[Long-term efficacy of subthalamic nucleus deep brain stimulation on non-motor symptoms in Parkinson's disease]

To investigate the long-term efficacy of subthalamic nucleus deep brain stimulation (STN-DBS) on non-motor symptoms in Parkinson's disease (PD). A retrospective analysis was performed on 13 PD patients who underwent bilateral STN-DBS surgery at the First Affiliated Hospital of Sun Yat-sen University from 2010 to 2011. Nonmotor symptoms were comprehensively assessed at baseline and 1, 3, and 10 years after surgery. The assessment include Mini-mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), the Hamilton Anxiety Scale (HAMA), the Hamilton Depression Scale (HAMD), the Parkinson's Disease Sleepiness Scale-Chinese Version (PDSS-CV), the Epworth Sleepiness Scale (ESS) and the Parkinson's Disease Quality of Life Questionnaire (PDQ-39). Levodopa quivalent daily dosage (LEDD) was recorded. MoCA scores improved within 3 years postoperatively (all P<0.05), while MMSE scores showed no significant change compared to baseline (all P>0.05). Both MMSE [(23.7±5.7) vs (28.4±2.4)] and MoCA [(18.4±6.4) vs (22.2±5.0)] scores were lower than preoperative levels more than 10 years after operation(all P<0.05). PDSS-CV scores showed no significant differences at any postoperative time point compared with those before operation(all P>0.05). Compared with baseline, ESS scores remained stable within 3 years (all P>0.05) but increased significantly beyond 10 years [(10.9±8.2) vs (6.9±4.2), P=0.042].HAMD and HAMA scores were lower than those before operation within the first 3 years (P<0.05), but returned to baseline levels beyond 10 years (both P>0.05). Compared with baseline, The PDQ-39 Summary Index decreased within 3 years (P<0.05), but returned to baseline beyond 10 years (P=0.089).Compared with the preoperative LEDD [(689±204) mg], significant reductions were observed at 1 year [(439±300) mg], 3 years [(411±213) mg], and beyond 10 years [(489±170) mg] postoperatively (all P<0.05), corresponding to reductions of 36.29%, 40.40%, and 29.10%, respectively. STN-DBS improves quality of life, emotion, and cognition of PD patients within 3 years postoperatively. Beyond 10 years, quality of life and emotion return to baseline, while cognition deteriorates compared with that before surgery.