We systematically searched PubMed, Embase, and Cochrane databases from inception to August 2024 for studies involving PD patients treated with bilateral STN-DBS, evaluating QoL using the Parkinson's Disease Questionnaire (PDQ), with a minimum follow-up of 12 months post-surgery. Continuous outcomes were pooled using standardized mean differences (SMD), and statistical analyses were conducted using R version 4.3.2.
Results: Out of 4106 screened articles, 42 studies with a total of 2767 patients were included in the meta-analysis. QoL improvements were observed up to 36 months post-surgery (SMD 0.83; 95% CI 0.29 to 1.37), followed by a decline to pre-operative levels at 60 months (SMD -0.06; 95% CI -0.26 to 0.15). Subdomain analysis at 60 months revealed significant deterioration in cognitive function and communication. Meta-regression indicated that QoL improvements were independent of clinical and sociodemographic factors such as age, sex, and disease duration; however, there was a correlation with mean baseline PDQ (P = 0.01).
Conclusions: This meta-analysis provides long-term QoL trends following STN-DBS, highlighting a further need to explore the factors driving the decline in QoL and develop strategies to mitigate this deterioration.
期刊介绍：
Movement Disorders Clinical Practice- is an online-only journal committed to publishing high quality peer reviewed articles related to clinical aspects of movement disorders which broadly include phenomenology (interesting case/case series/rarities), investigative (for e.g- genetics, imaging), translational (phenotype-genotype or other) and treatment aspects (clinical guidelines, diagnostic and treatment algorithms)
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