Publications by authors named "V Stoker"
Genetic stratification of motor and QoL outcomes in Parkinson's disease in the EARLYSTIM study.
Parkinsonism Relat Disord
October 2022
Article Synopsis
- The study explores whether genetic variables can predict outcomes of subthalamic deep brain stimulation (STN-DBS) in patients with Parkinson's disease (PD).
- Researchers aimed to replicate an earlier finding that a specific genetic variant (SNCA rs356220) was linked to better STN-DBS responses and looked at additional genetic factors from recent genome-wide association studies (GWAS).
- Although the SNCA rs356220 variant didn't predict motor outcomes, it was associated with improved quality of life; other genetic markers showed predictive value for DBS outcomes, but polygenic risk scores were not useful in this context.
The EARLYSTIM Study compared deep brain stimulation (DBS) with best medical treatment (BMT) over 2-years, showing a between-group difference of 8.0 from baseline in favor of DBS in health-related quality of life (HRQoL), measured with the PDQ-39 SI (summary index). This study obtained complementary information about the importance of the change in HRQoL as measured by the PDQ-39, using anchor-based (Patient Global Impression of Change, PGIC) and distribution-based techniques (magnitude of change, effect size, thresholds, distribution of benefit) applied to the EARLYSTIM study data.
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- Deep brain stimulation (DBS) shows significant improvements in social, occupational, and psychosocial functioning in younger Parkinson's disease (PD) patients compared to best medical therapy (BMT) over 24 months.* -
- Both DBS and BMT groups had similar work status at the start and end of the study, but the BMT group had a higher rate of patients unable to work at the 24-month mark.* -
- Apathy in patients may affect their perceived work ability, with discrepancies between physician assessments and patients' self-ratings noted in the study.*
Background: Effects of DBS on freezing of gait and other axial signs in PD patients are unclear.
Objective: Secondary analysis to assess whether DBS affects these symptoms within a large randomized controlled trial comparing DBS of the STN combined with best medical treatment and best medical treatment alone in patients with early motor complications (EARLYSTIM-trial).
Methods: One hundred twenty-four patients were randomized in the stimulation group and 127 patients in the best medical treatment group.
Objective: Several randomized studies have compared the effect of deep brain stimulation (DBS) of the subthalamic nucleus with the best medical treatment in large groups of patients. Important outcome measures differ between studies. Two such major studies, the life-quality study of the German Competence Network for Parkinson's disease (LQ study) and the US Veterans Affairs/National Institute of Neurological Disorders and Stroke trial (VA/NINDS trial), were compared here in order to understand their differences in outcomes.
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