Editors' note: Quality of life predicts outcome of deep brain stimulation in early Parkinson disease

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In their prespecified secondary analysis of the EARLYSTIM trial, Dr. Schuepbach et al. sought to evaluate which demographic and clinical factors would predict an improvement in the Parkinson's Disease Questionnaire Summary Index (PDQ-39-SI). In summary, the investigators found that only subjective symptom severity at baseline was independently associated with improvement in the PDQ-39-SI—with worse baseline symptoms correlating with more responsiveness to subthalamic nucleus deep brain stimulation (STN-DBS). “Off” time, stage of the illness (advanced vs early), and more specific elements of the PDQ-39-SI may have also been useful for predicting responsiveness to STN-DBS, as Dr. Sidiropoulos writes in their response. On reevaluation of the patient-level data, Dr. Deuschl confirms that there is no difference in improvement in PDQ-39-SI based on the stage of PD. However, the duration of “off” time appears to strongly correlate with improvement after STN-DBS and is particularly noted in the advanced population. In conclusion, the investigators encourage clinicians to use these clinical predictors in the counseling of patients when STN-DBS is being considered. In their prespecified secondary analysis of the EARLYSTIM trial, Dr. Schuepbach et al. sought to evaluate which demographic and clinical factors would predict an improvement in the Parkinson's Disease Questionnaire Summary Index (PDQ-39-SI). In summary, the investigators found that only subjective symptom severity at baseline was independently associated with improvement in the PDQ-39-SI—with worse baseline symptoms correlating with more responsiveness to subthalamic nucleus deep brain stimulation (STN-DBS).