Health-related quality of life in Parkinson's disease after pallidotomy and deep brain stimulation

This study explored the multidimensional outcome of three neurosurgical int erventions for Parkinson's disease (PD): pallidotomy (N = 23), pallidal dee p brain stimulation (DBS) (N = 9), and thalamic DBS (N = 7). All patients c ompleted the Sickness Impact Profile (SIP) and the Beck Depression Inventor y. Pallidotomy patients also completed the Profile of Mood States, the Beck Anxiety Inventory, and a disease-specific quality of life (QOL) measure, t he Parkinson's Disease Questionnaire (PDQ-39). Three months after surgery, all neurosurgical groups showed significant improvements in mood and functi on, including physical, psychosocial, and overall functioning. Pallidal DBS and pallidotomy patients who completed additional QOL measures reported de creased anxiety and tension, increased vigor, improved mobility and ability to perform activities of daily living, and decreased perceived stigma. Psy chosocial dysfunction scores from the SIP were related to depressed mood bo th at baseline (r = .42) and at followup (r = .45), but the physical dysfun ction subscale was not related to mood at either time point, suggesting tha t disruption of social relationships due to PD may have more impact on affe ctive distress than physical symptoms alone. Results suggest that neurosurg ical interventions for PD improve disabling PD motor symptoms and also impr ove several domains of quality of life. (C) 2000 Academic Press.