Pallidotomy and quality of life in patients with Parkinson's disease: An early study

The purpose of this study was to analyze the effect of stereotactic neuroph ysiologically guided pallidotomy on health-related quality of life (QoL) of patients with Parkinson's disease (PD). Eleven patients with PD (seven men , four women; mean age, 57.2 years; mean duration of disease, 14 years) wit h motor complications refractory to medical therapy underwent unilateral pa llidotomy. Clinical assessment was carried out a week before surgery and 4 months after the surgical procedure and was based on the Core Assessment Pr ogram for Intracerebral Transplantations protocol. QoL was measured by mean s of the PDQ-39. A set of rating scales (Hoehn & Yahr, Unified Parkinson's Disease Rating Scale, Schwab and England, Northwestern University Disabilit y Scale of Walking, Abnormal Involuntary Movement Scale), timed tests, and self-evaluations of motor function and mood were applied. Improvement was f ound in dyskinesias (74%) and off-period disability (42%). Cardinal motor s igns improved significantly (30%-59%). Four dimensions of the PDQ-39 (Mobil ity, ADL, Emotions, Bodily Pain) showed a significant improvement (p <0.01- 0.001). The global effect on QoL, measured through the PDQ-39 Summary Index (35.3%; 95% confidence interval: 15.60-54.97), was also significant (p <0. 01) but unrelated to major clinical changes. Pallidotomy significantly impr oves QoL in patients with advanced PD. QoL measurement provides relevant in formation that is probably not attainable by clinical assessment.