Abstract
AimsDeep brain stimulation (DBS) is known to dramatically improve motor complications in patients with Parkinson's disease (PD), but its effect on urinary symptoms and health‐related quality of life (HRQOL) remains unknown. We aimed to examine the relationship between urinary symptoms and HRQOL in patients with PD who underwent DBS.MethodsThe International Prostate Symptom Score (IPSS) and overactive bladder symptom score (OABSS) were determined to evaluate urinary symptoms in patients with PD who underwent DBS. Postoperative evaluations were performed at 3 months, 1 year, and 3 years postoperatively. We also performed a urodynamic study (UDS) in 13 patients with PD preoperatively and postoperatively. A follow‐up UDS was performed 2.0 ± 0.5 years postoperatively.ResultsThe preoperative urinary symptoms questionnaire was completed by 28 patients, of whom 14 completed the postoperative urinary symptoms questionnaire after 3 months, 18 after 1 year, and 10 after 3 years. The mean OABSS and IPSS did not change significantly at any follow‐up periods postoperatively. When assessing the relationship between urinary symptoms and HRQOL and motor functions, the OABSS and IPSS showed significant positive correlations with HRQOL at 3 months postoperatively. The OABSS and IPSS showed significant positive correlations with activities of daily living (ADL) during the off‐phase at 3 years postoperatively. All urodynamic parameters remained unchanged postoperatively.ConclusionsDeep brain stimulation did not significantly affect urinary dysfunctions in patients with PD. Urinary symptoms might partially contribute to HRQOL at 3 months postoperatively and ADL during the off‐phase at 3 years postoperatively.
Highlights
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) and globus pallidus interna (GPi) is a standard therapy for patients with advanced stages of Parkinson’s disease (PD) with motor complications such as dyskinesia and wearing‐off (Okun, 2012)
Urinary symptoms might partially contribute to health‐related quality of life (HRQOL) at 3 months postoperatively and activities of daily living (ADL) during the off‐phase at 3 years postoperatively
We have revealed that many of the recorded neurons in the STN preferentially fired during the bladder storage phase in normal cats (Sakakibara et al, 2003), suggesting that STN‐DBS might be effective for patients with PD with urinary dysfunctions
Summary
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) and globus pallidus interna (GPi) is a standard therapy for patients with advanced stages of Parkinson’s disease (PD) with motor complications such as dyskinesia and wearing‐off (Okun, 2012). We have revealed that many of the recorded neurons in the STN preferentially fired during the bladder storage phase in normal cats (Sakakibara et al, 2003), suggesting that STN‐DBS might be effective for patients with PD with urinary dysfunctions. The detailed relationships between urinary symptoms and motor dysfunction and health‐related QOL (HRQOL) are unknown, which is important for the clinical examination of patients with PD after DBS.
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