Abstract
Background
Fatigue is a common and disabling non-motor symptom (NMS) in Parkinson’s disease (PD) patients. However, the effect of subthalamic nucleus (STN) deep brain stimulation (DBS) on fatigue has not been widely studied.
Objective
To determine the effect of STN DBS on fatigue in PD patients, measured by the Non-motor symptoms scale (NMSS).
Methods
Cross-sectional analysis of 50 patients with PD who underwent STN DBS at King’s College Hospital and Salford Royal Hospital with fatigue scores (measured by question number 4 from domain 2 (sleep/fatigue) of the NMSS as the primary outcome measure. Secondary outcome measures included the PD Sleep Scale (PDSS), Scales for Outcome in PD (SCOPA)-motor examination, activities of daily living, motor complications, Hoehn and Yahr (HY) stage and changes in Levodopa Equivalent Daily Dose (LEDD).
Results
50 patients with a mean follow-up period of 1.98 ± 1.36 years were studied. Significant improvement in median fatigue scores (4.00 (0.75–9.00) to 1.00 (0.00–4.50); p = .001) was observed. In addition, improvements in question 5 (sleep maintenance and fragmentation; 8.00 (4.00–12.00) to 0.00 (0.00–4.00); p < .001) and in domain 2 total score (sleep/fatigue; 20.00 (8.75–27.25) to 6.00 (0.75–16.00); p < .001) were also significant, together with improvements in NMSS total score, SCOPA scores and HY stage (p ≤ .02). Moreover, LEDD but especially dopamine agonists LEDD was significantly reduced after DBS (310.00 (0.00–480.00) to 150.00 (0.00–300.00); p < .020).
Conclusions
Even though open label and not using a validated fatigue scale, this observational analysis suggest that fatigue improves significantly after STN DBS with persisting benefits at two years follow-up.
Acknowledgments
We acknowledge data collection efforts by all contributors, collaborators and administrative staff of the NILS study. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
Disclosure statement
No potential conflict of interest was reported by the author(s).