The impact of subthalamic deep-brain stimulation in restoring motor symmetry in Parkinson's disease patients: a prospective study

Raquel Pinheiro Barbosa (1) , Caroline Moreau (2, 3) , Anne Sophie Rolland (2, 3) , Olivier Rascol (1) , Christine Brefel-Courbon (1) , Fabienne Ory Magne (1) , Paulo Bastos (1) , Amaury de Barros (1) , Elodie Hainque (4) , Tiphaine Rouaud (5) , Ana Marques-Raquel (6) , Alexandre Eusebio (7) , Isabelle Benatru , Sophie Drapier (8, 9) , Dominique Guehl (10) , David Maltête (11, 12) , Christine Tranchant (13, 14, 15) , Thomas Wirth (13, 14, 15) , Caroline Giordana (16) , Melissa Tir (17, 18) , Stéphane Thobois (19) , Lucie Hopes (20) , Cécile Hubsch , Bechir Jarraya (21) , Jean-Christophe Corvol (4) , Matthieu Béreau (22) , David Devos (2, 3) , Margherita Fabbri (1, 23)

1 CIC 1436 - Centre d'investigation clinique de Toulouse
2 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
3 LilNCog - Lille Neurosciences & Cognition - U 1172
4 ICM - Institut du Cerveau = Paris Brain Institute
5 CHU Nantes - Centre Hospitalier Universitaire de Nantes
6 CHU Clermont-Ferrand
7 AMU - Aix Marseille Université
8 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
9 CIC - Centre d'Investigation Clinique [Rennes]
10 CHU Bordeaux
11 CHU Rouen
12 DC2N - Différenciation et communication neuronale et neuroendocrine
13 IGBMC - Institut de Génétique et de Biologie Moléculaire et Cellulaire
14 Inserm U964 - CNRS UMR7104 - IGBMC - Centre for Integrative Biology - CBI
15 UNISTRA - Université de Strasbourg
16 CHU Nice - Centre Hospitalier Universitaire de Nice
17 LNFP - Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559
18 CHU Amiens-Picardie
19 ISC-MJ - Institut des sciences cognitives Marc Jeannerod - Centre de neuroscience cognitive - UMR5229
20 CHU Nancy - Centre Hospitalier Universitaire de Nancy
21 UNICOG-U992 - Neuroimagerie cognitive - Psychologie cognitive expérimentale
22 LINC - Laboratoire d'Imagerie et de Neurosciences Cognitives
23 NeuroToul - Centre d’Excellence en Maladies Neurodégénératives

Background and objectives: The impact of subthalamic deep-brain stimulation (STN-DBS) on motor asymmetry and its influence on both motor and non-motor outcomes remain unclear. The present study aims at assessing the role of STN-DBS on motor asymmetry and how its modulation translates into benefits in motor function, activities of daily living (ADLs) and quality of life (QoL). Methods: Postoperative motor asymmetry has been assessed on the multicentric, prospective Predictive Factors and Subthalamic Stimulation in Parkinson's Disease cohort. Asymmetry was evaluated at both baseline (pre-DBS) and 1 year after STN-DBS. A patient was considered asymmetric when the right-to-left MDS-UPDRS part III difference was ≥ 5. In parallel, analyses have been carried out using the absolute right-to-left difference. The proportion of asymmetric patients at baseline was compared to that in the post-surgery evaluation across different medication/stimulation conditions. Results: 537 PD patients have been included. The proportion of asymmetric patients was significantly reduced after both STN-DBS and medication administration (asymmetric patients: 50% in pre-DBS MedOFF, 35% in MedOFF/StimON, 26% in MedON/StimOFF, and 12% in MedON/StimON state). Older patients at surgery and with higher baseline UPDRS II scores were significantly less likely to benefit from STN-DBS at the level of motor asymmetry. No significant correlation between motor asymmetry and ADLs (UPDRS II) or overall QoL (PDQ-39) score was observed. Asymmetric patients had significantly higher mobility, communication, and daily living PDQ-39 sub-scores. Conclusions: Both STN-DBS and levodopa lead to a reduction in motor asymmetry. Motor symmetry is associated with improvements in certain QoL sub-scores.

Mots clés: Deep brain stimulation; Parkinson's disease; Motor symmetry; Quality of life

Domaines: Neurosciences [q-bio.NC]

Raquel Pinheiro Barbosa, Caroline Moreau, Anne Sophie Rolland, Olivier Rascol, Christine Brefel-Courbon, et al.. The impact of subthalamic deep-brain stimulation in restoring motor symmetry in Parkinson's disease patients: a prospective study. Journal of Neurology, 2024, Journal of Neurology, ⟨10.1007/s00415-023-12162-7⟩. ⟨hal-04480277⟩